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Understanding Your Blood Pressure And How To Help Control It

What those numbers mean and what you can do about them.

its important to get your blood pressure checked at least every five years because the higher your blood pressure the higher your risk of developing problems with your health’, is the advice of Sue Williams, a practice nurse at a busy Surrey GP surgery. We look at what at blood pressure is, what is ideal, and how you can look after it.

What is blood pressure and how is it measured?

Each beat of your heart pumps blood around your body to deliver oxygen and energy to every cell. As the blood is pumped round, it presses against the sides of our blood vessels. We measure the strength of this as ‘blood pressure.’

Our blood pressure is measured in mmHg (millimetres of mercury) and it’s given as two figures, one over the other:

Systolic – the pressure on the vessels when your heart pumps blood outDiastolic - the pressure on the vessels when your heart takes a rest between beats

So, blood pressure of 120/80 means: a systolic pressure of 120mmHg and a diastolic pressure of 80mmHg.

Is my blood pressure normal?

‘Do you know what your blood pressure is? Make time to get it checked by a healthcare professional,’ says Sue. If you have a blood pressure measurement that’s between 90/60 and 120/80 you’re within the ideal range. Lower than 90/60 and you may have low blood pressure, and if your reading is 140/90 or higher, you may have high blood pressure. Just one high or low measurement doesn’t mean you actually have high or low blood pressure, as pressures can go up and down during the day, or from day to day. Your doctor will take regular readings to see if your pressures stay consistently high or low over time before making a diagnosis.

Diagnosed with high blood pressure (hypertension)?

It’s unlikely you’ll feel any symptoms of having high blood pressure. Untreated hypertension puts strain on your cardiovascular system, increasing your risk of stroke and heart attack, heart disease, vascular dementia, and kidney disease.

Diagnosed with low blood pressure (hypotension)?

This is less common than high blood pressure. Some people naturally have low blood pressure with no ill effects. It may be caused by certain medications, being dehydrated or heart failure. If your blood pressure is lower than your normal, your GP will be able to advise.

ways to keep high blood pressure under control

Maintain a healthy weight: when you’re overweight, your heart must work harder to pump blood around your body. This can raise blood pressure. Even the loss of a few pounds in weight will have a positive effect on your blood pressure. The NHS has a 12-week diet and exercise plan to help you kick start weight loss. ‘Clinical studies show that eating a diet that is high in fruits, vegetables, low fat dairy, whole grain, fish and poultry can really make a difference’ advises Sue.

Exercise: An active lifestyle keeps your cardiovascular system in good condition and helps maintain a healthy weight, both of which help lower blood pressure. The NHS recommends we do 2.5 hours of moderate aerobic activity such as cycling, brisk walking or swimming each week; this can be broken up into 5 sessions of 30 minutes per week. And exercise needn’t cost a fortune.

Eat healthily and hide the salt pot: 5-a-day is the key here: limit your fat intake and fill up on plenty of fruit and vegetables (bananas, dried fruit, melons, baked potatoes, avocados and squashes are particularly good), and fibre-rich foods such as wholegrain versions of bread, rice and pasta.

Salt can raise blood pressure, so aim to eat no more than 6g of salt each day. Sue says, ‘It’s good to get into the habit of not adding salt to your cooking or to your food at mealtimes’.

alcohol consumption: When you drink more than the recommended weekly amount of alcohol, you risk raising your blood pressure over time. Alcohol can also make you gain weight, another risk factor for hypertension, so it makes sense to cut down if you drink more than 14 units a week.

Keep control of caffeine: More than four cups of coffee daily may increase your blood pressure, so keep your intake of caffeinated drinks to a sensible level as part of a balanced diet, and make sure you stay hydrated with water and other non-caffeinated drinks. Cutting down on caffeine may also help you to…

Get a decent night’s sleep: Research has shown that sleep deprivation can, over time, increase your risk of high blood pressure. For the sake of your cardiovascular and general health, it pays to get at least six hours sleep a night. Check out these tips to help you get some decent shut-eye.

Don’t smoke: Smoking and high blood pressure both narrow your arteries. If you have

hypertension and smoke, your arteries will narrow far more quickly and increase your risk of heart and lung diseases. Get support to stop smoking.

Sue concludes: ‘We must all take responsibility for our own health and wellbeing and making a few lifestyle changes as discussed above can help significantly in the long-term control of our blood pressure and overall health. If you are struggling with this and need more help and support, then contact your GP or local health centre for help and guidance’.

Adult Improving Access to Psychological Therapies programme

The Improving Access to Psychological Therapies (IAPT) programme began in 2008 and has transformed treatment of adult anxiety disorders and depression in England. Over 900,000 people now access IAPT services each year, and the Five Year Forward View for Mental Health committed to expanding services further, alongside improving quality.

IAPT services provide evidence based treatments for people with anxiety and depression (implementing NICE guidelines). Details of local IAPT services are available on the NHS website.

IAPT services are characterized by three things:

  1. Evidenced based psychological therapies: with the therapy delivered by fully trained and accredited practitioners, matched to the mental health problem and its intensity and duration designed to optimize outcomes. From April 2018 all clinical commissioning groups are required to offer IAPT services integrated with physical healthcare pathways. The IAPT Pathway for People with Long-term Physical Health Conditions and Medically Unexplained Symptoms guidance is intended to help with implementation and sets out the ideal pathway for IAPT services.

  2. Routine outcome monitoring: so that the person having therapy and the clinician offering it have up-to-date information on an individual’s progress. This supports the development of a positive and shared approach to the goals of therapy and as this data is anonymized and published this promotes transparency in service performance encouraging improvement.

  3. Regular and outcomes focused supervision so practitioners are supported to continuously improve and deliver high quality care.

The priorities for service development are:

  • Expanding services so that at least 1.5m adults access care each year by 2020/21. This means that IAPT services nationally will move from seeing around 15% of all people with anxiety and depression each year to 25%, and all areas will have more IAPT services.

  • Focusing on people with long term conditions. Two thirds of people with a common mental health problem also have a long term physical health problem, greatly increasing the cost of their care by an average of 45% more than those without a mental health problem. By integrating IAPT services with physical health services the NHS can provide better support to this group of people and achieve better outcomes.

  • Supporting people to find or stay in work. Good work contributes to good mental health, and IAPT services can better contribute to improved employment outcomes.

  • Improving quality and people’s experience of services. Improving the numbers of people who recover, reducing geographic variation between services, and reducing inequalities in access and outcomes for particular population groups are all important aspects of the development of IAPT services.

Integrated care

Local partnerships to improve health and care

NHS organisations and local councils in England are joining forces to coordinate services around the whole needs of each person. Their aim is that people can live healthier lives and get the care and treatment they need, in the right place, at the right time.

Find out more

Take a look at the Next steps on the NHS Five Year Forward View.

Sign up to the Future Health and Care bulletin, providing the latest news and events on integrating health and care across the country.

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