g387 hm bloodpressure english(1)

7/29/2019 G387 HM Bloodpressure English(1)

1/32

Beating Heart Disease Together

Information for South Asians

Blood pressure

and how to control it


2/32

About this booklet People who have high blood pressure have a greater risk o developingcoronary heart disease, or having a heart attack, stroke, heart ailure andother health problems.

South Asians living in the UK are at greater risk o developing coronary heartdisease than the rest o the UK population because they are more likely todevelop high blood pressure or diabetes both o which are risk actors orcoronary heart disease. (A risk actor is something that increases your chanceo developing a disease.) It is important to control your blood pressure inorder to reduce that risk.

This booklet explains:

what high blood pressure is what low blood pressure is how your blood pressure is measured why high blood pressure is harm ul how medicines can help, and what you can do to help control your blood pressure.

The in ormation in this booklet is not a substitute or the advice your doctormay give you based on his or her knowledge o your condition.

This booklet is available inBengali , Gujarati , Hindi , Punjabi and Urdu . This English version has been produced to help relatives, carers and healthpro essionals who do not read these languages.


3/32

But I dont eel ill! 4

Why is high blood pressure harm ul? 4What is high blood pressure? 5

What causes high blood pressure? 6

What about low blood pressure? 7

How can my doctor tell i I have high blood pressure? 9

What can I do to help control my blood pressure? 15

Medicines or blood pressure 23

Everyday activities 27

For more in ormation 28

Technical terms 30

Index 31

Contents


4/32

High blood pressure also known as hypertension rarelymakes people eel ill. For most people, the only way o knowing i you have high blood pressure is to have yourblood pressure measured.

High blood pressure can cause headaches in a very small numbero people, but only i their blood pressure is very high. Problems withsight, breathlessness and nose bleeds can sometimes be a sign o

high blood pressure.

About one in every our South Asian adults in England has high bloodpressure. It is more common in older people than in younger people.

But I dont feel ill!

To put it very plainly, the higher your blood pressure,the shorter your li e expectancy. People with high bloodpressure run a higher risk o having a heart attack or a stroke(which damages the brain).

I le t untreated or a long time, high blood pressure can lead to kidneyailure and even damage your sight. It can also lead to heart ailure,which is when the pumping action o the heart becomes less efective.Heart ailure may happen in people whose heart has become enlargedbecause o uncontrolled high blood pressure.

I you have high blood pressure, reducing your blood pressure can loweryour risk o having all o these problems. In this booklet we givein ormation on the diferent ways o lowering blood pressure.

Why is high blood pressure harmful?

4 | Blood pressure and how to control it


5/32

Blood pressure is the pressure o the blood in your arteries the blood vessels that carry the blood rom your heart to therest o your body.

You need a certain amount o pressure to keep the blood owing.High blood pressure develops i the walls o the larger arteries losetheir natural elasticity and become rigid, and the smaller blood vesselsbecome narrower.

Your heart is a pump that beats by contracting and then relaxing. The pressure o blood owing through the arteries varies at diferenttimes in the heartbeat cycle.

Blood pressure is measured in millimetres o mercury or mmHgor short. A blood-pressure reading gives two numbers or example,130/80mmHg. The rst number is the systolic pressure and the second

is the diastolic pressure.

Your target blood pressureYour target is to have a blood pressure below 140/85mmHg (140 systolicand 85 diastolic). Or, i you have diabetes, kidney disease, or disease o the heart and circulation, your target is below 130/80mmHg.

Blood pressure and how to control it| 5

What is high blood pressure?

The highest pressure, known assystolic pressure ,is the pressure when the beat or contraction o yourheart orces blood round your body.

The lowest pressure,diastolic pressure , is thepressure between heartbeats when the heart is resting.


6/32


What causes high blood pressure?

There is no single defnite cause o high blood pressure.The ollowing can all play a part:

Genes are another actor. So, i one or both o your parents have (or had)high blood pressure, you have a greater chance o developing it too.

In a very small number o people, a single cause is ound, such asnarrowing o an artery to a kidney, or abnormal production o hormonesrom the adrenal glands. Occasionally, some medicines used to treatulcers, arthritis or depression may cause a rise in blood pressure.

not doing enough physical activity

being overweight

having too much salt

drinking too much alcohol, and

not eating enough ruit and vegetables.


7/32


People with low blood pressure tend to live longer than people with high oreven normal blood pressure. Low blood pressure is sometimes discoveredduring a routine examination. Most people with low blood pressure donthave any noticeable symptoms.

In some people who have blood pressure below 90/60mmHg, this cancause dizziness or even ainting when they get up a ter bending over orlying down, especially in older people. I you are having symptoms o

dizziness, it is important that you see your doctor. I your blood-pressurereading is unusually low, your doctor should check to make sure there isnot a medical cause.

There is usually no need to treat low blood pressure. Only a very smallnumber o people need to take medication or it.

What about low blood pressure?


8/32


9/32


Your doctor or nurse will probably measure your bloodpressure using a digital blood-pressure monitor like the onein the photo opposite. And you may need to have some othersimple tests too.

We describe all this in more detail below.

How is blood pressure measured?A digital blood-pressure monitor is made up o a box with a tube leadingto a cuf. The cuf is wrapped round your upper arm. At the press o abutton, the cuf in ates to a certain level and then automatically de ates.While it is in ated, the cuf will eel slightly uncom ortable as no blood canget through to your lower arm. In the cuf there is a sensor which detectsyour pulse and changes the in ormation into blood-pressure readingswhich appear on a display screen.

Be ore you have your blood pressure taken, you should have rested orat least ve minutes. You should be sitting down when you have themeasurement taken.

Some doctors or nurses may use a diferent type o machine called amercury sphygmomanometer (pronounced svig-mo-man-ometer) tomeasure your blood pressure. The doctor or nurse wraps the cuf round

your arm, pumps up the cuf, and then uses a stethoscope to listen to theblood owing through the artery at the bend o your arm. He or she willthen gradually release the pressure in the cuf.

Your doctor or nurse will probably check your blood pressure severaltimes be ore con rming a diagnosis o high blood pressure. Once yourblood pressure is well controlled, they will usually measure it every threeto six months.

HOW CAN MY DOCTOR TELL IF I HAVE HIGHBLOOD PRESSURE?


10/32


11/32


24-hour monitoringSome doctors use 24-hour monitoring to measure your blood pressure. This involves strapping a small recording device round your waist, orcarrying it in a pouch as in the photo opposite. The monitor is connected

by a narrow tube to a cuf which is wrapped round your upper arm. The cuf in ates and de ates regularly throughout the day and nightto record your blood pressure.

Once the monitor has been attached, you will be allowed to go home andcarry on as normal. You will need to return the ollowing day to have themonitor removed. You should not take it of during the 24-hour period.

Home blood-pressure monitorsSome people have their blood pressure assessed by using a bloodpressure monitor at home. Many GP surgeries now loan out monitors, likethe one below, or a week or two or people to use at home. This providesa number o blood-pressure readings which the doctor will assess, inmuch the same way as 24-hour monitoring. To get the best rom yourhome monitor, ask your doctor or practice nurse to show you how to useit, and how to read and record the results.


12/32


Wrist monitorsSome people buy their own wrist monitor, like the one above, so that theycan measure their blood pressure at home. I you are using a wristmonitor, make sure that your wrist is level with your heart when taking thereading. Wrist monitors may not give as accurate a reading as other typeso blood-pressure monitors.

Changes in blood pressureEveryones blood pressure varies during the day. It tends to be highest inthe morning and lowest at night. Your blood pressure may also becomehigh i you are anxious or under stress. Some people get worried aboutseeing their doctor, and having their blood pressure taken can make itgo up. That is why your doctor will probably want to take two or threeseparate measurements be ore deciding whether you really do haveconsistently high blood pressure.


13/32


What other tests will I have?I your doctor thinks you have high blood pressure, he or she willprobably examine your chest and may look at your eyes with anophthalmoscope to see whether high blood pressure has afected

the blood vessels at the back o your eye.Your doctor may also do some tests to nd out more about thehealth o your heart and circulation. The main tests are:

Will I have to start taking medicinesstraight away?Your doctor or practice nurse will probably monitor your bloodpressure or a ew weeks or months be ore deciding whether to treatit with medicines. In the meantime you can do a lot to help your ownhealth by looking at your li estyle and making changes wherenecessary. (See page 15.)

an electrocardiogram (ECG) a test to record therhythm and electrical activity o your heart

a urine test to look or signs o blood, sugar or proteinin the urine.

blood tests to nd out your cholesterol levels andblood sugar levels, and whether your high bloodpressure has caused any damage to your kidneys, and


14/32


15/32


What can I do to help control my blood pressure?

This is what you can do to help control your blood pressure:

We explain all these things in more detail on the ollowing pages.

Its also important to look at the other areas o your li estyle that cause

extra risk to your heart, such as smoking or having a diet that is high in at.For more on this, see our booklet Looking after your heart (see page 28).

Be more physically active The type o activity recommended or the heart is moderate, rhythmic(aerobic) activity such as brisk walking, cycling or dancing. Walking andcycling are particularly good as you can o ten build them into yourdaily routine.

Be more physically active.

I youre overweight, lose some weight.

Cut down on salt.

Eat more ruit and vegetables. I you drink alcohol, drink within sensible limits.


16/32


I you have high blood pressure but do not have heartdisease or angina

I you have high blood pressure that is well controlled, and you donthave heart disease or angina, your target is to build up to 30 minuteso moderate activity a day on at least ve days o the week. Moderateactivity means any activity that makes you eel warm and slightly out o breath or example, brisk walking. You can split the 30 minutes a dayinto two sessions o 15 minutes, or three sessions o 10 minutes.

Start of slowly and build up your exercise time and intensity gradually.I you are starting a new activity, it is important to ask your GP i you aret enough, and whether the activity is suitable or you. I you have high

blood pressure, it is best to avoid exercises such as weightli ting orweight training.

I you have angina as well as high blood pressure

I you have angina, you need to nd out what you can easily managewithout getting chest pain, and then gradually increase the amount o activity you do. You should discuss your exercise plans with your doctor.

You could plan a weekly exercise programme based on walking. Choosea walking distance and speed that you know you can cover easily withoutgetting angina. Make this your target. Do this much twice a day or twodays. Each time, assess whether the activity was easy or di cult. I it wasairly easy or easy, very gradually increase the distance each day or thenext two days. I the activity was di cult, limit yoursel to a slower speedor shorter distance until you nd it easy. Make sure that you can easily dothe activity be ore increasing your target. And keep your activity regularand requent and within, rather than beyond, your limits.


17/32


I youre overweight, lose some weightI you areoverweight , losing weight will help control your bloodpressure. For some people, losing weight is all they need to do to gettheir blood pressure down.

Your body shape is important too. People rom South Asia tend tobe apple-shaped (where much o the body at is around the waist),rather than pear-shaped (where the body at is ound around the hips)like many Europeans. People who have too much at around their waisthave a much greater risk o developing diabetes, which is a risk actoror coronary heart disease.

Waist measurements

To nd out how the body at around your waist increases the risk toyour health, you need to measure your waist.

How to measure your waist:

Your risk o developing diabetes, high blood pressure and coronaryheart disease is greater i you are a South Asian woman with a waistmeasurement o 80 centimetres (32 inches) or more, or i you are aSouth Asian man and your waist is 90 centimetres (36 inches) or more.

4. Make a note o this measurement.

This is your waist measurement.

1. Find the top o your hip bone

and the bottom o your ribs.2. Breathe out naturally.

3. Place the tape measure mid-waybetween these points and wrapit around your body.


18/32


Losing weightI you need to lose weight, dont try to lose the extra weight too quickly.Losing weight slowly and steadily (about a pound a week) is more healthy,and youre more likely to keep the weight of or good. Being physically

active plays an important part in losing weight. For more in ormation onlosing weight and how to do more physical activity, see our bookletLooking after your heart . (See page 28.).

Cut down on salt There is a link between having too much salt in your diet and having highblood pressure. It is the sodium in the salt that contributes to high bloodpressure. The body needs very small amounts to unction properly. In the

UK we eat much more than twice what we need. The target should be tohave less than 6g o salt a day, although we dont even need as muchas this.

Try cooking without adding any salt, and not adding salt to your ood atthe table. Use spices to avour your ood instead. In act, many spicesalready contain some salt.

Most o the salt we eat is hidden in processed oods and bread. Check theingredients labels on oods to nd out which have the least salt. Avoidoods that contain a lot o salt such as sauces, canned soups, processedmeats, dried sh, ried or roasted peanuts, cashew nuts, and snacks suchas Bombay mix, crisps and biscuits. You will nd that within a month yourtaste will have adjusted and you wont need so much salt to enjoy theavour o your ood.

Eat more ruit and vegetablesFruit and vegetables contain potassium, which can help keep bloodpressure down. Theyre also low in salt.

Aim to eat at least 5 portions o a variety o ruit and vegetableseach day, but pre erably have 7 to 9 portions a day to help loweryour blood pressure.


19/32


20/32


I you drink alcohol, drink within sensible limitsDrinking too much alcohol can contribute to disorders o the heartand circulation, including high blood pressure and stroke.

I you're a man , drink no more than 3 to 4 units o alcohol a day.

I you're a woman , drink no more than 2 to 3 units o alcohol a day.

I you do drink alcohol, spread your drinking over the whole week ratherthan drinking large amounts in any one day.

WomenNo more than 2 to 3

units o alcohol a day

1 unit o alcohol =

a small glass (100ml) o wine(10% ABV [alcohol by volume])

or

hal a pint (300ml) o normalstrength lager, cider or beer

(3% to 5% ABV)or

a pub measure (25ml)o spirits

MenNo more than 3 to 4units o alcohol a day


21/32


What about stress?Stress ul situations can cause your blood pressure to rise, but the bloodpressure usually returns to normal once the stress has gone away.Relaxation or meditation may help you to avoid those short-term rises in

blood pressure. Also, things that cause long-term stress such as nancialworries, or strain at work may contribute to high blood pressure, butmore research is needed.

SmokingSmoking is a major risk actor or coronary heart disease. Your bloodpressure rises during the time you actually smoke a cigarette. I yousmoke and you also have high blood pressure, your arteries will become

narrowed much more quickly. Stopping smoking is a great li estylechange. I you stop smoking, your risk o having a heart attack or strokealls to about hal that o a smoker within one year.

I you dont smoke but live with someone who does smoke, breathingin their smoke could be harm ul to you. It can increase your risk o developing coronary heart disease, as well as theirs.


22/32


23/32


There are many drugs available or reducing high bloodpressure. The aim is to lower blood pressure gradually overseveral weeks or months.

Most people need at least two types o medicine to lower their bloodpressure enough. Dont be worried i your doctor changes yourmedicines several times in order to try to get your blood pressure tothe recommended level. Your doctor may also change your medicinesi they give you side efects.

Side efectsMost people taking medicines or high blood pressure eel per ectly welland have no side efects rom the medicines. I you do seem to have anyside efects, tell your doctor about them, but dont stop taking yourmedicines without his or her advice.

I a rash develops soon a ter you start a new treatment

Report this to your doctor immediately. You may have an allergyto the medicines.

I you eel light-headed or dizzy, or i you aint

These efects may be particularly noticeable when you get up rombending or lying down, or i you are older. I these side efects are severe,it may be that your tablets have reduced your blood pressure too much. Tell your doctor. He or she might reduce the dose o the drug, or give youdiferent medicine.

I you orget to take your medicineI you orget to take your medicine, theres no need to take an extra one.Just take your normal dose next time.

Medicines for blood pressure


24/32


Other medicinesMedicines or high blood pressure can react with other medicines,including some that are available without a prescription. So always check with your doctor or pharmacist be ore you take them. Tell your doctor i you are taking any herbal remedies too.

Types o medicines to treat high blood pressure There are several groups o medicines that are given to treat highblood pressure, including ACE inhibitors, angiotensin II antagonists,beta-blockers, calcium channel blockers (calcium antagonists), diuretics,alpha-blockers and centrally-acting drugs. People with high bloodpressure are not all given the same medicines to control their blood

pressure, as diferent medicines suit diferent people.Getting the right combination o medicines to control your blood pressuremay take some time. It is important that you do not stop taking yourmedicines without speaking to your doctor. I you get side efects, discussthese with your doctor who will know whether the dose can be adjustedor i your medication needs to be changed.

For more in ormation on the types o medicines that you might need,see our booklet Taking medicines for your heart . (See page 28.)


25/32


26/32


27/32


Can I still drive?High blood pressure has ew symptoms, so it should not afect your abilityto drive. However, you should not drive i your medicines cause symptomswhich afect your driving ability. This includes visual disturbances orainting episodes. I this happens, ask your doctor i he or she can changeyour medicines to prevent the symptoms.

I you have a licence to drive a large goods vehicle (LGV) or passenger-

carrying vehicle (PCV), you will need to tell the Driver and VehicleLicensing Agency (DVLA, Swansea SA99 1TU) i you have uncontrolledhigh blood pressure or i your medicines cause symptoms which afectyour driving ability. You may need to stop driving and apply to renewyour licence once your high blood pressure is under control.

What about holidays?Always remember to take enough medicines to last the whole holiday.

Carry some in your hand luggage, and keep a note o their names andstrength separately, in case your baggage goes missing.

Air travel does not afect blood pressure, but rushing and carrying heavycases might. So leave plenty o time or your journey, and make sure thatyou dont have to carry your cases too ar.

Be ore you travel, you should always check with your airline what

medicines they will allow you to take on board the plane. This isparticularly important i you need injections or diabetes.

Everyday activities


28/32


For more information

British Heart Foundation website bh .org.uk For up-to-date in ormation on coronary heart disease,the British Heart Foundation (BHF) and its services.

Heart HeLPLine 0300 330 3311

For in ormation and support on anything relating to heart health. This service is available in English only.

Booklets The ollowing booklets are available in Bengali, Gujarati, Hindi,Punjabi and Urdu:

Blood pressure and how to control it

Cholesterol and what you can do about it Diabetes and how it a ects your heart Heart ailure Living with angina and heart disease Looking a ter your heart Taking medicines or your heart

The ollowing booklets are available in English only:

Eating or your heart Healthy meals, healthy heart Physical activity and your heart Smoking and your heart So you want to lose weight or good


29/32


DVDS The ollowing DVDs are available in Urdu, Hindi, Gujarati, Punjabi andBengali. They are ree, but a donation o 5 per DVD would be welcome.

Living to prevent heart disease Get ft, keep ft prevent heart disease Cardiac surgery Cardiac rehabilitation A airs o the heart

MagazinesHeart & soul is a glossy li estyle magazine aimed at the South Asiancommunity. This ree magazine is packed ull o in ormation on leadinga healthy li estyle and eatures celebrities talking about their ownhealth, delicious recipes and real-li e stories. To receive your ree copycall0870 600 6566 .

Heart health is a ree magazine , produced by the BHF especially orpeople with heart conditions. The magazine, which comes out six timesa year, includes updates on treatment, medicines and research and looksat issues related to living with heart conditions, like healthy eating andphysical activity. It also eatures articles on topics such as travel, insuranceand bene ts. To subscribe to this ree magazine, call 0300 330 3300or go to bh .org.uk/hearthealthmag

How to Order The British Heart Foundation also produces other educationalmaterials that may be o interest. To nd out about these, to ordera Heart health catalogue , or to order publications, please call the BHFOrderline on 0870 600 6566 , go to bh .org.uk/publications oremail orderline@bh .org.uk . You can download many o ourpublications rom bh .org.uk/publications

Our publications are ree o charge, but we would welcome a donation.


30/32


Technical terms

arteries The tubes that take the blood away rom the heart to the resto the body.

blood pressure The pressure o blood in the arteries.

cholesterol A atty substance mainly made in the body by the liver.Cholesterol plays a vital role in how every cell in the body works, but toomuch cholesterol in the blood can increase the risk o getting coronaryheart disease.

coronary heart disease When the walls o the arteries becomenarrowed by a gradual build-up o atty material called atheroma.

diastolic blood pressure The lowest pressure, which occurs betweenheartbeats, when the heart is resting.

digital electronic monitor An instrument to measure blood pressure.

ECG See electrocardiogram.

electrocardiogram A test to record the rhythm and electrical activity o the heart. Also called ECG.

heart ailure When the pumping action o the heart is poor.

hypertension High blood pressure.

monitor See digital electronic monitor.

sphygmomanometer An instrument used to measure blood pressure.

systolic blood pressure The highest pressure, which occurs when thebeat or contraction o the heart orces the blood round the body.


31/32


activity 15alcohol 20

blood-pressure monitors 9

body shape 17

causes o high blood pressure 6

driving 27

drugs 23exercise 15

healthy eating 18

holidays 27

low blood pressure 7

measurement o blood pressure 9

medicines 13, 23

missed medicines 23

monitors 9

salt 18

side efects o medicines 23smoking 21

stress 21

symptoms 4

target blood pressure 5

tests 13

waist measurement 17weight 17

wrist monitor 12

INDEX

Have your sayWe would welcome your comments to help us produce the bestin ormation or you. Why not let us know what you think? Contactus through our website at bh .org.uk/contact . Or, write to us atthe address on the back cover.

Th B i i h H F d i i h i h h i i li h h


32/32

G 3 8 7

0 2 0 9

British Heart FoundationGreater London House180 Hampstead RoadLondon NW1 7AWPhone: 020 7554 0000Fax: 020 7554 0100Website: bh .org.uk

British Heart Foundation 2009, a registered charity in England and Wales (225971) and Scotland (SC039426)

The British Heart Foundation is the nations heart charity, saving lives throughpioneering research, patient care and information. We rely on donations tocontinue our vital work. If you would like to make a donation to the British HeartFoundation, please ring our donation hotline on 0300 330 3322 or contact usthrough our website at bh .org.uk/donate or send it to us at the address below.

This booklet is available in Bengali, Gujarati, Hindi, Punjabi and Urdu . This English version has been produced to help relatives, carers and healthprofessionals who do not read these languages.

To order further copies, please call the BHF Orderline on 0870 600 6566 .

This service is available in English only.

g387 hm bloodpressure english(1)

Documents