ANGINA & HEART ATTACK (MYOCARDIAL INFARCTION)
Dr. Richard Mansfield
BSc (Hons) MB ChB MD FRCP FESC
CONSULTANT CARDIOLOGIST
Note: I am happy to answer general questions regarding the content of this website, but I cannot give clinical advice. Such requests will not be answered.
There are two separate measurements recorded with a blood pressure machine. The top figure and larger of the two is the systolic blood pressure and the bottom figure and smaller of the two is the diastolic blood pressure. Both of these are important. A normal blood pressure would be 120/80.
We all need some blood pressure to make us feel well and for our bodies to function normally but high blood pressure is dangerous. It can lead to heart attack, heart failure, stroke and kidney damage. The problem with high blood pressure is that it often goes unnoticed, as it generally does not cause symptoms. Often it is picked up incidentally when attending a GP surgery or clinic appointment.
The vast majority of people with high blood pressure have what is called essential hypertension for which there is no obvious underlying cause. Some patients do have a cause for their increase in blood pressure, however, and if the blood pressure does not respond quickly to medication a number of investigations may be recommended to look into this.
Identification of high blood pressure and its treatment is important, as it is an independent risk factor for the development of coronary artery disease along with high cholesterol, diabetes, cigarette smoking and a family history of angina or heart attacks.
In some patients the blood pressure is only elevated when they attend their surgery or see a doctor and this is the so-called "white coat" effect. Home monitoring of blood pressure may show that ordinarily it is well within the normal range.
It is usual to have some blood tests as well as an ECG and an echocardiogram.
If blood pressure is shown to be high on a number of occasions then it is very likely that your doctor will recommend some treatment. Simple measures include increasing exercise, reducing the salt in your diet, avoiding excess of alcohol, increasing intake of fruit and vegetables and losing weight. Beetroot juice has been shown to lower blood pressure (https://www.bhf.org.uk/news-from-the-bhf/news-archive/2015/january/beetroot-and-blood-pressure). A variety of tablets are available to try and help with blood pressure and it may be necessary to combine a number of different medications to achieve the desired effect.
The target blood pressure for many patients is equal to or less than 140/85 mmHg. In the setting of diabetes or other conditions a target of 130/80 may be set.
Automatic Blood Pressure Monitor - Blood pressure can be recorded using an automatic digital device like the one seen here.
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