High Blood Pressure (Hypertension): Symptoms, Causes and Treatment

High blood pressure is often called the silent killer, and in Pakistan roughly one in three adults over 18 is thought to have it. Most do not feel a thing. They find out at a pharmacy check, during a visit for something else, or, sadly, after a stroke or heart attack. Because it rarely gives warning signs, knowing your numbers is the single most useful thing you can do.

What is high blood pressure?

Blood pressure is the force of blood pushing against the walls of your arteries. It is written as two numbers, such as 120/80. The top number is the pressure when the heart beats and the bottom is the pressure between beats.

One high reading does not mean you have hypertension. Doctors look at several readings on different days. Our guide on checking your blood pressure at home explains how to measure it properly.

High blood pressure symptoms

Most people have no symptoms. When pressure is very high, some people notice:

• A pounding headache, often at the back of the head
• Dizziness or blurred vision
• Nosebleeds
• Chest pain or shortness of breath
• Palpitations

These symptoms are not reliable, so do not wait for them. Go to the emergency room if you have a very high reading with chest pain, severe headache, weakness on one side, trouble speaking or confusion.

What causes high blood pressure?

• Too much salt in food: achaar, chutney, papad, namkeen, chips, instant noodles, salted nuts and extra salt at the table
• Being overweight and not getting enough physical activity
• Smoking, including shisha, and alcohol
• Long-term stress and poor sleep, including sleep apnoea
• Kidney disease, an underactive or overactive thyroid, and diabetes
• Some medicines, such as painkillers like ibuprofen, decongestants and steroids
• Large amounts of liquorice (mulethi)
• Family history and increasing age

Why it matters

Over the years, high pressure damages blood vessels. It raises the risk of heart attack and stroke, heart failure, kidney disease, eye damage and memory problems. The reassuring part is that bringing the pressure down reduces these risks substantially.

Lifestyle changes that lower blood pressure

• Keep salt below about one teaspoon (5 grams) a day, counting what is already in bread, pickles and packaged food.
• Cook with less salt and add flavour with lemon, garlic, ginger, cumin, coriander and mint.
• Eat more fruit, vegetables, daal and low-fat dairy. Foods rich in potassium, such as bananas, spinach and coconut water, help balance salt.
• Walk briskly for 30 minutes on most days.
• Lose extra weight. Each kilogram lost can lower pressure a little.
• Stop smoking and limit sweet, strong chai if it makes you jittery.
• Manage stress with prayer, walks, hobbies, family time and enough sleep.

Blood pressure medicines

If lifestyle changes are not enough, or your risk is high, your doctor will prescribe tablets. There are several families, and many people need a combination:

• ARBs such as losartan, telmisartan and olmesartan, which relax blood vessels
• ACE inhibitors such as enalapril and ramipril
• Calcium channel blockers such as amlodipine, which can cause ankle swelling in some people
• Diuretics such as hydrochlorothiazide, which help the body remove salt and water
• Beta-blockers such as bisoprolol, used particularly when there is heart disease

A few points matter. Take your tablet every day even when your readings are normal, because they are normal because of the medicine. Do not stop suddenly. ARBs and ACE inhibitors must not be used in pregnancy. Mention all your other medicines, especially painkillers, to your doctor.

Key takeaways

• High blood pressure usually has no symptoms, so measure it regularly after the age of 30.
• Salt reduction, exercise and weight control are powerful and should accompany any medicine.
• Take blood pressure tablets regularly and do not stop on your own.
• Very high readings with chest pain, weakness or confusion are an emergency.

Related medicines on Medimart

These are commonly prescribed for high blood pressure:

• Amlodipine: a calcium channel blocker
• Losartan: an ARB that relaxes blood vessels
• Telmisartan: an ARB taken once daily
• Olmesartan: another ARB
• Bisoprolol: a beta-blocker
• Hydrochlorothiazide: a water tablet, often combined with others

Prescription medicines are supplied only against a valid prescription. Please take them only as advised by your doctor.

Browse blood pressure medicines on Medimart with delivery across Pakistan. Prescription medicines are supplied only against a valid prescription.

This guide is for general information and does not replace advice from a doctor. Please have your blood pressure checked and discuss it with your doctor.