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What is blood pressure?
 
The heart is a small but very powerful pump that beats steadily throughout your life, circulating five litres (more than 10 pints of blood) around the body every minute. The smaller blood vessels through which the blood passes produce a resistance to blood flow. The pumping of the heart against this resistance creates the blood pressure necessary for the circulation of the blood. This circulation is essential for nutrition of the major organs, such as the heart, kidneys, liver and brain, providing the vital oxygen and nutrients necessary for life. So, everyone needs to have a blood pressure to maintain their circulation!
 
When the heart contracts, the highest pressure it produces is called the systolic pressure; when it relaxes, the lowest pressure is called the diastolic pressure. Both of these pressures are important in determining the risk of heart attack and stroke, so both will be measured by your doctor. A normal blood pressure in a young person might be around 130/80 (often described as 130 over 80) - this is shorthand for a systolic pressure of 130 and a diastolic pressure of 80. We start thinking blood pressure is high when it is above 160/100.
 
Understanding high blood pressure
 
Blood pressure is vital to life whilst high blood pressure can be a threat to it. A permanently raised blood pressure leads to an increased tendency to blood vessel damage, and blood clot formation which may result in heart attack, stroke, or kidney failure. High blood pressure affects one in six of us. High blood pressure tends to run in families. ironically, you may be totally unaware that your blood pressure is high. Apart from rare exeptions, there is no cure for high blood pressure. Treatment lowers blood pressure, but when it is stopped the blood pressure rises again.
 
What causes high blood pressure?
 
In the vast majority of people with high blood pressure there is no single clearcut cause, and the condition is called essential hypertension. Continued research is important in this area. Since the cause is not known, treatment is based on keeping the blood pressure normal. A number of factors combine to raise the blood pressure, of which heredity is most important - high blood pressure tends to run in families. Contrary to popular myth, high blood pressure is not a disease of the nervous/ highly-strung, or caused by a stressful lifestyle. If your blood pressure is high your doctor may arrange several measurements as the stress of seeing a doctor may initially cause blood pressure to rise! In a very few people there is a specific cause for high blood pressure, and removal of the cause can produce a 'cure'. Your doctor will know when to look out for indications of these rare conditions.
 
Treatment
 
There are now lots of effective treatments for high blood pressure, and one drug or a combination of drugs, can usually be found that will suit you without causing side effects. Treatment lowers blood pressure, but when it is stopped the blood pressure usually rises again as there is no cure for high blood pressure - apart from rare exceptions.
 
How can I help myself?
  
" If you smoke - stop! Smoking doubles your risk of heart disease and trebles your chance of dying before reaching retirement.
" Aim to keep your alcohol intake down to 3, and preferably, 2 units per day (a unit is equivalent to a half-pint of beer, a glass of wine, or a single measure of spirit). A small amount of alcohol is probably fine for your health, and may even be beneficial, but larger amounts can increase the blood pressure and may damage the liver.
" Avoid being overweight. This can increase the blood pressure, and is bad for your joints, your breathing, and maybe even for your appearance! It may also help to avoid foods containing saturated fats, such as dairy products (butter, cheese and full-fat milk) and red meats. Also avoid fried foods and eggs, All of these may increase the blood cholesterol.
" Try to take regular exercise, because it reduces the blood pressure and helps to keep weight down. Exercise does not have to be excessive and should be built up slowly. Walking, swimming, cycling and jogging are all appropriate forms of excercise. If you are in doubt, discuss this with your doctor first.
" Avoid adding salt to food at the table. Some people are very sensitive to the effects of salt, and for them it can be particulary helpful.

What is cholesterol and where does it come from?

Cholesterol is a type of fat. It is essential for the normal functioning of our bodies.
However, if the level is too high there is an increased risk of arteries becoming blocked
(cardiovascular disease). This can cause angina and heart attacks or blockage to the arteries
causing pain in the legs when walking. Some of the cholesterol in the body comes from the
diet but much of it is made ourselves in the liver. The main sources of cholesterol in the diet
are animal fats such as butter, cream and fatty meat. Cholesterol from the liver or the diet is then transported through the blood to other parts of thebody that need it.
 
What should the cholesterol level be?
There is no easy answer to this question. On average in the western population the
cholesterol level is too high. Many people would quote a "desirable" cholesterol as being
less than 5.2 mmol/L. Below this level there is certainly no need to try to lower the cholesterol further. People should simply try to follow a healthy lifestyle with a sensible diet
and some exercise. Above this level it is important to consider overall risk in deciding
whether a particular cholesterol level is too high for a particular person.
A high cholesterol is only one of a number of risk factors for cardiovascular disease.
Others include smoking, having high blood pressure, having diabetes and being male.
These risk factors interact so that having two or more of them causes considerably increased risk by comparison with only having one. In individual people it is better to view the overall cardiovascular risk rather than lust the risk due to cholesterol. For example a moderately raised cholesterol in a female non-smoker with a normal blood pressure may be of little importance. However, in a male smoker that same moderately raised cholesterol may contribute substantially to the overall risk.
 
What can be done to lower cholesterol?
Things that people can do themselves include following a sensible diet and taking some
I exercise. Dietary advice in general would be to base meals around potatoes, bread,
pasta, rice and cereals (preferably wholewheat varieties, increase the fruit and vegetable
content of the diet; use more lean meat and fish; use semi-skimmed or skimmed milh; and
reduce the content of fatty meats and meat products such as sausages and pies. If you are
overweight, there should also be an overall reduction in the amount of food in an attempt to
bring weight down to a more satisfactory level.
Exercise can have a beneficial effect on cholesterol levels and blood pressure and can
I contribute to people's overall sense of well being. The goal is for about 20 minutes of
exercise 3 times per week and should be enough to make you slightly out of breath, but not
so strenuous that you are unable to talk. It is also possible to incorporate more exercise into
your lifestyle by walking or cycling instead of taking the car or bus, by using the stairs instead of the lift and so on.
Finally, if cholesterol remains unacceptably high there are a number of effective and safe
drug treatments that have now been proved to lower cholesterol and reduce people's risk
of having heart attacks.
 
Summary
 
" Most people with high blood pressure feel perfectly well - the only way to find out if you have high blood pressure is to have it checked.
" High blood pressure cannot usually be cured - but it can be treated successfully.
" Lifestyle modifications, such as reducing weight and alcohol intake are helpful - and can sometimes reduce the need for tablets.
" Treatment can usually be found to keep your blood pressure within normal limits - but not cause side effects. You should continue to lead a normal active life.
" With treatment - which is usually necessry for the rest of your life - the risk of a heart attack or stroke is dramatically reduced.