My blood pressure worries me, can you help? DR MARTIN SCURR answers your health ...

Q: My blood pressure worries me. The top number is very high, between 138 and 216, while the bottom number is in the 70s and 80s. But I have not used salt on my food for 30 years, I do not smoke and rarely drink. I eat lots of fruit and veg and have good cholesterol levels. I can’t work out why I have this problem. Can you suggest a solution?

Karen Buckley, Kettering.

A: I can see why you are puzzled, and there are probably many readers in a similar position. Let me start with a short tutorial on what the blood pressure readings mean.

A reading consists of two figures. The top number is the systolic pressure, the pressure in the arteries when the heart contracts, pushing out blood (about 140ml, a teacupful) with each beat. A normal reading is 120 or lower.

The second figure, the diastolic pressure, is when the heart relaxes between beats — this should be 80 or lower. If the reading is consistently above 140 over 90, this is known as hypertension.

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Treatment for all types of hypertension is essential because it can lead to heart disease, heart attacks, stroke, kidney dysfunction, and left ventricular hypertrophy (file photo)

Treatment for all types of hypertension is essential because it can lead to heart disease, heart attacks, stroke, kidney dysfunction, and left ventricular hypertrophy (file photo)

What you describe is a subtype called isolated systolic hypertension (ISH), where the systolic (top) reading is above 140 and the diastolic number is below 90. This condition affects older patients; studies have shown that systolic pressure rises and diastolic pressure falls after the age of 60. The elevated pressure is due to a reduction in the stretchiness or elasticity of the artery walls — part of the ageing process.

ISH accounts for up to 80 per cent of cases of high blood pressure in this age group. Other risk factors include obesity, lack of exercise, genetics (such as hypertension in one or both parents), and a high salt intake.

Treatment for all types of hypertension is essential because it can lead to heart disease, heart attacks, stroke, kidney dysfunction, and left ventricular hypertrophy (an enlargement and thickening of the walls of the heart’s main pumping chamber).

Treatment can involve lifestyle changes, such as salt restriction, exercise and weight loss, and long-term medication.

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Even if you do not add salt to your food, bear in mind that many manufactured foods, such as ready-meals, contain a lot of ‘hidden’ salt. We shouldn’t be consuming more than 6g (around a teaspoon) of salt a day, so always check food labels.

Studies have confirmed the effectiveness of these lifestyle measures in controlling blood pressure. However, if they fail to bring the systolic reading down after some months, drug therapy must be started.

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It is unclear whether you are already under the care of a specialist, but I would suggest you see your GP about starting on medication, as you appear to have ISH despite leading a healthy lifestyle.

This is not the place for me to describe the different classes of drugs available, that is a task for your GP, who has a full understanding of your

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