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High Blood Pressure symptoms
In the UK a patient is usually regarded as having hypertension if they have a systolic blood pressure above 160mmHg or a diastolic blood pressure above 100mmHg, after several measurements over a period of time. Unfortunately a large number of patients with high blood pressure show no outward symptoms and usually feel fine. The initial diagnosis may have been made at a routine health check or when attending for something completely different or even relatively trivial. The patient may be inclined to stop their treatment because of this lack of symptoms or due to side effects from their medication. The risks of not complying with the treatment and the availability of more suitable anti-hypertensives may not been explained fully at the outset. The main complications caused by not complying with treatment are stroke, heart disease, peripheral vascular disease, renal failure and retinopathy.
Over 95 per cent of patients with hypertension have primary (or essential) hypertension, in which there is no immediately obvious underlying cause but probably includes complex genetic and environmental factors. When considering the individual patient, it is vital to take factors, such as smoking, cholesterol and diabetes, into account. Treating blood pressure alone, disregarding other risk factors is relatively ineffective at preventing stroke and myocardial infarction.
In up to 5 per cent of hypertensives the high blood pressure is "secondary" or due to an underlying disease, usually involving the kidneys or endocrine system. Effective treatment of this underlying condition can sometimes abolish the hypertension.
Within an individual patient, blood pressure can vary considerably. For example, it tends to be highest first thing in the morning and lowest at night. It is also higher in cold weather and after consuming caffeine, tobacco or alcohol.
The most accurate device for non-invasive blood pressure measurement is a well cared for mercury manometer; however, mercury is likely to be outlawed in the near future because of concerns about its safety. Aneroid manometers are inaccurate unless regularly calibrated. In the future, it is likely that most blood pressure readings will be made with electronic oscillometric devices. Manufacturers of these types of blood pressure monitors include Omron, Braun, Phillips, Seinex, A&D and Visomat. Care should be taken when choosing a blood pressure monitor that has been carefully validated or certified for clinical use. Decisions concerning the management of hypertension should be based on blood pressure readings taken on several occasions over a period of time. Some patients only exhibit hypertension when their physician is present called "white coat hypertension ". Clinical studies have shown improved detection and treatment of high blood pressure when regular home blood pressure monitoring is conducted in consultation with a GP. Home measurement takes away the effects of the ‘white coat’ problems with readings, supplements the doctor's readings and provides a more accurate complete pressure history.
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