My name is Brian Williams

My name is Brian Williams.

I'm the professor of medicine
at the University of Leicester

and the University Hospitals
of Leicester NHS Trust.

Under normal circumstances,
a normal blood pressure in an adult

is less than 120/80.

If your blood pressure
is persistently elevated,

and it's the persistent elevation
which is important,

then it can cause damage
to blood vessels,

the kidneys, the heart and the brain.

That's why we're interested in detecting
people with a high blood pressure.

We call the high blood pressure

About 25 per cent or one quarter
of all adults have high blood pressure

that might benefit from treatment.

Once you get to the age of about 60,

then about half of all adults
have high blood pressure,

so it's quite a common problem
that gets more frequent with ageing.

As a doctor I often get asked
by patients what causes it.

Well, in about 90 per cent
or nine out of ten cases,

we can't identify a cause,

it's just that
your blood pressure tracks

at a slightly higher level
than what would be ideal.

In most cases we simply identify it
and treat it.

One of the big problems
about high blood pressure

is that it really doesn't cause
any symptoms at all.

That creates a problem for us
in medicine

because if you don't have symptoms,

the only way we can detect it
is by routine screening.

And that is why having your
blood pressure measured by your doctor

is really part of the routine
examination your doctor will do

when he has the opportunity to see you
perhaps about another illness,

or he may call you in to have a check
periodically for blood pressure.

The other thing I would say is that if
your doctor measures your blood pressure

or you measure it yourself
and it's high,

don't be alarmed by that

because quite often the second time
or third time it's measured

the blood pressure falls
to a normal value.

Quite a lot of us
get a slightly high blood pressure

when we have our blood pressure measured
for the first time.

There are two approaches to treatment.

The first are things
that you can do yourself.

We know that if you have a diet
that is high in salt, for example,

some people
are particularly sensitive to salt

and their blood pressure will rise.

So a diet that has a reduced level of
salt may help lower your blood pressure.

Also because blood pressure
is associated

with increased risk
of cardiovascular disease,

if you have high blood pressure

we would often recommend
a number of lifestyle changes

to try and reduce your blood pressure
and your risk.

Inevitably we would recommend
that you stop smoking if you smoke.

Inevitably we would recommend that
you try and maintain your body weight

as an ideal body weight
by taking some regular exercise.

If you drink alcohol, as many people do,

that's not a problem
if you have high blood pressure,

but if you drink too heavily
it can put your blood pressure up,

particularly binge-drinking, which can
produce a surge in blood pressure.

So we would recommend that you have
a sensible and moderate alcohol intake.

In terms of diet itself,

we would recommend
that you eat the usual vegetables

and try and reduce
the amount of fat in your diet,

all of which will be important

in reducing
your overall cardiovascular risk.

We have a number
of medications available.

Most of them need to be taken
once a day.

Your doctor will select the medication
that is best suited to you

based on your overall profile
and your age, etcetera.

Another question that I often get asked,

particularly with a younger patient
with high blood pressure,

is whether or not it runs in families.

Well, there is no doubt that if
your parents have high blood pressure,

on average
you have a slightly higher risk

of developing high blood pressure.

So if your mother and father
have high blood pressure,

make sure you get
your blood pressure checked.

In many cases it will be normal

but in some cases you may have inherited
some of these unknown factors

that give rise
to an elevation in blood pressure

that appear to be
genetically determined.

So in terms of further advice,

if you've recently had your
blood pressure measured as a one-off

or you've measured it yourself at the
supermarket and found it a bit high,

I would say this.

If it's the first time
it's been measured

it will need to have repeated measures

by your doctor or the nurse
in your doctor's surgery

just to find out where it levels off at

and to see
whether it's persistently high.

If it is persistently high,
as I've discussed,

lifestyle changes can make
a major impact on your blood pressure,

maintaining an ideal body weight,

moderating your alcohol intake

and trying to avoid foods
that contain too much salt in the diet.

If that doesn't work,
and it doesn't for everybody,

then you may need drug treatment,

but I would like to reassure you
that these days

the drugs that we use
are really very well tolerated

and they are incredibly effective
at controlling blood pressure

and, importantly, in reducing the risk

of stroke and heart disease
later in life.