Blood pressure is the force of blood against your artery walls. When it stays too high, it increases the risk of stroke, heart attack, heart failure and kidney disease. Treatment aims to lower that risk over time. You can have high blood pressure and feel well, so symptoms aren't a reliable guide.
Blood pressure normally changes with activity, stress and sleep, so a rise after exercise or a stressful moment doesn't necessarily mean you have hypertension. Your doctor looks at repeated readings to see whether it stays high.
Call triple zero (000) for severe, worsening or persistent chest pain, or chest discomfort with breathlessness, sweating, nausea or pain spreading to your arm, jaw or back.
Do not wait for a routine appointment or drive yourself to hospital.
Systolic pressure, the top number, is the pressure as your heart pumps blood. Diastolic pressure, the bottom number, is the pressure as your heart relaxes between beats. Both are measured in millimetres of mercury, written as mmHg. Either number can be high.
The ranges used to diagnose high blood pressure differ for clinic, home and 24-hour readings. Your doctor looks at the average and how the measurements were taken. A single reading doesn't tell you what your treatment target should be.
A health professional takes these readings. Sitting quietly with a correctly fitted cuff helps give an accurate result. Talking or moving can affect it. Some clinics use an automatic monitor that takes several readings and calculates an average.
Measuring blood pressure over several days shows what happens outside the clinic and can help check whether treatment is working. Use an upper-arm monitor that's been tested for accuracy. Take readings at the times agreed with your doctor and record them with the date and time. Keep the full set, including the higher readings, so the doctor can judge the whole pattern.
A 24-hour blood pressure monitor takes readings automatically during your usual day and while you sleep. You may hear this called ambulatory monitoring. The results show patterns that occasional home readings can miss, including whether your pressure falls during sleep. A diary of activities, sleep and symptoms helps your doctor make sense of the results.
Usually, there's no single known cause. This is called primary hypertension, or essential hypertension. Family history, diet, weight, alcohol and how active you are can all contribute. Secondary hypertension has a specific cause, such as kidney disease, a hormone condition or a medicine. Sleep apnoea, which interrupts breathing during sleep, is also linked to high blood pressure. Your doctor may check for these conditions if blood pressure rises suddenly, starts at a young age or stays high despite several medicines.
White-coat hypertension means your blood pressure is high at the clinic but within the normal range outside it. Masked hypertension is the opposite: clinic readings are within the normal range, but readings elsewhere are high. Measurements at home or over 24 hours can help identify these patterns.
Before changing treatment, your doctor will compare your readings and check how they were taken. They'll also ask about your medicines and health history.
The goal of treatment is to lower the long-term risk of stroke, heart and kidney problems without letting blood pressure fall too low. Your target depends on your readings and health, including any dizziness or falls. Home or 24-hour readings can show whether a change in treatment is working outside the clinic.
Regular activity, less alcohol and less salt can help. Much of the salt in a diet comes from packaged foods, sauces and processed meats, so it's worth comparing the sodium on labels. These changes can work alongside medicine rather than replacing it.
ACE inhibitors and ARBs widen blood vessels, so blood flows with less resistance. Calcium channel blockers also help blood vessels relax. Diuretics lower pressure by helping the body pass excess fluid in urine. A combination can lower pressure more effectively than one medicine alone. The medicines chosen and their doses need to suit your health.
Follow-up readings show whether the combination is enough or is making your pressure too low. Some medicines also need blood tests to check kidney function and mineral levels. If readings stay high, the next step is to check their accuracy, how the medicines are being taken and whether another condition is contributing. Tell your doctor about side effects or missed doses so they can decide whether the treatment needs changing.
Your doctor may suggest tests to look for a cause or check whether high blood pressure has affected your body. Blood and urine tests can check your kidneys, mineral levels and whether there's protein in your urine. A separate pathology service does these tests. If your doctor suspects a hormone condition, you may also need hormone tests.
An electrocardiogram (ECG) records the heart's electrical activity. It can show an irregular heartbeat or signs of thickened heart muscle. An echocardiogram uses ultrasound to look at the heart's structure and how it pumps. Your doctor chooses tests based on your symptoms, examination and previous results.
You'll need a valid referral from your GP or specialist for this consultation. It should explain the blood pressure concern and include recent readings, current medicines and any available test results.
Consultations are privately billed. If you're eligible, Medicare pays part of the consultation fee when you have a valid referral from your GP or specialist. The clinic will confirm the amount left to pay before the visit.
If the cardiologist recommends separate tests, their purpose and cost will be explained beforehand. Your GP will receive a report of the findings and any suggested changes to treatment. Ongoing appointments may be with your GP, the cardiologist or another specialist, depending on the care you need.
Heartscope cardiologists see patients at clinics in Melbourne and Queensland. If you have a referral, our team can confirm the location and appointment details.
View clinic locationsYes. With a valid referral from your GP or specialist, you may be able to see a cardiologist to discuss your blood pressure and treatment. The clinic isn't an emergency service. Any hospital procedures take place elsewhere.
Lower readings may mean your medicine is working. Some people need it long term, while others may need less as their health changes. Don't stop or change the dose without speaking with the doctor who prescribed it.
No. Some replace part of the sodium with potassium and may be unsuitable if you have kidney disease or take certain medicines. Check with your doctor or pharmacist before using one.
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