In short
High blood pressure (hypertension) means blood is pushing too forcefully against your artery walls over time. Most people feel no symptoms, so the only way to know is to have it measured. Left untreated, it increases the risk of heart attack, stroke, heart failure and kidney disease.
When high blood pressure is urgent
Seek emergency medical care immediately if a very high reading comes with any of the following:
- Chest pain or pressure
- Severe headache, confusion, or changes in vision
- Weakness, numbness or drooping on one side of the face or body, or difficulty speaking
- Severe breathlessness
Busamed Hillcrest 24-Hour Emergency Unit: 031 768 8911. This information must never delay emergency care.
Understanding the two numbers
A blood pressure reading has two numbers, for example 120/80 mmHg. The first (systolic) is the pressure when the heart pumps; the second (diastolic) is the pressure when the heart rests between beats.
One high reading does not mean you have hypertension. Blood pressure varies with activity, stress and even the setting in which it is measured, so diagnosis is usually based on repeated readings, sometimes including home or 24-hour monitoring. Your clinician will interpret your numbers in the context of your overall health.
Why it often goes unnoticed
Hypertension rarely causes symptoms until it has been present for some time. People can feel completely well while the extra pressure gradually affects the heart, arteries, brain, kidneys and eyes. That is why regular checks matter, particularly if you have a family history or other risk factors.
Common contributing factors
Often there is no single cause. Factors that can contribute include:
- Increasing age and family history
- Excess weight and low physical activity
- A diet high in salt and low in fruit and vegetables
- Regular heavy alcohol intake and smoking
- Some medical conditions, such as kidney disease, and some medicines
Why a cardiologist may become involved
Many people with high blood pressure are managed by their general practitioner. A cardiologist may be involved when blood pressure is difficult to control, when there are signs it has affected the heart, or when there are other heart symptoms. In that setting an echocardiogram can show whether the heart muscle has thickened or whether heart function is affected.
Treatment is individual
Treatment usually combines lifestyle measures with medicines when needed. The choice of medicine and the target reading depend on your age, other conditions and overall risk. Please do not start, stop or change blood-pressure medicines without speaking to the clinician who prescribed them.
Questions to ask your clinical team
- What blood pressure target is right for me?
- Should I monitor my blood pressure at home, and how should I do it?
- Has my blood pressure affected my heart, and how would we check?
- Which lifestyle changes would make the biggest difference for me?
Common questions
Can I feel when my blood pressure is high?+
Usually not. Most people with high blood pressure have no symptoms, which is why measurement is essential.
If my readings improve, can I stop my tablets?+
Improved readings often mean the treatment is working. Do not stop medicines on your own — discuss any change with your prescribing clinician.
Sources and further reading
General patient education written in plain language and informed by the sources above. It is not a substitute for an individual assessment, and does not describe practice-specific fees, referral rules or preparation — please confirm these with the practice.