By Dr Naveed Ijaz, Chief Clinical Officer and Consultant in Family Medicine, MyGP Clinic
Most of the serious conditions I see in general practice announce themselves. There is pain, or a lump, or a cough that will not shift. High blood pressure does none of that. It sits quietly for years, damaging the arteries, heart, kidneys and brain, and the first sign that anything was wrong is often a stroke or a heart attack.
That is why it earned the nickname the silent killer. Around one in four adults in the UK has high blood pressure and a large chunk of them have no idea.
The good news is that it takes about a minute to measure and in most cases it responds very well to treatment. So here are the questions worth asking, whether you see me, your NHS GP, a nurse or a pharmacist.
What is my blood pressure and what do the numbers mean?
Ask for the actual reading. Not “fine” or “a bit up”, but the two numbers.
The top number is the pressure when your heart pumps, the bottom when it relaxes between beats. A healthy clinic reading is usually around 120 over 80. We start calling it high blood pressure at 140 over 90 or above in clinic, or 135 over 85 at home.
One high reading does not make a diagnosis. It goes up if you have rushed to the appointment, had three coffees, or are simply nervous in a consulting room, which even has a name, white coat hypertension. What matters is the pattern over time.
Do I need to monitor it at home?
For a lot of people, yes. Home readings are one of the most useful things you can bring to an appointment, and a far more honest picture than a single reading taken in a rush.
Buy a clinically validated monitor that goes around your upper arm, not your wrist. The British and Irish Hypertension Society keeps a list on its website. Sit quietly for five minutes first, back supported and arm at heart level, then take two readings a minute apart, morning and evening, for a week and write them down.
Should I be having cholesterol and diabetes checks too?
Almost certainly. Raised cholesterol and high blood sugar cluster with high blood pressure, and each one multiplies the effect of the others. Both show up on a simple blood test, and type 2 diabetes can sit undetected for years.
Is my cardiovascular risk higher than I realise?
We can calculate your ten year risk of a heart attack or stroke using a tool called QRISK, which turns your blood pressure, cholesterol, age, weight, family history and ethnicity into a percentage. But it does not capture everything. You can have a normal cholesterol and still have a heart attack.
How often should I get checked?
NHS advice is that adults over 40 should have a blood pressure check at least every five years. I think that is far too relaxed. If you are over 40, carrying extra weight around the middle, have a family history of heart disease or stroke, or you are of South Asian or African Caribbean background, do not wait five years.
It is not just about weight and cholesterol
Sleep is badly underrated. Poor sleep and untreated sleep apnoea drive blood pressure up. So does stress. Alcohol has a bigger effect than most people expect, and so does sitting still all week. Regular movement, even a brisk half hour walk most days, genuinely shifts the numbers.
None of that is glamorous advice. It is just the stuff that works.
Where we come in
At MyGP Clinic we run structured health checks that pull all of this into one appointment rather than five separate ones over eighteen months, reviewed properly and explained in plain English.
If you have not had your blood pressure checked in the last year, please do. It takes a minute, it costs nothing at your local pharmacy and it is one of the few things in medicine where a little attention now saves a great deal later.
