Blood pressure, hypertension, what do the numbers mean? - August 2025

Welcome back to Coffee Break, where your pulse may quicken but hopefully not your blood pressure. Today we're talking a potential i-blood pressure, the silent ninja of the medical world, sneaky, silent and surprisingly common. It's the same thing that can quietly take away in the background until it causes all sorts of trouble, like a badly behaved toddler with a markup in. We'll be chatting about what it is, why it matters and how you can take control before it takes control of you. Plus we'll throw in some lifestyle tips, mistabust and how sometimes the best medicine isn't medicine at all. So whether your pressure is high or low, you just came to listen to the presenters, we've what you covered. So let's lower the tension and dive in. I'm Dr Jeff Ham and I'm Dr Sam again me. This is season one of Coffee Break. We are two general practitioners from beautiful dogs that are in the United Kingdom and we are happy to have you here with us for another Coffee Break. In our show we give you helpful and useful health and wellness information in short and easily digestible episodes. That's right and hopefully in a fun and enjoyable way as well. In today's VARC of Health Information we hope to be your trusty island of reliable and impartial independent, unbiased information. We may even have some guests with us to help. So sit back and enjoy. A Coffee Break. So I think the first thing to say is a bit like a lot of things in medicine, we may have a symptom for and we want to talk about this one not only because it's an important topic but because it is a silent condition, you don't feel the symptoms do you and a regular monitoring can detect the early signs of it and that's important because it's a leading risk factor for heart disease, stroke, kidney disease, diabetes and other health problems. That's right and sometimes it's hard to try and explain to people the importance of high blood pressure. I use an analogy based on potential heating systems and boilers and really simplistically you can think of your circulatory system in that very similar way. So like your boiler at home you could run your boiler at an incredibly high pressure. It would still do everything that it should be doing but it's not the best thing to do for your system. You may not notice it, you may not have any particular symptoms of doing that but your boiler is going to run out a lot faster. There's going to be a lot more damage to the other elements of the system compared to if your boiler was running at a proper all lower pressure. It's a very simplistic way of looking at it but I think it explains why we're so interested and keen to try and sort out people's blood pressures. Yeah indeed and a couple of interesting facts is did you know that one in two strokes and heart attacks are the result of high blood pressure, a third of adults in the UK have raised blood pressure and 50% of adults with high blood pressure don't know that they have it and so aren't receiving treatment. Yeah definitely it's quite worrying when you hear those statistics isn't it? Theoretically if you and I did nothing and we just continue to get older as we currently are one of us is potentially going to have high blood pressure and not know anything about it. Yeah absolutely. So what is blood pressure? Normal blood pressure by definition is considered to be between 90 over 60 and 120 over 80 and this is all readings measured at home or at a pharmacy or a GP surgery or clinic. Yeah indeed. And then we do say that it is high when it goes above 135 over 85 at home if that region was taken at home or if it was taken at a GP surgery or a pharmacy or a clinic then a number over 140 over 90 would be considered high and low blood pressure is considered to be 89 over 59 or lower. People say well why do we measure blood pressure this way? Why do we talk about a number over another number? The actual numbers represent historical measurements so blood pressure was measured using a column of mercury. Some of us are old enough to remember the old blood pressure machines in GP surgeries where there was a column of mercury which we know all they use and the number of millimeters of the mercury was pushed up correlated with the pressure in the arteries. Now these days we don't use mercury and blood pressure machines but the machines are calibrated to do just exactly the same measurement but without using the mercury. Yeah that's really helpful to know isn't it because otherwise the numbers do feel a bit meaningless. So what do those numbers mean so the top number usually the higher number is the systolic pressure and that's a measure of the pressure in your arteries when your heart is beating and then the second number the lower number is the diastolic pressure and that measures the pressure in your arteries when your heart is at rest between bees. Yeah definitely. So my potential as we alluded to typically has no symptoms until the damage that it causes has occurred and it's sometimes referred to therefore as the silent killer and so early detection of this is really important and regular home monitoring of your blood pressure can therefore help in the early detection as well as managing high blood pressure and thereby reducing the risk of those severe complications that happens with longstanding, untreated and managed high blood pressure. Yeah absolutely and then when you know if you do know that your blood pressure is elevated you can start to take some preventative measures to reduce the risk of developing more serious health issues. That's most often at the early stages simple lifestyle changes. For example adopting a healthier diet particularly they've studied salt and restricting salt in a diet can significantly reduce blood pressure, increasing physical activity and quitting smoking. So we talk about home monitoring which is a very practical approach at measuring your blood pressure at home it's convenient it reduces variability in the settings which contribute to bone is also called white coat high potential that increasing your blood pressure from simply coming to see your doctor or your nurse or seeing the hospital monitor your blood pressure at home improves accuracy and it allows you to take control and we're going to put some out to's in the show notes that Sam do you want to do a few key points on what people need to do and not do to do their blood pressure at home? Yeah absolutely so the first thing to do is to not rush into it now it's always advised people so if you've decided you're going to agree to do some home blood pressure readings obviously you need to find a nice comfortable place to sit so that you can sit with your legs on the firmly on the ground both feet on the ground uncrossed and you need to be able to take a chance to be sitting there avoiding talking, laughing or chewing at the time. Place the cuff on your arm it needs to sit on the upper part of your arm about with the lower part of the cuff about two centimeters above your elbow and then when you're sitting still and avoiding the things we said use the machine to take two to three readings with a one minute delay between each reading keeping to the same arm each time and write down your all three measurements. We do recommend that you always write down all the measurements and you don't round them up or down and also not to worry or panic if you see unexpected readings that look really strangely high or low just record them all because you'll probably find that there will be occasional numbers that look very different to the others and this is quite a common thing. The other thing we will always suggest is to discard your first day of readings if you started to use the monitor regularly for us let's say for a week or two and then once you've got your readings you can take an average and that average will give you a clearest to whether your blood pressure is persistently high or low. Definitely you will normally hear from your surgery if you've not had a blood pressure documented for a period of time for instance we tend to use a timescale of five years so if we don't have a blood pressure on your records in the last five years we'll probably contact you to ask you to do this. There are different places you can get your blood pressure checked if you're not going to check it at home. For instance here at the surge we've got a new blood pressure, height and weight machine so a lot of surgeries have the ability to check it in the surgery but you can also get an appointment to your local chemist or appointments with your healthcare assistance, your nurses or your GP. Absolutely. Yeah. BPM home is another service that's being rolled out locally here in Dorset. It's being increasingly offered. And it's a system whereby we are inviting patients who, again, we've not heard from for a long time or had blood pressures. They are being invited to record their readings at home and submit them remotely. And currently here at our practice, the pharmacy team are keeping an eye on these and contacting people who may need further action. And there's also lots of resources available out there. Just one example is the blood pressure UK charity. They have lots of examples leaflets that explain about more about blood pressure and they even have an app that you can use for monitoring your pressure. Definitely. And I think it's important to say this is such a big topic that I think this is probably going to be our first episode about hypertension. We've got all sorts of other things to talk about, low blood pressure. But really, importantly, the treatments for high-potentials. So, some of you have mentioned lifestyle and those things are incredibly important. But if those lifestyle changes don't work, then we need to bring your blood pressure down in other ways, which we can do with medication. And I think that's probably an episode in itself. So the future where we can talk about what medications your clinician can give you to try and help bring your blood pressure down. So, Jeff, do you have a take home point for our listeners? Yes, I think so. It's interesting. I tend to use the analogy of boilers and any of my patients who are listening will probably have heard me talk about boilers this way in relation to blood pressure. But I think it's really helpful because it does reflect that your blood pressure can be high and you will in all likelihood know nothing about it. You won't get symptoms from high blood pressure. Your blood pressure actually has to be really dangerously high before you start to experience symptoms like nose bleeds and headaches and those sort of things. So actually, it's really important to get blood pressure checked to be able to monitor it and just to know so we can pick up early and prevent that damage happening. Yeah, absolutely. And again, thinking about the boiler analogy, I think if we're willing to invest annually, it's a money in having our boiler service, which let's face it, doesn't really tell us if it's got symptoms or not, but we're willing to keep that maintained. Then we should be willing to spend less than an annual boiler service, perhaps on our own, blood pressure machine or just actually comparatively short amount of time just to occasionally check our blood pressure and make sure we're not missing that very important silent condition that we can so easily remedy. This has been an episode of Coffee Break. We hope you have enjoyed it. And if you have, then we hope you will join us again for another Coffee Break soon. Remember, if you do want to get in touch with us, or if you have any ideas or suggestions, then please feel free to email us at the show at [email protected]. You can listen to us and subscribe to the show on any of the podcast platforms and via your computer, smartphone and home smart devices. We have used a variety of resources for the information in the show to try and ensure that it is up to date and the most applicable. We have also put any important links we've discussed in the show notes. Coffee Break is a coffee break production and is created written and hosted by me, Dr Sam McGinley and me, Dr Jeff Hamm. The editor and producer is Dr Jeff Hamm. All the content we provide in the show is for general informational purposes only. The content does not constitute medical or healthcare advice. The content is valid in England at the time of recording. The content should not be relied upon as a substitute for professional, medical or healthcare advice applicable to your specific circumstances. We advise that you always consult a qualified medical professional for any medical matters.