High blood pressure (hypertension): numbers, symptoms and what to do

A blood pressure reading has two numbers, such as 120/80:

• The top number (systolic) is the pressure when your heart pumps.
• The bottom number (diastolic) is the pressure when your heart rests between beats.

Doctors in the Philippines use these numbers, measured properly in a clinic:

• 140/90 or higher on more than one occasion means you have high blood pressure (hypertension).
• 180/120 or higher is dangerously high. Check again after a few minutes. If it is still that high, see when to get help now.

One high reading does not mean you have hypertension. Blood pressure can go up for a while with stress, coffee, smoking or exercise. A diagnosis is made after readings on different days.

If you are being treated, Philippine guidelines aim for a blood pressure below 130/80 for most adults. Your doctor will set the right target for you, depending on your age and other health problems.

Most people with high blood pressure feel completely fine. That is why it is called a silent killer: it can damage the heart, brain, kidneys and eyes for years before anything feels wrong.

Many people think they can feel when their blood is high, for example as a stiff or painful nape (batok), dizziness or a headache. These feelings have many other causes, and most people with high blood pressure have none of them. The only way to know your blood pressure is to measure it. Never decide to take or skip a medicine based on how you feel.

Very high blood pressure can sometimes cause a severe headache, blurred vision, chest pain or shortness of breath. These can be signs of an emergency.

Most high blood pressure has no single cause. It builds up over years. Your risk is higher if you:

• are older, or high blood pressure runs in your family
• eat a lot of salt and few fruits and vegetables
• are not physically active
• are overweight
• smoke or use other tobacco, or drink a lot of alcohol
• have diabetes or kidney disease

Salt is a big part of the problem in the Philippines. Filipino adults eat about twice the sodium the WHO recommends. The WHO advises less than 5 grams of salt a day, which is just under one teaspoon in total. Much of it is hidden in:

• patis, toyo, bagoong and seasoning mixes or broth cubes
• salted and dried fish such as tuyo and daing
• instant noodles and canned foods such as corned beef and luncheon meat
• processed meats such as hotdogs, longganisa, ham and tocino
• chips, chicharon and other salty snacks

Sometimes high blood pressure is caused by another condition, such as kidney disease, a hormone problem or some medicines. Your doctor may check for these.

Over time, high blood pressure strains your blood vessels and your heart. It is the leading risk factor for stroke and heart attack. It can also lead to heart failure, kidney damage and problems with your eyesight.

Bringing your blood pressure down lowers these risks.

High blood pressure in pregnancy needs special care. A reading of 140/90 or higher in a pregnant woman should be checked by a doctor the same day, because it can be a sign of pre-eclampsia, which is dangerous for mother and baby.

You can get your blood pressure checked for free at your barangay health station, rural health unit or YAKAP clinic. If you have high blood pressure, a home monitor helps you and your doctor see how you are doing.

For an accurate reading:

1. Don't smoke, exercise or drink coffee, tea or soft drinks for 30 minutes before.
2. Empty your bladder.
3. Sit quietly for 5 minutes with your back supported, both feet flat on the floor and legs uncrossed.
4. Rest your arm on a table so the cuff is at the level of your heart.
5. Put the cuff on bare skin on your upper arm, just above the elbow. Use a cuff that is the right size for your arm.
6. Stay seated and still while it measures.
7. Take two or three readings, one minute apart, and write them all down with the date and time.

Choose a validated digital monitor (one tested for accuracy) with a cuff for the upper arm. Ask your health center or a pharmacist if you are not sure which one to buy.

Our free AI blood pressure coach can help you keep a log of your readings and understand them.

Lifestyle changes help everyone with high blood pressure. For some people with slightly high readings, they may be enough:

• Eat less salt: cook with less patis and toyo, taste food before adding more, and choose fresh food over instant and canned food.
• Eat more vegetables and fruit.
• Be active for at least 150 minutes a week, such as a brisk 30-minute walk on most days.
• Lose weight if you are overweight.
• Stop smoking and other tobacco use, and drink less alcohol.

Many people also need maintenance medicine. Common blood pressure medicines include amlodipine, losartan, enalapril, metoprolol and hydrochlorothiazide. Your doctor chooses which one, and how much, based on your health.

• Take it every day, even when you feel fine. Your blood pressure is normal because the medicine is working.
• Don't stop or change your medicine without talking to your doctor, even if your readings look good. Don't take extra pills because of a high reading, and never take someone else's blood pressure medicine.
• If you have side effects, tell your doctor. There are other medicines to try.

These five medicines are among the free medicines at PhilHealth YAKAP clinics, prescribed by your YAKAP doctor. Your health center may also have free or low-cost maintenance medicines.

Need help sticking to your treatment? Ask a nurse or book a call with a nurse.

The same habits that treat high blood pressure also help prevent it: less salt, more vegetables and fruit, regular activity, a healthy weight, no smoking and little or no alcohol.

Know your numbers. Have your blood pressure checked regularly, and more often if it was high before, you are older, you are overweight or you have diabetes. Your yearly first visit at your YAKAP clinic includes a free health check.

High blood pressure is common in the Philippines, and many people who have it don't know it. Until recently, only about 1 in 5 Filipinos with high blood pressure had it under control, according to the WHO. A simple check is the first step.