Conditions · Dubai

High blood pressure: protecting the heart

High blood pressure usually causes no symptoms, but over years it strains the heart, arteries, kidneys and brain. European guidelines define hypertension as a clinic reading of 140/90 or higher, with a lower range called elevated blood pressure. Treatment lowers the risk of heart attack and stroke. Dr Shady Habboush treats high blood pressure at Saudi German Hospital Dubai.

Dr Shady HabboushConsultant Interventional Cardiology · Saudi German Hospital Dubai2 min read3 sourcesMedically reviewed against ESC and NHS guidance

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Dr Shady Habboush working in the cardiac catheterisation lab at Saudi German Hospital Dubai

Signs worth a check

Clinic readings at or above 140/90, or home readings at or above 135/85
Elevated readings (from 120/70) with diabetes, kidney disease or other heart risk factors
Blood pressure that stays high despite three medicines (resistant hypertension)
High blood pressure at a young age, which may need tests for a cause

Risks and alternatives

Blood pressure medicines can have side effects, such as dizziness, swollen ankles or a cough, depending on the type. If one medicine does not suit you, there are alternatives. Targets are set with you, taking your age and other conditions into account.

How it is assessed

01
Confirm the diagnosis with home or 24-hour ambulatory readings, not a single clinic reading.
02
Check for effects on the heart and kidneys: ECG, urine and blood tests, and sometimes an echo.
03
Assess your overall heart risk, including cholesterol, diabetes and smoking.
04
Agree a target and a plan: lifestyle changes for everyone, and medicines when needed, often a combination in one tablet.

Treatment options

Lifestyle changes help everyone: less salt, regular activity, a healthy weight, limited alcohol and not smoking.

Most people with hypertension need medicines, and many need two or more. Combination tablets reduce the number of pills.

For most adults on treatment, the 2024 European guidelines aim for a top (systolic) reading of 120 to 129, if this is well tolerated. Your own target is agreed with you.

Treatment is usually long term. Do not stop medicines without talking to your doctor, even when readings are normal.

How to measure blood pressure at home

1
Use a validated upper-arm monitor with the right cuff size.
2
Sit quietly for 5 minutes, back supported, feet flat, arm resting at heart level.
3
No caffeine, smoking or exercise for 30 minutes before.
4
Take two readings a minute apart, morning and evening, for at least 3 days and ideally 7, and write them down.
5
Bring the record, or the monitor, to your appointment.

Questions about this

What is a normal blood pressure?

The 2024 European guidelines call a clinic reading below 120/70 non-elevated, 120/70 to 139/89 elevated, and 140/90 or higher hypertension. At home, hypertension starts at 135/85.

Why does my reading go up at the clinic?

Some people have higher readings in clinic (white coat effect). Home or 24-hour readings show your usual blood pressure.

Do I have to take tablets for life?

Often, yes, because high blood pressure is usually long term. Lifestyle changes can lower the dose or number of medicines for some people.

Can high blood pressure cause symptoms?

Usually not, which is why it is called silent. Very high blood pressure with headache, chest pain, breathlessness or weakness needs urgent care: call 998.

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