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Dublin: 6 °C Friday 22 November, 2019
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Why don't Irish people get their blood pressure checked?

High blood pressure can cause a heart attack, stroke or cognitive difficulty in later life.

Image: Shutterstock/Syda Productions

WHEN’S THE LAST time you got your blood pressure checked? “Hypertension, or abnormally high blood pressure, awaits everyone,” says Dr Eamon Dolan.

“It’s just about what stage a person is at.”

Dolan is a stroke physician at Connolly Hospital, and chair of the Irish Heart Foundation’s Council on blood pressure. And he believes there’s a complacency around getting blood pressure checked – especially considering the associated serious illnesses (heart disease, cognitive difficulties as well as organ problems).

Blood pressure is the leading cause of strokes in Ireland, and heart disease kills more people than any other disease.

“When I’m with a family in the casualty room after someone’s been admitted with a stroke, and I ask them about blood pressure, they’ll say ‘Oh it was up from time to time, but it never got treated’,” Dolan says.

“Essentially it’s noted, never gets managed, and leads to serious problems in later life.”

Who’s at risk?

We all are.

Blood pressure increases because of a lack of exercise, smoking, bad diets (especially those heavy in salt) – but also because of age.

The vessels carrying blood to and from the heart get harder with age, making them less flexible and making people more prone to hypertension.

“If you’re in your 20s, 30s or 40s, it’s about future proofing yourself,” says Dolan.

“In younger people, something might show up as a kidney problem, or an overactive gland that causes a rise in blood pressure – but that’s in less than 10%.

“And then if you manage blood pressure at an early age, you stop a great strain on your arteries, which can get damaged along with your organs as you get older.”

shutterstock_348206060 Source: Shutterstock/Christoph Burgstedt

Men are also more at risk than women, as there’s a collection of factors that put men at greater risk (women’s hormones can help protect against the effects). Around half of blood pressure tests come back as normal, but it’s the complacency around high blood pressure results that means silent problems progress.

“People get higher-than-average results, and say it’s because I was rushing to the appointment, or I’m stressed,” Dolan says.

That’s not always the case, which is why you should get three blood pressure tests per session.

“If you act on high blood pressure early, it can offset many issues.”

What’s involved in a test?

Your blood pressure can fluctuate depending on the time of day, so the more tests you have done, the more certainty there is.

It’s best to get tested three times in the one setting.

140/90 is classed as ‘elevated’, and if your tests average above that, then you should get an out-of-office blood measurement, which is where your tested for a full 24 hours, which will take 40 readings.

Older doctor study Source: PA Images

And if those come back high, start looking at the factors that could be causing hypertension, and make changes.

“We don’t want people to ignore it. If more people simply acted when they get high blood pressure results, we’d make progress, which would have huge benefits to stroke reduction and cognitive impairment.”

Although Alzheimer’s counts for 50% of cognitive difficulties in people in their late-50s early-60s, 40% is due to multiple small strokes in the background of the brain, which is related to high blood pressure.

“When asked if they noticed cognitive difficulties, they say ‘In retrospect, you’d have to ask them the same thing over and over again,’” Dolan says.

GPs support

shutterstock_558373990 Source: Shutterstock/Kalinovskiy

GPs should be provided with the funding to carry out blood tests, according to Dolan.

He says that the UK’s practice of prompting opportunities to get their blood pressure measured, has brought about some improvement in overall healthcare.

“There needs to be greater opportunities for people to go get checked. It just isn’t good enough in this day and age that we’re not prompting people to get checked. He says that nurses and pharmacists could be given the equipment and funding to carry out the checks which would be crucial in identifying those most in danger.

“There’s a pyramid of hypertension, and if we don’t measure blood pressure, there’s no way of finding out who’s most at risk,” Dolan says.

According to his own research though, 3% of the population in Ireland would have severe hypertension – HSE research suggests that 30-40% of people have some form of high blood pressure.

We measured 77,000 people’s blood pressure for 24 hours and found that 3-5% were at the top of that blood pressure pyramid – but it really depends on where you draw the line.
Below that threshold, you might have a diabetic, overweight smoker who would be more at risk.

Which brings us back to the heart of the issue: if you don’t know whether your blood pressure is dangerously high or not, go find out.

As part of the Irish Heart Foundation’s efforts to get more people tested, pharmacists at Boots outlets around the country will be holding free blood pressure checks and Ambulatory Blood Pressure Monitoring (ABPM) that helps to identify and treat factors which can lead to stroke and heart disease. See here for more info.

Read: If someone you know goes into cardiac arrest, you’re their best chance of survival

Read: ‘It’s confusing for people’: Irish Heart says saturated fats link to heart disease still valid

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