Dr. Nicholas Pegge : Cardiologist
High blood pressure is a common condition which can be asymptomatic until it causes complications. These complications can be severe, and if left too late, irreversible, or only partially reversible.
The long term consequences of hypertension include coronary artery disease, heart failure, stroke, kidney disease, and arrhythmias especially AF and atrial flutter.
However, effective treatment for hypertension can prevent, or at the least, postpone these consequences for many years or even decades.
Once life style issues (weight, smoking, exercise, reduction of salt in the diet) have been addressed, a wide range of drug treatment for hypertension is available.
Several separate major classes of drug are available, and there are multiple different alternative drugs within each class, so everyone should be able to find a drug regimen that suits them best.
The major classes of blood pressure pills include ACE inhibitors; Angiotensin receptor antagonists (sometimes known as ARBs, or sartan drugs); calcium channel blockers; diuretics especially thiazide diuretics; beta blockers; alpha blockers; plus some other agents less often used.
NICE stresses now the role of 24 hour ambulatory blood pressure monitoring in selecting which patients really need drug treatment for their blood pressure.
Young people with high blood pressure may need to have some simple tests on the blood and urine, plus an ultrasound scan of the kidneys to look for underlying causes; but mostly, hypertension comes on without any other treatable cause.
Dr Nicholas Pegge MA (Cantab.) MB BS (London) FRCP