High blood pressure, or hypertension, is one of the most serious risks factors for death from heart diseases and strokes, responsible for 13% of all deaths globally. In South Africa more than 1 in 3 adults live with high blood pressure and it is responsible for 1 in every 2 strokes and 2 in every 5 heart attacks. High blood pressure is known as a 'silent killer' because there are rarely any symptoms or visible signs to warn that blood pressure is high. That is why more than 50% of people with high blood pressure are unaware of their condition. In some cases, typically with very high blood pressure, symptoms such as headaches, visual disturbances, nose bleeds, nausea, vomiting, facial flushing and sleepiness may be experienced. Do not wait for symptoms to appear. High blood pressure becomes more likely with older age, but anyone, no matter their age, gender, fitness level or lifestyle can develop high blood pressure. Blood pressure should be measured at least once every year, so don’t delay!

What does a blood pressure reading mean?

A blood pressure measurement is recorded as two numbers: systolic and diastolic. Systolic blood pressure (SBP) indicates the pressure when the heart contracts, and therefore the pressure is always higher. The diastolic blood pressure (DBP) indicates pressure when the heart is resting between beats. A blood pressure measurement is expressed as one figure “over” another, for example, 140/90 mm Hg (SBP/DBP). High blood pressure is diagnosed when EITHER OR BOTH of these values are persistently raised on more than one occasion, when measured correctly.

A guide to blood pressure reading

How to manage high blood pressure

If blood pressure is slightly higher than normal, a further increase in blood pressure can be prevented. If blood pressure is already high it can be improved by making lifestyle changes and by taking blood pressure medication. A doctor can advise whether someone needs to start medication immediately or if they should first make lifestyle improvements only, based on their other lifestyle risk factors and medical history. Once someone starts blood pressure medication it is usually permanent, and medication should be taken regularly for it to work well. Sometimes one medication is not sufficient and a second or third medication needs to be added. Making lifestyle changes along with medication is important to achieve the best possible results.
For more advice, contact The Heart and Stroke Foundation South Africa on 021 422 1586 or email Read more about salt and high blood pressure by downloading this leaflet

Making small lifestyle changes can make steady improvements in blood pressure. Together, these changes can make a big difference!

  • Eat a healthy, balanced diet. Regularly eating plenty of fruits, vegetables, whole grains, lentils and beans, and low-fat dairy have been proven to effectively reduce blood pressure. In fact, scientists specifically designed a diet called Dietary Approaches to Stop Hypertension, also known as the DASH diet. This diet emphasizes fruits, vegetables, low-fat dairy products, whole grains, poultry, fish and nuts; and limits sugary drinks, sweets and red meat.
  • Cut down on salt. A high salt intake is linked to high blood pressure. Reduce the salt added to food during cooking and at the table. Make use of fresh and dried herbs, spices, garlic, ginger, chili and lemon juice to add flavour to food, without adding too much salt or salty ingredients like chicken or BBQ spice. Foods like packet soups, stock cubes, gravies, cheese, many breakfast cereals, breads, salty snacks, processed meats and fast foods are very high in salt, so should be used sparingly too.
  • Get active. Moderate- to vigorous-intensity aerobic physical activity can effectively reduce systolic blood pressure over several months by an average of 10 mmHg.
  • Be smoke-free. After each cigarette blood pressure will temporarily increase for 30 minutes! Chronic smoking increases the stiffness of blood vessel walls, making the damage caused by high blood pressure even worse.
  • Achieve and maintain a healthy weight. If overweight, losing even 2 to 5 kg of weight can already help to reduce blood pressure, and even greater reductions can be achieved with further weight loss towards a healthy weight.
  • Manage stress. Stress and anxiety can directly increase blood pressure and indirectly lead to unhealthy habits such as poor dietary choices, not enough exercise, and tobacco or alcohol use.
  • Limit alcohol. Women should not regularly exceed one alcoholic drink per day, and men should not drink more than two alcoholic drinks per day. People with very high blood pressure should ideally avoid alcohol completely or discuss their alcohol intake with their doctor first.
  • Take medication regularly. Not taking blood pressure medications correctly is one of the most common causes of uncontrolled high blood pressure. Prescribed medication for hypertension should be taken regularly as instructed by a doctor or nurse.
  • Know your numbers. Even when taking blood pressure medication, blood pressure may remain too high or increase again over time. Blood pressure should be checked regularly, or as recommended by a doctor or nurse.

There are various physical and lifestyle factors that can make you more likely to develop high blood pressure. Being aware of your risk factors will help you to identify the changes you can make to lower your risk. Some of these risk factors include:

  • Family history: a close member of your family has high blood pressure.
  • Age: The likelihood of blood pressure increases with age. In fact, nearly 8 in 10 South Africans over the age of 55 years have high blood pressure.
  • Physical inactivity.
  • An unhealthy diet. Especially one that is high in salt and low in fruits and vegetables.
  • Being overweight or obese.
  • Drinking too much alcohol.
  • Smoking and tobacco use.

High blood pressure causes damage to the blood vessels, including the blood vessels inside some of the organs such as the eyes, the kidneys and the brain. Uncontrolled high blood pressure can lead to a heart attack, stroke, kidney failure and blindness. The increased workload can also weaken the heart and lead to heart failure. Tiredness, shortness of breath and swollen ankles are often experienced. Blood pressure medication should always be taken exactly as prescribed and should not be stopped or changed unless advised to do so by a medical doctor.

Enough pressure is needed in the arteries for blood to travel from the heart to the different parts of the body. High blood pressure is when the force of the blood flowing through the blood vessels is persistently too high. It is normal for blood pressure to fluctuate, therefore high blood pressure is only diagnosed when it remains high on several occasions or when it is dangerously high on one occasion.