High Blood Pressure
Also called: hypertension, HBP, raised blood pressure
Blood pressure that stays higher than it should over time. It rarely causes symptoms, which is why it is usually found by measuring rather than by feeling unwell.
Quick answer
- What it is
- Blood pressure is the force of blood against artery walls. In hypertension that pressure stays elevated over time, which gradually strains the heart, blood vessels, kidneys and eyes.
- Common symptoms
- Usually none. Most people feel completely well, which is why it is often called a silent condition and why regular measurement matters.
- How it's treated
- Lifestyle changes, and medication when readings stay above target. Several medication classes are used, often in combination at lower doses.
- Who can help
- Diagnosis and targets come from a physician or nurse practitioner. Pharmacists help with monitoring, side effects, adherence and medication reviews.
- Warning signs
- A very high reading together with chest pain, severe headache, vision changes, weakness on one side or difficulty speaking needs emergency care.
Managing this long term? Pill4Me pharmacists in Chilliwack can help.
Book a medication reviewWhat is high blood pressure?
Blood pressure is written as two numbers — the pressure while the heart contracts (systolic) over the pressure while it relaxes (diastolic). A single high reading is not a diagnosis; blood pressure moves throughout the day and rises with stress, pain, caffeine and the appointment itself. Diagnosis is based on a pattern across several readings, often including measurements taken at home or over 24 hours.
What makes hypertension worth treating is not how it feels — it usually feels like nothing at all — but what sustained pressure does over years. It thickens and stiffens artery walls, makes the heart work harder, and is one of the leading contributors to stroke, heart attack, heart failure and kidney disease. Lowering it measurably reduces those risks, which is why treatment continues even though nothing feels different.
Common symptoms
Hypertension itself usually causes no symptoms. Symptoms that are sometimes attributed to it — and which are worth reporting rather than assuming — can include:
- Headaches, particularly if new, severe or persistent
- Shortness of breath on exertion
- Nosebleeds, which are common in general and rarely caused by blood pressure
- Dizziness or lightheadedness
- Chest discomfort — never something to wait out
Having these symptoms does not confirm a diagnosis — they overlap with other conditions. Assessment by a pharmacist, physician or nurse practitioner is what establishes the cause.
Causes and risk factors
What causes it
- In most people there is no single cause — this is called primary or essential hypertension, and it develops from a combination of genetics, age and lifestyle
- Less commonly, hypertension is secondary to another problem such as kidney disease, sleep apnea, thyroid disorders or hormonal conditions
- Some medications raise blood pressure, including NSAIDs such as ibuprofen and naproxen, decongestants, and some hormonal treatments
What raises the risk of developing it
- Age — blood pressure tends to rise over the decades
- Family history of hypertension
- Higher sodium intake
- Carrying extra weight
- Low physical activity
- Regular alcohol above recommended limits
- Smoking
- Untreated sleep apnea
- Type 2 diabetes or chronic kidney disease
Risk factors make a condition more likely across a population — they are not causes, and having several does not mean you will develop it.
When should I seek medical care?
Seek urgent or emergency care
- A very high reading together with chest pain, shortness of breath, severe headache, vision changes, confusion, or weakness or numbness on one side of the body — call 911
- Difficulty speaking or a drooping face — these are stroke signs and time matters
- Fainting
If you are unsure how urgent something is, call 8-1-1 to speak with a HealthLink BC nurse at any hour, or 911 in an emergency.
Worth asking a pharmacist
- Side effects such as ankle swelling, a dry cough or dizziness on standing
- Home readings you are unsure how to interpret, or a monitor you would like checked
- Whether an over-the-counter product is safe — many cold remedies contain decongestants that raise blood pressure
- Doses being missed, or a regimen you would like simplified
- Concerns about cost or coverage
See a physician or nurse practitioner
- Home readings consistently above the target you were given
- Readings that have risen after being stable
- Side effects that are not settling and are affecting whether you take the medication
- Planning a pregnancy, since some blood pressure medications are changed beforehand
How is high blood pressure treated?
Lifestyle measures
- Reducing sodium, which for most Canadians means reducing packaged and restaurant food rather than the salt shaker
- Regular aerobic activity, which lowers readings measurably
- Limiting alcohol
- Weight management where appropriate
- Stopping smoking — it does not lower the number much, but it changes the risk the number represents
- Treating sleep apnea if it is present
Medication
Several classes are used, and combinations at lower doses are often preferred to one medication at a high dose. ACE inhibitors and ARBs relax blood vessels and protect the kidneys, particularly in diabetes. Calcium channel blockers such as amlodipine relax the artery walls directly. Thiazide diuretics reduce fluid volume. Beta blockers are used in specific situations such as after a heart attack. Which combination suits you depends on your age, kidney function, other conditions and what you tolerate.
Monitoring
Home monitoring with a validated upper-arm monitor gives a better picture than occasional clinic readings. Kidney function and electrolytes are checked periodically on most blood pressure medications, and your overall cardiovascular risk — including cholesterol and blood sugar — is usually reviewed alongside.
This is a general overview, not a treatment plan. What is right for you depends on your history, your other conditions and everything else you take — that is a conversation with your prescriber or pharmacist.
Medications used for high blood pressure
These are commonly used in Canada for this condition. Being listed here does not mean a medication is appropriate for you — that depends on your assessment.
Browse every guide in the Drug Information A–Z.
Can a BC pharmacist assess high blood pressure?
Not for diagnosis
High blood pressure is diagnosed and managed by a physician or nurse practitioner, and is not one of the minor ailments BC pharmacists can diagnose and prescribe for. Pharmacists do contribute in practical ways: checking your home monitor and technique, sorting out side effects, flagging over-the-counter products that push readings up, running a PharmaCare-covered medication review, and contacting your prescriber when a change is needed.
Coverage in British Columbia
Most first-line blood pressure medications are available as inexpensive generics and are widely covered. Coverage still depends on your PharmaCare plan, your deductible and, for a few products, Special Authority requirements. Pill4Me Pharmacy can check your coverage before you fill — call 604-705-3644.
Coverage depends on the medication, indication, PharmaCare plan and, for some medications, Special Authority requirements — see BC PharmaCare.
Frequently asked questions
What is a normal blood pressure reading?
Can high blood pressure cause headaches?
Can a pharmacist prescribe blood pressure medication in BC?
Do I have to take blood pressure medication for life?
Can I take ibuprofen if I have high blood pressure?
Related reading
Related conditions
Guides and services
Managing this long term?
Most of what goes wrong with long-term conditions is medication-related — interactions, side effects that quietly stop people taking things, doses that drift out of step. A pharmacist review covers all of it, and moving your prescriptions to Pill4Me means someone is watching High Blood Pressure between appointments.
Pill4Me Pharmacy is at 5625 Promontory Rd Unit 101, Chilliwack, BC. We deliver free to Chilliwack, Sardis, Promontory, Vedder and Yarrow, and you can reach a pharmacist directly at 604-705-3644.