The Who, What, Why, and How of High Blood Pressure (Hypertension)



High Blood Pressure–Understanding the Silent Killer


Dr Rivera weighs in on the Who, What, Why, and How of High Blood Pressure.


What is hypertension?

Hypertension is raised blood pressure. This means that the force of the blood inside your blood vessels (arteries) is raised.


Your blood pressure reading has two figures, for example, 120/80. The top number (systolic BP) is measured when your heart is pumping blood out. The bottom number (diastolic BP) is measured when your heart is resting between beats. Hypertension is a blood pressure above 140/90

Why is it important to know about hypertension?

In South Africa, approximately 40% of adults over the age of 25 years old have raised blood pressure. Hypertension is often called the ‘silent killer’ because you may have no symptoms at all, until there are serious and permanent complications, such as a heart attack, stroke, loss of vision or kidney damage.

What is the main cause of hypertension?

Up to 90% of people with raised blood pressure have essential hypertension. This means that there is no obvious underlying cause, and it is most likely a combination of genetic and lifestyle factors.


A small number of people have secondary hypertension, which is due to an underlying disease (e.g. kidney disease, medication, tumours)

What are the four stages of hypertension?

Hypertension is divided into stages, depending on the severity.


The stage of your hypertension will help determine the management.

Systolic BP (mmHg) Diastolic BP (mmHg)

High normal 120-139 80-89

Grade 1 140-159 90-99

Grade 2 160-179 100-109

Grade 3 180 or higher 110 or higher


How long can you live with hypertension?

If your blood pressure is well controlled you can live a long and healthy life.

Can hypertension be cured?

Most hypertension can not be cured but can be easily controlled with daily medication. If you make dramatic lifestyle changes (lose weight, stop smoking, exercise regularly, reduce stress) you may be able to reduce or stop your medication, under your doctor’s supervision.

How can I prevent hypertension?

If you have a family history of hypertension, it is possible to prevent (or delay the onset) if you follow a healthy lifestyle.

  • regular exercise: brisk walking for 30 minutes per day

  • diet: low fat, low salt and low sugar

  • maintain normal body weight: BMI less than 25

  • avoiding smoking

  • moderate alcohol intake: maximum 2 units per day

How do you feel when your blood pressure is high?

Most people will not have any symptoms of hypertension. If it gets very high, you may have a headache, dizziness or blurred vision.

Get your blood pressure taken as part of your next annual health screening.

Click here to book a health screening with Dr Rivera.