High blood pressure (hypertension) is a common health condition, sometimes called 'the silent killer', but what is hypertension and how can you avoid it? Let's look at the who, what, why, and how of high blood pressure, and offer some quick tips on how to cut your risk.

Who has hypertension?

According to Blood Pressure UK, a staggering one in three adults (around 16 million people) in the UK have high blood pressure. With no obvious symptoms of hypertension, around a third of those with the condition don't even know they have it.

Hypertension is more likely to affect people who:

• Smoke
• Don't get regular exercise
• Have stressful lifestyles
• Drink alcohol regularly
• Are overweight or obese
• Are black (which also increases the risk of complications and mortality from hypertension)
• Are male (32% of men have hypertension, compared to 29% of women)
• Have a family history of hypertension
• Are over the age of 45 (for men) or 65 (for women)
• Eat a high-sodium and/or low potassium diet
• Have low vitamin D status.

Some chronic health conditions, such as kidney disease, diabetes, and sleep apnea can increase the risk of hypertension, as can pregnancy. Children can also develop hypertension, typically due to kidney or heart problems, but increasingly because of lifestyle and dietary factors.

Why is high blood pressure such a problem?

Hypertension is the main risk factor for stroke and is a major risk factor for heart attack, heart failure and kidney disease. Compared to people with normal blood pressure, people with high blood pressure are three times more likely to develop heart disease and stroke and twice as likely to die from these causes. Emerging evidence also suggests that high blood pressure may be a risk factor for vascular dementia.

What qualifies as high blood pressure?

Hypertension is diagnosed when blood pressure is consistently at or above 140mmHg and/or 90mmHg.

The only way to know if you have high blood pressure is to get it checked. Regular check-ups are also vital for knowing if treatment is helping to control hypertension.

What can you do about high blood pressure?

Around three quarters of people with high blood pressure are not being treated for it or are not being treated effectively to get their blood pressure under 140/90 mmHg. Those who are taking medications typically need to take two or more separate drugs to effectively manage the condition.

While medications for lowering blood pressure can be lifesaving, they can have unwanted side effects. Fortunately, there are many steps you can take today to reduce your need for multiple medications.

Some risk factors are, of course, non-modifiable. There isn't anything you can do, for instance, about your family history, age, race, or sex. You can, however, make a big difference to your risk of hypertension with just a few dietary and lifestyle changes.

Top of the list for cutting your risk of high blood pressure are:

• Quitting smoking
• Cutting down alcohol intake
• Achieving and maintaining a healthy body weight
• Exercising regularly (150 minutes a week at least)
• Limiting salt consumption (avoid processed, pre-packaged foods, and add salt to taste at the table instead of when cooking)
• Getting enough potassium in your diet (from vegetables, fruits, nuts, seeds, whole grains, and legumes)
• Getting enough vitamin D (from sun exposure April to October, or through a supplement).

The hidden secret of this list is that many of the changes required help to reinforce other changes. For instance, getting regular exercise can not only help you to meet and maintain a target weight, it also helps with stress management, helping you to cut down on any use of alcohol or tobacco that is tied to stress. Quitting smoking can also help you to breathe more easily and avoid upper respiratory tract infections, thereby removing a barrier to exercise.

One great way to tick off several of the items on this list all at once is to get out and garden this summer. This will help you get the exercise, vitamin D, and stress relief you need, can result in homegrown potassium-rich fresh food, and can help you manage your weight more effectively. All in all, getting out in the garden is a great way to boost your happiness, and help lower your blood pressure.