Health condition · Clinically reviewed
High blood pressure (hypertension), the guide that answers what to do next.
One in three UK adults has it. Most feel completely fine - which is exactly the problem. Here is what the numbers actually mean, what to do about them, and when to worry.
Why trust this guide
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Clinically reviewed
Written by our editorial team and reviewed by a registered UK clinician before publication.
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Sourced, not summarised
Every claim is checked against NICE, BHF or a peer-reviewed source you can see at the end.
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Updated for 2026
Reflects current UK guidance on targets, medication choice and lifestyle change.
Key facts
High blood pressure at a glance.
The essentials, in plain English - what it is, how common it is, what the numbers mean, and how it is treated in the UK today.
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What it is
Persistently raised force of blood against the artery walls, measured over multiple readings.
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How common
Around 1 in 3 UK adults - many undiagnosed because there are usually no symptoms.
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UK target
Clinic reading under 140/90 for most under-80s; under 150/90 for 80+ (NICE NG136).
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Main risks if untreated
Stroke, heart attack, heart failure, kidney disease and vascular dementia.
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How it is diagnosed
Confirmed with 24-hour ambulatory monitoring or a week of home readings, not a single clinic reading.
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First-line treatment
Lifestyle change first; then ACE inhibitor/ARB, calcium-channel blocker or thiazide-like diuretic depending on age and ethnicity.
Why this guide matters
Small numbers, very big consequences.
Blood pressure is easy to measure and easy to treat - but only if you know your numbers. The three points below shape everything else on this page.
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Numbers change lives
A 10 mmHg reduction in systolic BP roughly cuts heart-attack and stroke risk by a fifth.
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A single reading is not the answer
What matters is your average - measured properly, at home or over 24 hours.
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This is not a symptom-driven diagnosis
Waiting until you feel something is exactly the mistake. Check yours.
How the diagnosis is made
From first raised reading to a clear plan.
The steps a UK GP will normally follow, in order - so you know what to expect and why.
Phase 1 · Recognising
Spotting and confirming a raised reading
Phase 2 · Confirming
Baseline tests and end-organ checks
Phase 3 · Managing
Lifestyle plan and medication if needed
- 01
Recognising
A raised reading is picked up
Often at a routine check, or after a symptom prompts a check.
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Recognising
It is confirmed with repeat readings
A single high reading is not enough - anxiety alone can push it up.
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Recognising
You are offered ABPM or home monitoring
24-hour ambulatory monitoring, or a week of paired morning and evening home readings.
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Confirming
Baseline tests
Blood tests (kidney function, cholesterol, HbA1c), urine dip, ECG and a cardiovascular risk score.
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Confirming
End-organ check
Looking for early effect on the eyes, heart or kidneys.
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Managing
Lifestyle plan agreed
Salt, alcohol, weight, activity, sleep - each has measurable effect on blood pressure.
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Managing
Medication if needed
Started at a low dose, reviewed at 4 weeks, adjusted to reach your target.
Typical timeline: 2-6 weeks from first reading to a settled plan.
Symptoms
What high blood pressure actually feels like.
Usually, nothing. When symptoms do appear, they matter - here is what to look for and when to seek urgent care.
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Usually silent
Most people have no symptoms until damage is already being done. That is why it is called the silent killer.
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Persistent headaches
Especially early morning headaches at the back of the head, with very high readings.
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Blurred or spotty vision
A sign of high pressure affecting the small vessels behind the eye.
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Chest pain or breathlessness
A red flag - possible strain on the heart or a coexisting cardiac problem.
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Nosebleeds
Rare from blood pressure itself, but common when it is very high.
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Palpitations
Occasional in high blood pressure; more common with atrial fibrillation, which often coexists.
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Dizziness on standing
Sometimes from the condition, more often a side effect of over-treatment.
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When to seek urgent care
Readings above 180/120 with symptoms, chest pain, breathlessness, weakness or slurred speech - call 999.
Treatment
How high blood pressure is treated in the UK.
Lifestyle first, medication where needed - what each option does, and how much it typically moves the numbers.
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Salt reduction
Under 6 g a day. Reducing salt alone can lower systolic BP by 5-6 mmHg.
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Regular activity
150 minutes a week of moderate activity typically reduces BP by 5-8 mmHg.
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Weight loss
Losing 1 kg lowers BP by around 1 mmHg. A 5-10 kg loss makes a real difference.
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Alcohol within limits
No more than 14 units a week, spread across several days.
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ACE inhibitor / ARB
First-line under 55 and not of African-Caribbean origin. Protects the kidneys too.
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Calcium-channel blocker
First-line at 55+ and for people of African-Caribbean origin.
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Thiazide-like diuretic
Often added second or third; effective at lowering BP long-term.
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Home monitoring
Twice a day for a week gives a fairer picture than a clinic reading.
What this guide is based on
The sources behind every number on this page.
UK national guidance and specialist society standards, current at the time of last review.
Key references
Guidelines and standards we relied on.
A quiet reminder
This guide is for information, not medical advice.
Your GP knows your history and can tell you which parts apply to you. If in doubt, get your blood pressure checked.
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National Institute for Health and Care Excellence (NICE). Hypertension in adults: diagnosis and management (NG136).
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British and Irish Hypertension Society. Standards for blood pressure measurement.
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British Heart Foundation. High blood pressure: patient information.
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NHS. Overview - High blood pressure (hypertension).
Red flags
When high blood pressure becomes an emergency.
Most of the time, hypertension is a slow burn. These are the situations where it stops being slow - and you should act today.
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BP 180/120 or above
Especially with any of the symptoms below - call 999 or attend an emergency department.
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Sudden severe headache
Worst-ever headache, thunderclap onset, or with vomiting - urgent assessment.
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Chest pain or tightness
With or without breathlessness. Do not drive yourself.
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Face drooping, arm weakness, slurred speech
FAST signs - call 999. Time matters.
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New visual disturbance
Especially with a very high reading - possible hypertensive retinopathy.
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Pregnancy over 20 weeks
Any raised BP in pregnancy needs same-day assessment to exclude pre-eclampsia.
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Blood in the urine
Combined with raised BP, could indicate a kidney cause - see a GP promptly.
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Palpitations with light-headedness
Could suggest atrial fibrillation - which often coexists and increases stroke risk.
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Suddenly stopping medication
Some BP medicines must be reduced gradually. Never stop without medical advice.
Living with it
A long-term condition, but a very manageable one.
Four things that make the biggest difference day to day - habits, monitoring, medication and reviews.
A quiet reminder
Consistency beats intensity, every time.
Small, steady changes - kept up for months - do more than a heroic week that does not last.
- 01 Daily habits
Small changes, big numbers
Halving your salt, walking 30 minutes a day and losing a stone can be as effective as a tablet.
- 02 Monitoring
Trust the trend, not a reading
A weekly average from home readings is more useful than any one number.
- 03 Medication
Timing and side effects
Take at the same time each day. Common side effects settle within a few weeks - talk to your GP before stopping.
- 04 Reviews
Annual review as a minimum
A yearly medication and lifestyle review, more often if your BP is not yet at target.
Frequently asked
Everything we get asked about high blood pressure.
Quick answers on targets, monitoring, medication, lifestyle change and when to worry.
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What blood pressure is considered high in the UK?
A clinic reading of 140/90 or above, confirmed by 24-hour ambulatory monitoring or a week of home readings averaging 135/85 or above (NICE NG136).
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Does high blood pressure cause symptoms?
Usually not - which is why it is called the silent killer. Symptoms only appear at very high levels, or once damage has been done.
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What is a normal home blood pressure reading?
Ideally under 135/85 for most adults; under 145/85 if you are over 80.
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How often should I check my blood pressure at home?
When starting or adjusting treatment - twice a day for a week, morning and evening, two readings a minute apart. Otherwise once every few months.
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Can I lower my blood pressure without medication?
Often yes, if it is only mildly raised. Losing weight, cutting salt, drinking less, moving more and sleeping better all lower BP - sometimes enough to avoid medication.
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Which medication is used first?
Under 55 and not of African-Caribbean origin: an ACE inhibitor or ARB. At 55+ or of African-Caribbean origin: a calcium-channel blocker. A thiazide-like diuretic is often added next.
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Will I need to take medication for life?
For most people, yes. Blood pressure returns when medication stops. That said, meaningful weight loss can sometimes allow a dose reduction under medical supervision.
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Is coffee bad for blood pressure?
It raises BP briefly but not long-term for most people. Cutting back is only necessary if you drink a lot or notice it clearly worsens your readings.
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What is white-coat hypertension?
BP that is high in the clinic but normal at home or on 24-hour monitoring. It is real - and needs monitoring - but does not need treatment in itself.
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When should I call 999?
A reading of 180/120 or above with chest pain, breathlessness, severe headache, visual changes, weakness or slurred speech is an emergency.
Related content
Keep reading.
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Atrial fibrillation
A common irregular rhythm that often coexists.
Learn more -
Stroke
The stroke risk that raised BP creates - and how to prevent it.
Learn more -
Cardiac MRI
A detailed look at heart muscle and function.
Learn more -
ECG & heart monitoring
Detecting an irregular rhythm behind palpitations.
Learn more