What is hypertension and what causes it? Tracey Hawthorne, an author based in the Western Cape, shares her experience of the condition.

“A few years ago, at the age of 56, I began having dramatic nosebleeds several times a week. I was concerned because I’d never had a single nosebleed before. I was in good physical shape: the right weight, fit and eating properly, and I didn’t smoke or drink alcohol.

“I wasn’t, however, in a great space psychologically. At that stage, I’d been solely responsible for almost two years for the care of my father, who was in his 80s, including through the repeated lockdowns during the COVID-19 pandemic, and two serious operations and one emergency hospitalisation and their aftermath.”

“Anyone who has been the sole caregiver of an old, ailing person will know exactly what I’m talking about. I was on duty 24/7 as my father’s nurse, therapist, cook, maid, chauffeur, IT technician, and entertainment director, while also earning a living and running a household, and I was nearing total emotional depletion.”

“I battled on, largely alone, for another six months. Then the nosebleeds started.

“When I went to my doctor, the first thing he did was take my blood pressure. ‘Whoops!’ he said, as he read the numbers: ‘This cuff isn’t working. Wait here, I’ll go and get another one.’

“The cuff had, in fact, been working – it was just that my blood pressure was off the charts. I was in a hypertensive crisis, meaning that the reading was over 180/120 – normal blood pressure is between top number systolic below 120 and bottom number diastolic below 80. That was at the root of my nosebleeds: my sustained high blood pressure had damaged my blood vessels.”

What is hypertension (high blood pressure)?

Blood pressure is the measurement of the pressure of blood pushing against the blood-vessel walls. When your healthcare professional takes your blood pressure, the top number (systolic pressure) shows the force as blood pumps out of your heart, and the bottom number (diastolic pressure) is created as your heart rests between beats. High blood pressure, or hypertension, is when the force of blood pushing against your artery walls is consistently too high – 140/90 or higher.

How does high blood pressure affect your health?

If your blood pressure remains high, it can lead to serious conditions like a heart attack, heart failure, stroke or kidney disease. It’s crucial to know that high blood pressure has no symptoms at all, which is why it’s often called the silent killer. In Tracey’s case, she was in fact “lucky” to have had the nosebleeds, otherwise the problem may have gone undetected, with possibly fatal consequences.

What causes hypertension?

High blood pressure is often related to unhealthy lifestyle habits, such as smoking, drinking too much alcohol, being overweight, increased salt (sodium) intake in one’s diet and not exercising enough. It can also occur because of prolonged stress or depression, and the possibility of developing hypertension increases with age.

A treatment plan for hypertension

Tracey says the first thing her doctor told her was “that I could no longer look after my father alone – I needed help, and a lot of it. He didn’t mince his words about the possible catastrophic consequences of my condition, and one of my siblings agreed to allow my father to live in an empty cottage on their property. This removed a gigantic daily stress from my life”.

Although Tracey has none of the lifestyle risk factors for hypertension, her blood pressure is still dangerously high, and she takes daily medication to keep it stable. “I also focus on keeping my stress levels as low as possible. I walk daily, continue to eat healthily and go to my doctor for six-monthly check-ups. At these appointments, the strength of the medication I’m on can be tweaked, depending on how I’m doing.”

When is high blood pressure an emergency?

“Some people experiencing a hypertensive crisis may have symptoms, while others may not have any symptoms at all,” says Dr Andile Xana, a cardiologist at Mediclinic Heart. “If you can check your own blood pressure and see a reading of 140/90 after 2 readings this should already raise concerns however if the readings are 180/120 you should contact your doctor immediately for further advice.”

If your blood pressure is high and you’re also experiencing one or more of these symptoms, get to your nearest Mediclinic Emergency Centre immediately:

  • Severe headache
  • Dizziness
  • Confusion
  • Nausea or vomiting
  • Chest pain
  • Changes in vision
  • Shortness of breath
  • Seizures
  • Nosebleeds.

How to lower blood pressure naturally

Lose weight. Losing even a few kilograms can help reduce blood pressure if you’re overweight or obese

Eat healthy. Get enough fruits, vegetables, whole grains, and lean proteins while limiting salt and processed foods

Get moving. Regular activity helps lower your blood pressure

Sleep well. Insufficient rest can lead to elevated blood pressure

Chill out. Stress management techniques, such as meditation and deep breathing, help reduce tension and promote relaxation

Cut down on alcohol and quit smoking. Both play a vital role in reducing blood pressure and maintaining healthy levels.

Find your closest Mediclinic Emergency Centre here.

Medically reviewed by