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You are in: Home > Heart Information > Living With Heart Conditions > High Blood Pressure > Living With High Blood Pressure

Living With High Blood Pressure

If you have been told that you have high blood pressure then there may be lots of thoughts and questions going through your mind and you may wonder what the future is going to be like.

Remember that high blood pressure is not a disease in itself. For most people, making the necessary lifestyle changes as well as taking any drugs that have been prescribed, means that you can lead a normal active life.

Areas of your life that you may be concerned about include:

• Work
• Stress
• Your sex life
• Female contraception
• Hormone replacement therapy (HRT)
• Driving
• Holidays and flying
• Sport

Work

If your blood pressure is well controlled then you should be able to continue working. However if you work as a diver, submariner or airline pilot then it is unlikely that you will be able to continue working. This is because extreme changes in speed and / or pressure can sometimes cause problems if you have high blood pressure.

If you work with machinery you must discuss this with your doctor, before any treatment is prescribed, as some drugs can make you drowsy.

It is important that you are honest with your employer. Sometimes they may require you to undergo a medical examination to fulfil conditions for pension funds and insurance purposes. If you decide that the physical requirements of your job are too much for you, it may be necessary to retrain or find alternative duties at your workplace. If your work has an occupational health department, they can be a useful source of support and information.

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Stress

Stress increases your blood pressure for short periods of time. Once the stress is relieved your blood pressure returns to normal. Stress has not been proven to actually cause high blood pressure. However if you are leading a stressful life, for prolonged periods, you may find that you are, for example, not eating a healthy diet, smoking or drinking too much and not taking enough exercise. All these things will contribute to raising your blood pressure.

Your sex life

You may worry about how sex will affect your blood pressure, or if it is safe to have sex at all. These fears are natural so it can be reassuring to know that sex, like any exercise, raises your blood pressure but only briefly. Your blood pressure falls immediately afterwards. This temporary increase in blood pressure is normal and safe.

Sex should be thought of as another form of physical activity, no more stressful to the heart than other forms of moderate exercise.

Sometimes high blood pressure, and blood pressure lowering drugs, can cause problems with sex.

• Some men may have problems with impotence. Some of the physical causes of impotence include high blood pressure and heart disease. Sustained high blood pressure can affect the blood vessels in the penis, making it more difficult to have an erection.
• Impotence can also occur as a side effect of blood pressure lowering drugs, in particular thiazide diuretics and beta blockers. Impotence that is caused by drugs is always reversible.
• High blood pressure can reduce blood flow to the vagina. Women may occasionally find that sex is painful or that they are less likely to have an orgasm.
• High blood pressure itself does not cause loss of libido (sexual desire). However, if you are worried about your health you may find that you do not want to have sex. Try to talk to your partner about how you are feeling; it's easy to feel rejected when sexual intimacy changes. Retaining closeness and intimacy within your relationship will help to overcome difficulties. Remember that you can express your feelings in many different ways, for example through talking, with body language and physical contact such as kissing and cuddling.
• Very rarely heart attacks and strokes can occur during sexual activity. This is relatively rare in comparison with other activities which raise your blood pressure for similar lengths of time.

Even though you may find it embarrassing, talk to your doctor if you are having problems with sex. If you think that your problems started after you began your treatment your doctor can try you on a different drug.

Do not buy or use drugs such as Viagra© unless your doctor has prescribed it for you.

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Female contraception

Some forms of hormonal contraception are not recommended if you have high blood pressure.

Before you start using any form of hormonal contraception (e.g. the pill, patch, injection, implant, 'coil'/ intra–uterine device or vaginal ring) your doctor / family planning nurse will talk to you about which method is best for you.

• 'Combined' contraceptives (e.g. the 'pill', patches, vaginal rings) all contain 2 hormones: oestrogen and progestogen. These can all cause a small rise in your blood pressure and your doctor / family planning nurse may not recommend these methods if you have high blood pressure. Combined contraceptives should be avoided if you have high blood pressure and you have a family history of heart disease, you are overweight, you smoke or you have diabetes / migraines.
• 'Progesterone only' contraceptives (e.g. the 'mini-pill', injections, implants and Mirena® 'coil') are not known to affect blood pressure; however, you will need to have your blood pressure closely monitored.

If your blood pressure rises while you are taking any form of hormonal contraception you may wish to consider another form of contraception.

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Hormone replacement therapy (HRT)

Hormone replacement therapy (HRT) can reduce the unpleasant effects of the menopause by increasing your hormone levels (progesterone and / or oestrogen).

HRT is not known to have any effect on your blood pressure as the amount of oestrogen in HRT treatments is very low. However, your doctor may advise that your blood pressure needs to be under control before starting HRT.

HRT is not suitable for everyone. If you are considering it, you must talk to your doctor about the risks and benefits.

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Driving

If any of the drugs you are taking for your heart give you side effects which may affect your driving (e.g. drowsiness) then you are not allowed to drive.

• Group 1 Licence Holders (Motorcars and Motorcycles): you only have to stop driving if your drugs give you side effects such as drowsiness or dizziness. DVLA need not be notified.
• Group 2 Licence Holders (Lorries and Buses): you will not be allowed to drive if your resting blood pressure is consistently 180 mm Hg (systolic) or more and / or 100 mm Hg (diastolic) or more. The DVLA and your insurance company must be notified.
  Re-licensing may be permitted when your blood pressure is controlled.

For more information contact: DVLA

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Holidays and flying

If your blood pressure is well controlled then you should be safe to fly. If your blood pressure is very high, or is poorly controlled, then you will need to speak to your doctor before you arrange to fly.

If you have any concerns about your health then you need to contact the airline's medical department before travelling. This will allow medical clearance and fitness to fly to be assessed before you travel and allow the airline staff to help you with early boarding and inflight care if required.

If you are thinking about going on a holiday at high altitude you should check first with your doctor to see that you are fit enough to go. This is because your blood thickens and your blood pressure rises at high altitude. This may increase your risk of a stroke.

You have to declare if you have high blood pressure when buying travel insurance to ensure that you have the appropriate cover when abroad.

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Sport

If you have high blood pressure you should be doing exercise which keeps you moving (dynamic) and makes you breathe in more air (aerobic) e.g. walking, swimming, cycling, dancing, jogging.

You should avoid any form of exercise that involves staying in one place and straining to lift, or move, something, e.g. weight lifting. This is called static exercise. It strains your heart and will raise your blood pressure.

Even if your high blood pressure is controlled by drugs you should talk to your doctor before taking part in any 'extreme' sports (e.g. skydiving, parachuting, scuba diving, motor racing) as they can have an affect on your blood pressure. If you are unsure whether your sport is safe or classed as 'extreme' then talk to your doctor.

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