High blood pressure (Hypertension)
Having a raised blood pressure can increase your risk of developing heart disease, heart attacks, kidney disease, stroke and dementia. It rarely has any symptoms so usually the only way you will know if your blood pressure is high is by checking it. We recommend all adults have their blood pressure checked every 5 years, or if it has been high previously every year. If you want to know what your blood pressure is, we have a machine in the waiting room. Blood pressure naturally goes up and down, so we recommend taking three readings a few minutes apart. Pass the results to a receptionist who will log it in your medical record and if raised, pass it to a doctor or nurse who will contact you to discuss it.
If you are diagnosed with high blood pressure it is important to get it under control. This can be by lifestyle modifications including weight loss, increasing physical activity, stopping smoking and making changes changes to your diet and alcohol consumption. Some people need medication to control blood pressure; which tablet you are given will depend on your individual circumstances and your doctor will discuss options with you. We invite all our patients with raised blood pressure for at least annual reviews to check that the medication is still working and to check for any complications.
Heart disease
Heart disease is the leading cause of death in both the UK and worldwide. The main risk factors are raised blood pressure, smoking, diabetes, older age and having high cholesterol. The main symptoms of heart disease are angina, heart attacks and heart failure. If you have had any episodes of chest pain, particularly related to exertion, please discuss this as soon as possible with a doctor. A lot of chest pain is nothing to worry about, but by diagnosing heart disease the risk of becoming very unwell with it can be reduced with a combination of lifestyle changes and medication. We recommend if you have a pain in your chest which isn’t going away within a few minutes you should call 999.
If you have been diagnosed with heart disease, we offer at least annual review to check that your medications are still working. If you develop any new symptoms like ankle swelling, shortness of breath or increased fatigue after a heart attack this could be a sign of heart failure and it is important to discuss this with your GP.
Read more about heart disease here.
Stroke
A stroke is a serious, life-threatening condition that occurs when the blood supply to a part of the brain is blocked off. The earlier a person receives treatment for a stroke, the better the recovery they are likely to have. If you suspect someone may be having a stroke, call 999 immediately.
Signs and symptoms of stroke
F – Face – is their face drooping at one corner of the mouth? This could be a sign of a stroke
A – Arms – can they lift both arms above their head and hold them there? If one side is a lot weaker, this could be a sign of a stroke.
S – Speech – if their speech is slurred or not making sense, this could be a sign of a stroke
T – Time – time to call 999 if any of the signs above.
The main risk factors for stroke are raised blood pressure, smoking, diabetes, older age and having high cholesterol. An irregular heart rhythm known as atrial fibrillation (AF) can also increase the risk of having a stroke. You can significantly reduce your risk of having a stroke through a healthy lifestyle, such as eating a healthy diet, taking regular exercise, drinking in moderation and not smoking. Treating blood pressure and high cholesterol also helps to reduce the risk of a stroke. This is especially important if you have had a stroke before as your risk of having another (potentially more serious) stroke in the future is greatly increased.
We offer all our patients who have had strokes in the past regular reviews to ensure your risk of a further stroke remains as low as possible. We recognise that patients who have had strokes may need more support at home and in day to day living and can direct you to appropriate services.
Asthma
Asthma is a common long-term condition that can cause cough, wheeze, chest tightness and breathlessness. The severity of asthma varies from person to person. In many cases it can be very well controlled, usually with inhaled medication. We offer all our patients with asthma an annual review to check their inhalers are still controlling their symptoms, and you can book an appointment with one of our nurses if your symptoms are less well controlled than you would like. If you think you may have asthma, make an appointment to see a doctor to discuss your symptoms.
If you are happy with your current treatment you may complete your asthma review using this online form.
COPD
Chronic obstructive pulmonary disease (COPD) is the name for a collection of lung diseases including chronic bronchitis, emphysema and chronic obstructive airways disease. Typical symptoms of COPD include increasing breathlessness when active, a persistent cough with phlegm and frequent chest infections. The main cause of COPD is smoking. If you think you might have COPD, discuss with a doctor or nurse. It is possible to diagnose COPD with tests that can be done at the health centre, although in some cases we may recommend that you visit the hospital. The best way to prevent COPD is by stopping smoking. The main treatment of COPD is with inhalers. We offer all our patients with COPD an annual review to check their inhalers are still controlling their symptoms, and you can book an appointment with one of our nurses if your symptoms are less well controlled than you would like.
Diabetes
Diabetes is a long term condition that can cause a person’s blood sugar to become too high. There are two main types of diabetes; type 1 diabetes and type 2 diabetes. Type 2 diabetes is the most common form in the UK, 90% of people with diabetes have type 2. Symptoms of diabetes include feeling tired, thirsty and passing more urine than normal. Some people may also notice blurred vision and wounds that heal very slowly. People with diabetes can also get a lot of thrush, which has symptoms of itching or soreness and occasionally a white discharge in the genital region. A lot of type 2 diabetes is now being diagnosed incidentally through blood tests that are performed for other reasons.
Pre-diabetes
Pre-diabetes was previously known as “Impaired Fasting Glycaemia” and is where the blood sugar is raised; putting a person at higher risk of diabetes, but not yet diabetic. A lot of pre-diabetes can be reversed by reducing sugar in your diet, losing weight and increasing physical activity. If you have pre-diabetes we will offer an annual review of this to check it hasn’t progressed into type 2 diabetes.
If untreated, high blood sugars can cause a lot of problems with blood vessels, kidneys and eyes. Diabetes can increase the risk of heart disease and stroke. In severe cases people can develop kidney failure and blindness. These problems are avoidable by keeping the blood sugar under control. This can be through diet and lifestyle changes, but many people will need medication. There are several oral medications and people will sometimes need injections of insulin to lower their blood sugar. Your treatment will be personalised to you and monitored on at least an annual basis.
There is lots of useful information on both Type 1 and Type 2 diabetes on the Diabetes UK website.
Chronic kidney disease
Chronic kidney disease is a long term condition where the kidneys work less effectively. It will not usually cause symptoms until it is in an advanced stage. It is usually detected at earlier stages through routine blood testing as part of reviews for other conditions, for instance at the annual review for high blood pressure or heart disease. It can also be picked up on routine blood testing in previously healthy people. Chronic kidney disease is common and the major cause is advancing age. People with high blood pressure and diabetes are at greater risk of developing the condition.
There is no treatment for chronic kidney disease, but reducing the risk of it progressing can be achieved by keeping a high blood pressure under control, and by controlling blood sugar levels in people with diabetes. If chronic kidney disease progresses into the advanced stages some patients may need dialysis to take over the job of the non functioning kidneys. However most people will not need this, and for the majority chronic kidney disease is monitored by blood and urine tests at an annual review.