Blood pressure is the force of blood against the walls of the major arteries, normally measured at arm's brachial artery where pressure most nearly corresponds to that of blood leaving the heart. A dual reading is taken to record pressure for both the contracting and resting heart. Pressure varies with age: a normal young adult pressure is about 120/80.

Hypotension is abnormally low pressure which can accompany some illnesses, but is a bonus in general healthy life. Hypertension, abnormally high pressure, increases the risk of heart disease, strokes and kidney disease. Generally speaking the incidence of hypertension is higher in men than women. Among men blood pressure tends to in crease progressively from the early twenties, while with women the rise is more marked after the menopause. In younger women, it can remain symptomless until exacerbated by, for example, pregnancy or strenuous exercise (hypertension puts extra pressure on the heart and exercise increases this still further). In cases of sustained hypertension your doctor will prescribe drugs such as beta blockers, often in association with diuretics. These control pressure and its effects artificially, and if taking such drugs you should not rely on the pulse-rate method of controlling exercise. New 'danger factors' are constantly being discovered: below are some of the better established guidelines for hypertension.

Avoiding Hypertension

• Have your blood checked regularly; say every 3 years before you reach 35, then annually. This is easily done by your doctor. Additional readings should be taken before you start taking the contraceptive pill and every time you renew your prescription, when pregnant and each time you renew your hypertension drug prescription.l Note that the combined contraceptive pill has the effect of raising blood pressure as well as increasing the likelihood of thrombosis (clotting). Women between the ages of 35 and 40, when blood pressure increases naturally, should move on to another contraceptive method. Annual readings, whatever your age, are advisable if you have diabetes, or if your parents had high blood pressure. If both parents suffered from high blood pressure their children have about a 50:50 chance of developing it later in life.

• Smokers are among those at risk of developing hypertension, and any smoker diagnosed as having high blood pressure will have been strongly advised by their doctor to try and give up smoking, or at least cut down significantly. A diet high in polyunsaturates and low in saturated fats is widely thought to help reduce the risks of developing hypertension. This involves cutting down on animal fats, particularly fatty cuts of meat and full fat milk and cheeses, and eating more fish, lean meats, skimmed milk and so on.

• Reduce your salt intake: salt is thought to be a major food hazard in hypertension, particularly in severe cases. Avoid high-salt foods such as crisps and anchovies, reduce the amount of salt added in cooking and break the habit of adding it to cooked food. Reduce sugar, too. Recent research indicated that combined with a high salt intake sugar may also have a detrimental effect.

• Keep fit: regular exercise strengthens the heart, lowers blood pressure, counteracts stress - another danger factor in hypertension.

• Don't let yourself get overweight; this exacerbates and can even cause hypertension.

• Eat plenty of fruits, vegetables and grains. Get plenty of calcium, too, preferably from low-fat foods like cottage cheese. Reduce your caffeine intake.

• Include garlic (or tastefree capsules) in your diet: it thins the blood and aids circulation.

• Biofeedback has been found to help reduce blood pressure: patients follow readings on biofeedback machines which document their progress in controlling the autonomous nervous system. Some other therapies such as meditation, autosuggestion, autogenics and self-hypnosis have been found helpful, too. Do not try these as an alternative to drugs prescribed by your doctor.

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