What is high blood pressure (hypertension)?
Hypertension means blood pressure that stays persistently at or above 140/90 mmHg in clinic. It affects roughly one in four adults in the UK, becoming more common with age, excess weight, high salt intake, inactivity and family history, and many people are unaware they have it. Untreated, it steadily raises the risk of heart attack, stroke, heart failure, kidney disease and dementia — which is why it is worth finding and treating even though it usually causes no symptoms.
Diagnosis is confirmed with ambulatory (24-hour) or home blood pressure monitoring, since readings taken only in clinic can mislead. Assessment also includes blood tests, a urine check and an ECG to look for causes and any early organ effects, with specialist referral for resistant or suspected secondary hypertension.
Common symptoms
- Usually no symptoms at all
- Headaches (only with very high readings)
- Blurred vision (rare, severe cases)
- Nosebleeds (occasionally)
- Breathlessness or chest discomfort if complications develop
- Often discovered at a routine health check
How long will you wait?
Diagnosis and management are usually handled promptly in general practice, but a routine referral to a cardiology or specialist hypertension clinic for resistant or complex cases typically waits several months, with 24-hour monitoring and echocardiography adding further diagnostic queues.
Privately, you can typically see a consultant cardiologist within 3–7 days, with 24-hour monitoring, blood tests and an echocardiogram completed within 1–2 weeks.
NHS England median referral-to-treatment wait: 12.4 weeks, with 2.5 million people waiting over 18 weeks (May 2026). Individual waits vary by trust and urgency.
Treatment options
- Lifestyle changes. Reducing salt, losing weight, regular exercise, limiting alcohol and stopping smoking can lower blood pressure meaningfully.
- ACE inhibitors or ARBs. First-line tablets for many patients that relax blood vessels and protect the kidneys.
- Calcium channel blockers. Widely used first-line drugs, particularly effective in older patients and those of African or Caribbean heritage.
- Diuretics and additional agents. Thiazide-like diuretics and further drugs are added stepwise when blood pressure remains above target.
- Specialist review. Investigation for secondary causes and treatment optimisation when blood pressure resists three or more medications.
What does private treatment cost?
As a guide, a private cardiology consultation typically costs £200–£300, 24-hour ambulatory monitoring £150–£300 and an echocardiogram £300–£500.
Does health insurance cover high blood pressure (hypertension)?
Be aware that hypertension is a chronic condition, and UK private medical insurance does not cover chronic disease management: ongoing prescriptions, routine monitoring and regular reviews sit outside cover and stay with your GP. PMI can cover the initial diagnostic work-up and investigation of complications or suspected secondary causes if these arise after your policy starts. Pre-existing hypertension is typically excluded and may affect underwriting.
Frequently asked questions
I feel fine — do I really need treatment for high blood pressure?
Yes, if readings are persistently raised. Hypertension is often called a silent condition precisely because it damages arteries, heart, brain and kidneys over years without causing symptoms. Treatment decisions are based on your readings and overall cardiovascular risk rather than how you feel, and good control substantially reduces the risk of heart attack and stroke. Lifestyle changes alone are sometimes enough at milder levels.
Why do I need 24-hour or home monitoring before diagnosis?
Because a single clinic reading can mislead in both directions. Many people run higher in a medical setting — 'white coat' hypertension — while others are normal in clinic but high at home. Ambulatory or home monitoring captures your true average across ordinary life, preventing unnecessary lifelong medication in some people and identifying genuinely raised pressure in others. It is the standard for confirming the diagnosis.
Can high blood pressure be reversed without medication?
Sometimes, particularly at milder levels. Losing excess weight, cutting salt, exercising regularly, moderating alcohol and improving sleep can each lower blood pressure by a few points, and together may bring borderline readings back to normal. For higher readings or where cardiovascular risk is elevated, medication is usually needed alongside lifestyle change — and modern tablets are effective, cheap and generally well tolerated.