“I feel fine,” she says, brushing the crumbs off her top. “What’s the fuss for?”

I have dashed to my patient’s bedside after being summoned about her blood pressure of 220/105 mm Hg, thrice checked. In my head, I am running through a list of catastrophic consequences, including a brain haemorrhage, that could destroy her life in an instant.

The hospital doesn’t have an intensive care unit. How and where will I evacuate her? If a medication patch doesn’t work, can we run an infusion? At 82, she looks a decade younger but has she written an advance care directive in case she cannot make decisions for herself?

While the nurse and I act, the patient happily says at her age no one cares about blood pressure. Having seen a friend survive a hypertensive brain haemorrhage but left with lifelong disability, I disagree.

But her blithe response reminds me of the relevance of guidelines issued by the National Hypertension Taskforce of Australia.

Hypertension, defined as a blood pressure over 140/90, is by far the leading risk factor for preventable deaths. About 10 million people around the world, 25,000 of them in Australia and 75,000 in the UK, die annually from hypertension-related conditions such as stroke, heart and kidney disease and vascular dementia.

High blood pressure is common enough to have entered the vernacular – as in “this person raises my blood pressure”. But of the one in three Australians that has hypertension, half don’t even know it.........

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