High blood pressure: why it is often silent and how it is checked

High blood pressure is common in Bangladesh, yet many people who have it feel completely well. Here is why it is called a “silent” condition, how it is checked, when to get urgent help and which doctor to see.

What is blood pressure?

Blood pressure is the force of your blood pushing against the walls of your arteries (the blood vessels that carry blood from the heart to the rest of the body). It is written as two numbers, for example 120/80 mmHg (millimetres of mercury).

• The top number (systolic) is the pressure in the arteries when your heart beats.
• The bottom number (diastolic) is the pressure in the arteries between heartbeats.

Hypertension is the medical word for blood pressure that stays too high over time. The World Health Organization (WHO) defines it in adults as a top number of 140 mmHg or higher and/or a bottom number of 90 mmHg or higher, measured on two different days.

How common is it in Bangladesh?

The National Non-Communicable Disease Risk Factors Survey 2022 used WHO’s STEPS method. Its report, published by the Bangladesh College of Physicians and Surgeons in 2023, found that 23.5% of adults aged 18 to 69 had hypertension. That is nearly one in four. A published analysis of data from the Bangladesh Demographic and Health Survey 2022 found it more often in urban areas (25%) than in rural areas (21%).

Worldwide, WHO estimates that about 1.4 billion adults aged 30 to 79 had hypertension in 2024. About 44% of them (around 600 million people) did not know they had it. These figures come from WHO’s global hypertension report, published in September 2025.

Why does high blood pressure often have no symptoms?

WHO says most people with hypertension do not feel any symptoms. Many people do not know they have it until it causes serious health problems. The way to find out is to have your blood pressure measured.

Many people assume they are fine if they feel well. You cannot rely on this. If high blood pressure is not controlled, it can harm the body over time, even when you feel well.

Over time, uncontrolled high blood pressure can damage:

• The heart, leading to a heart attack, heart failure (when the heart cannot pump enough blood to the body’s organs) or an irregular heartbeat, which can cause sudden death
• The brain, the kidneys and other organs
• The blood vessels at the back of the eyes, which can affect vision

Who is more likely to have it?

Anyone can develop high blood pressure, but the risk is higher if you:

• are older (in the UK, the NHS advises adults aged 40 and over to have their blood pressure checked)
• are from a South Asian background, which the NHS lists as a higher-risk group
• have close relatives with high blood pressure
• eat a lot of salt, a lot of saturated or trans fats, or few fruits and vegetables
• are overweight, or not physically active
• use tobacco or drink alcohol
• have diabetes or kidney disease

WHO also lists air pollution as a risk factor. Sometimes another condition raises blood pressure. Examples include kidney disease, some hormone gland problems and pregnancy.

How is blood pressure checked?

The test itself

A health worker puts a cuff around your upper arm and pumps it up so it squeezes your arm. The pressure in the cuff is then slowly released, and the two numbers are recorded by a machine or by the health worker. The check is quick and painless.

One high reading is not a diagnosis

Blood pressure naturally goes up and down during the day. It can also be affected by things like visiting a health worker. A single reading is usually not accurate enough for a diagnosis, so doctors usually measure it several times before deciding you have hypertension.

What the numbers mean

Different health bodies use slightly different cut-offs. As a general guide:

Your doctor will tell you what your own target should be.

Checking at home and 24-hour monitoring

Your doctor may ask you to check your blood pressure at home with a machine and write down the readings. This is often done in the morning and evening for about a week, and the doctor looks at the average. The cuff needs to be the right size for your arm. Ask the doctor or nurse to show you how to use the machine correctly. Home readings do not replace your check-ups.

Sometimes a doctor arranges 24-hour ambulatory monitoring. You wear a cuff on your arm, connected by a tube to a small recorder worn on a belt. It measures your blood pressure automatically, about every 30 minutes during the day and every hour at night, while you go about your normal day.

Other tests you may be offered

If you have high blood pressure, your doctor may check whether it has affected your organs and look for other risks. Tests commonly include:

• a urine test for protein, blood or sugar, to check for kidney damage
• blood tests for kidney function, blood sugar and cholesterol
• an examination of the blood vessels at the back of the eyes
• an ECG (electrocardiogram), a quick, painless recording of the heart’s rhythm and electrical activity

How often should you be checked?

MedlinePlus (US National Library of Medicine) says all adults aged 18 and over should have their blood pressure checked from time to time. It recommends a check once a year from age 40. People at higher risk may need more frequent checks. Ask your doctor what is right for you.

What does treatment involve?

WHO says healthy habits help prevent high blood pressure. These include eating less salt, eating more vegetables and fruit, being physically active, keeping to a healthy weight, and avoiding tobacco and alcohol. Many people with hypertension also need medicine to lower their blood pressure.

Only a doctor can decide whether you need medicine and which one is right for you. This depends on your readings and your other health conditions. Keep your follow-up appointments, and talk to your doctor about any questions you have about your treatment.

Warning signs: get urgent medical care

Very high blood pressure, usually 180/120 or higher, can become an emergency. If you or a family member has high blood pressure and any of these signs, go to the nearest hospital emergency department straight away:

• severe headache
• chest pain
• shortness of breath or difficulty breathing
• blurred vision or other changes in eyesight
• confusion, not responding normally, or a fit (seizure)
• sudden numbness or tingling, trouble walking, or slurred or difficult speech (possible signs of a stroke)
• nausea or vomiting, dizziness, a nosebleed or an abnormal heartbeat

A woman who is pregnant, or who gave birth in the last few weeks, needs urgent medical help if she has any of these signs. They can point to pre-eclampsia, a serious condition that causes high blood pressure:

• a severe headache
• vision problems, such as blurring or seeing flashing lights
• pain just below the ribs
• vomiting
• sudden swelling of the face, hands or feet
• shortness of breath

For health advice that is not urgent, you can call the government health helpline Shasthyo Batayon on 16263. It is run by the Directorate General of Health Services (DGHS), and you can speak to a doctor 24 hours a day.

Which doctor should you see?

• Medicine specialist or general practitioner (GP): the right first step for most people. They can confirm the diagnosis, arrange tests and manage long-term treatment.
• Cardiologist (heart specialist): if you have chest pain, heart disease or heart failure, or if your blood pressure stays hard to control.
• Nephrologist (kidney specialist): if tests show kidney problems.
• Endocrinologist (hormone and diabetes specialist): if you also have diabetes or a hormone problem is suspected.
• Obstetrician and gynaecologist: if you are pregnant or planning a pregnancy.
• Neurologist: for follow-up care after a stroke.

This article is for general information and does not replace advice from a doctor who knows your health.

Find a doctor

Browse Cardiology doctors in Bangladesh on ratings.com.bd, with chambers and, where listed, visiting hours and phone numbers.

Sources

• WHO – Hypertension fact sheet
• WHO – Uncontrolled high blood pressure puts over a billion people at risk (23 September 2025)
• WHO Western Pacific – Hypertension
• May Measurement Month 2022: Bangladesh (PMC) – cites the National NCD Risk Factors Survey 2022 (STEPS)
• Socio-economic inequalities in hypertension prevalence and care cascade in Bangladesh (BDHS 2022 analysis, PMC)
• MedlinePlus – High blood pressure in adults
• NHS 111 Wales – Blood pressure test
• NHS Borders / BHF – Blood pressure information for South Asians
• NHS South West London – Hypertension guidance for primary care
• University Hospitals Birmingham NHS – 24 hour ambulatory blood pressure monitoring
• University Hospital Southampton NHS – 24 hour blood pressure monitor
• Home monitoring of blood pressure (PMC)
• Southend West Central PCN (NHS) – Know your numbers
• Oxford Health NHS – Time to check your blood pressure?
• Hertfordshire Community NHS Trust – People over 40 urged to get blood pressure checked
• NHS – Pre-eclampsia
• Mayo Clinic – Hypertensive crisis: What are the symptoms?
• Mayo Clinic – High blood pressure: diagnosis and treatment
• Preeclampsia – Symptoms and causes – Mayo Clinic
• Cleveland Clinic – Hypertensive crisis
• DGHS – Dial 16263 for doctor advice 24 hours

This article is general information, not medical advice. It was written by AI from the sources above. It did not pass the automatic check, and an administrator chose to publish it; no doctor or editor has reviewed it. For a diagnosis or treatment, see a registered doctor.