High Blood Pressure is Damaging Your Brain, Sight and Sex Life, Here’s How to Bring it Down

Changes to eyesight are often the first major red flag of high blood pressure. 

“These patients may present with a reduction in vision, blurred vision and headaches as the first sign something’s wrong,” says Dr Farhan Shahid, a consultant interventional cardiologist at The Harborne Hospital.

High blood pressure can damage the small arteries in the eyes, making them thicker and less efficient. “It takes very little for these arteries to narrow, because they’re already so tiny,” says Dr Castiello.

High blood pressure is also the leading cause of less common but more serious haemorrhagic strokes. Damaged blood vessels can burst, causing bleeding in the brain. Sometimes, the damage isn’t apparent at first but can accumulate over long periods.

When blood vessels narrow, stiffen or even leak, it reduces blood flow and can lead to small areas of tissue damage, known as “silent strokes”. 

Dr Castiello says: “These tiny, micro-strokes may not cause obvious symptoms at first but increase the risk of cognitive decline and vascular dementia, caused by impaired blood flow to the brain.” 

Research has consistently linked high blood pressure in midlife and beyond to an increased risk of dementia, as well as memory problems, slower thinking and other cognitive difficulties in later life. 

A recent Chinese study published in the journal Nature Medicine found that giving people help to tackle hypertension cut their risk of dementia by 15 per cent.

High blood pressure may also increase the risk of Alzheimer’s disease, since reduced blood flow and chronic stress on brain tissue can accelerate the build-up of harmful proteins. “The brain’s clearance mechanisms are impacted,” says Dr Castiello.

For men with chronic high blood pressure, erectile dysfunction is a common but rarely talked-about problem. “I think the prevalence is a lot higher than we’re aware,” says Dr Shahid. “Many patients are not comfortable discussing it.”

Just like other organs of the body, the penis relies on good blood flow to work properly, and when blood vessels become narrower or less responsive, it is more difficult to achieve or maintain an erection.

Even less commonly discussed is the potential impact on women’s libidos, but it is thought that reduced blood flow to the vagina could also cause a loss of sex drive.

Some research has shown a link between hypertension and sexual dysfunction in women, including reduced desire and satisfaction.

Dr Shahid points out that factors contributing to hypertension, including excess weight, poor diet and low fitness levels, can also affect sexual function. “Being overweight and inactive can reduce circulation, disrupt hormone balance and lower energy levels, all of which feed into the problem,” he says.

We should be eating no more than 6g, or one level teaspoon, of salt per day, but most of us eat too much. Seventy-five per cent of our intake comes from processed foods such as ready meals, processed meats, takeaways and even bread and cereals.

We should get used to checking food labels, says Dr Shahid. “Looking closely at where you’re getting additional salt and cutting down will be really helpful.” The FoodSwitch app allows you to scan barcodes and suggests healthier alternatives.

For those who insist on adding salt to everything, Dr Castiello suggests swapping to a lower-sodium, potassium-enriched version. “Potassium helps the body excrete excess sodium and relaxes blood vessel walls,” she says.

3. Try a DASH diet

The DASH diet, short for Dietary Approaches to Stop Hypertension, focuses on foods which support healthy blood vessels, especially potassium, magnesium and calcium, while being low in salt, saturated fat and sugar.

“Fruit and vegetables; wholegrains; lean protein such as fish and beans; and good fats such as extra-virgin olive oil, nuts and seeds are what we should be eating – not processed food,” says Dr Castiello.

Like a growing number of scientists, Dr Castiello believes there is a strong link between the gut microbiome and blood pressure. “Balancing the bacteria in the gut supports blood vessel function,” she says.

Fermented foods such as kimchi, kefir, sauerkraut, live yogurt and miso are good for the gut and have also been found to cause significant reductions in blood pressure.

One recent study of more than 20,000 Americans found that those who ate more gut-friendly foods were 13 per cent less likely to have hypertension.

Recent data, spanning several decades and including 20,000 people, suggest that blood pressure increases in line with alcohol consumption, starting from as little as one glass of wine per day.

According to the British Heart Foundation, regularly having more than four alcoholic drinks in a sitting can prevent receptors in the brain that help regulate blood pressure from working properly.

Dr Castiello recommends cutting it out entirely if possible. “It increases your blood pressure by volumes,” she says. “One glass of wine occasionally to be convivial is the most you should be drinking, and a reduction can make a significant difference quickly.”