This section will provide you with answers to frequently asked question about different long term conditions.

High Blood Pressure

What is high blood pressure?
Blood pressure is the measure of how strongly blood presses against the walls of your arteries. Blood pressure normally rises and falls throughout the day, but it can cause health problems if it stays high for a long time. High blood pressure or hypertension can lead to stroke, a heart attack, or kidney disease – leading causes of death in the UK and affecting 25,301 people in Dumfries and Galloways. 1

What are the signs and symptoms?
High blood pressure usually has no signs or symptoms so many people do not realise they have it. The only way to know your blood pressure reading is to have it measured by your doctor or practice nurse. High blood pressure is more common as you get older so having it checked regularly is very important.

What causes high blood pressure?
High blood pressure is usually a result of a number of risk factors. Several factors that are beyond your control can increase your risk for high blood pressure. These include your age, gender, family history or ethnic origin. Most risk factors you can control and are to do with lifestyle factors including, being overweight, eating an unhealthy diet, smoking, drinking too much alcohol and not exercising. Making changes to these lifestyle risk factors can significantly reduce high blood pressure in some people, improve your overall health and reduce your risk of heart disease and strokes.

How is your blood pressure measured?
Measuring your blood pressure can be carried out at your doctor’s surgery or at some pharmacies. A cuff is placed around your arm and then inflated, while a machine records your blood pressure. For more reliable readings, the doctor may use a stethoscope to listen to your blood flow. 1
When you have your blood pressure checked, you will be given two numbers. The first number is the pressure when your heart beats (this is called systolic pressure) and the second number is the pressure when your heart relaxes between beats (diastolic pressure). Both pressures are measured in millimetres of mercury, written as ‘mmHg’. 1

Normal Blood Pressure Levels
systolic: less than 120 mmHg
diastolic: less than 80 mmHg
At risk (prehypertension) systolic: 120–139 mmHg
diastolic: 80–89 mmHg
High systolic: 140 mmHg or higher
diastolic: 90 mmHg or higher

How is high blood pressure diagnosed?
Before being diagnosed with high blood pressure, your doctor will take a several blood pressure readings over a few days or weeks to make sure that the high reading is consistent. Your doctor may also give you a special machine to record your blood pressure at regular intervals at home. A follow up appointment with your doctor will be arranged to discuss the results. Typically, you are diagnosed with high blood pressure if it is consistently higher than 140/90mmHg.

How is high blood pressure treated?
If you have been diagnosed with high blood pressure, your doctor may prescribe you
medication. The medication you take will be tailored to your needs and you may need to
try several different types of medication before you find the one that suits you best.
These usually need to be taken once a day.
Common blood pressure medications include:

  • ACE inhibitors – such as enalapril, lisinopril, perindopril and ramipril
  • angiotensin-2 receptor blockers (ARBs) – such as candesartan, irbesartan, losartan,
    valsartan and olmesartan
  • calcium channel blockers – such as amlodipine, felodipine and nifedipine or
    diltiazem and verapamil.
  • diuretics – such as indapamide and bendroflumethiazide
  • beta-blockers – such as atenolol and bisoprolol
  • alpha-blockers – such as doxazosin
  • renin inhibitors – such as aliskiren
  • other diuretics – such as amiloride and spironolactone

The medication recommended for you will depend on things like how high your blood pressure is and your age.While many people treat their high blood pressure with medication, it is possible to lower your blood pressure naturally by making lifestles changes. You should talk to your doctor about the best ways to reduce your blood pressure. The following list includes some of the ways you could change your lifestyle 1 :

Reduce your salt intake
Eat at least five portions of fruit and vegetables every day
Lose weight if needed
Reduce your fat intake
Reduce your sugar intake
Give up smoking
Reduce your alcohol intake
Be more active
Reduce your stress levels and take time to relax

Useful organisations
All organisations are UK wide unless otherwise stated.

Alcohol Focus Scotland
Tel: 0141 572 6700
Email: enquiries@alcohol-focus-scotland.org.uk
Website: www.alcohol-focus-scotland.org.uk
Alcohol Focus Scotland is committed to improving the quality of people’s lives by changing

Scotland’s drinking culture – promoting responsible drinking behaviour and discouraging
drinking to excess.

Blood Pressure Association
Tel: 0845 241 0989
Website: www.bpassoc.org.uk
Provides a wide range of information on living with high blood pressure, types of
medication and lifestyle changes. You can become a member and receive regular
magazines and information updates.

British Heart Foundation (BHF)
Heart Helpline: 0300 330 3311
Website: www.bhf.org.uk
The Heart Helpline provides information from cardiac nurses on heart and health issues.

Chest Heart & Stroke Scotland
Advice Line Nurses: 0808 801 0899
Email: adviceline@chss.org.uk
Website: www.chss.org.uk
CHSS improves the quality of life for people in Scotland affected by chest, heart and stroke
illness, through medical research, influencing public policy, advice and information and
support in the community

Diabetes UK Scotland
Careline Scotland: 0345 123 2399
email: carelinescotland@diabetes.org.uk
Website: www.diabetes.org.uk/In_your_area/scotland/
Diabetes UK Scotland is dedicated to putting the interests of people with diabetes first,
through the best in campaigning, research and care.

Drinkline Scotland
Helpline: 0800 7 314 314 (9am to 11pm Monday to friday)
Drinkline offers free, confidential advice and support, information and self-help materials.

DVLA
Drivers Medical Enquiries
Tel: 0300 790 6806
Website: www.gov.uk/government/organisations/ driver-and-vehicle-licensing-agency
To find out if you need to tell dvla about a medical condition: www.direct.gov.uk/
drivingandMedicalconditions

Heart UK
Helpline: 0845 450 5988 (Monday – Friday from 10am to 3pm – Advice in punjabi Urdu and
Hindi available on fridays.)
Email: ask@heartuk.org.uk
Website: www.heartuk.org.uk
Heart UK are committed to raising awareness about the risks of high cholesterol, lobby for
better detection of those at risk, fund research into improved treatment and support
health professional training. It’s also why we work with a variety of partners to promote
healthier lifestyle options

Smokeline
Tel: 0800 84 84 84 (9am – 9pm, seven days a week)
Also text or chat online 7 days a week: 8am – 10pm at: www.canstopsmoking.com
Smokeline is Scotland’s national stop smoking helpline. Smokeline makes it easy for you to
talk to someone who knows all about quitting smoking. Smokeline advisers give free advice
and information about how to stop smoking. They can work with you to come up with a quit
plan that’s right for you and your lifestyle. Advisers also provide information about the free
stop smoking services provided by every health board in Scotland – so it’s easy to find out
what you need to know

Stroke Association
Stroke Helpline: 0303 3033 100
Email: info@stroke.org.uk
Website: stroke.org.uk
Contact us for information about stroke, emotional support and details of local services and
support groups.

1 Health and Social Care Partnership Strategies Plan 1, Dumfries and Galloways Change http://www.dg-
change.org.uk/wp-content/uploads/2015/10/0175-15-Final-Health-Social-Care-Strategic-Plan.pdf

2 Blood Pressure Guide, Blood Pressure Association. http://www.bpassoc.org.uk/blood-pressure-
information/blood-pressure-guide/

3 Stroke Association. https://www.stroke.org.uk/resources/high-blood-pressure-and-stroke

4 Stroke Association. https://www.stroke.org.uk/resources/high-blood-pressure-and-stroke
For support Email: support@lgbtplus.org.uk Call FREE on 0800 0209653
Dumfries & Galloway LGBT Plus is a Scottish registered charity SC045377

HIV

What is HIV?
HIV stands for Human Immunodeficiency Virus. HIV destroys certain blood cells that are
crucial to the normal functioning of your immune system, which defends the body against
infections and disease.

What are the signs and symptoms?
Most people who are infected with HIV experience a short, flu-like illness that occurs two
to six weeks after infection. The most common symptoms are:
• fever (raised temperature)
• sore throat
• body rash

Other symptoms can include:
• tiredness
• joint pain
• muscle pain
• swollen glands (nodes).
The symptoms, which can last up to four weeks, are a sign that your immune system is
putting up a fight against the virus. These symptoms can all be caused by conditions other
than HIV, and do not mean you have the virus. 1
Who can get HIV?
Anyone can be infected with HIV, no matter…
…your age
…your sex
…your race or ethnic origin
…who you have sex with

How is HIV spread?
Only five body fluids can contain enough HIV to infect someone:
…blood
…semen
…rectal fluid
…vaginal fluid
…breast milk

HIV can only get passed when one of these fluids from a person with HIV gets into the bloodstream of another person – through broken skin, the opening of the penis or the wet linings of the body, such as the vagina, rectum or foreskin. It is a fragile virus and does not live very long outside the body. HIV cannot be transmitted through sweat or urine or through the air.
The two main ways that HIV can get passed between you and someone else are:- through unprotected sex (anal or vaginal sex without a condom)
– by sharing needles or other equipment to inject drugs (including steroids)

Other ways HIV can be passed include:
…using a contaminated needle, syringe or other injecting equipment
…transmission from mother to baby during pregnancy, birth or breastfeeding
…through oral sex or sharing sex toys (although the risk is significantly lower than for anal and vaginal sex)
…healthcare workers accidentally pricking themselves with an infected needle (this risk is extremely low)
…blood transfusion (now very rare in the UK, but still a problem in developing countries)

How does HIV infect the body?
HIV infects the cells of your immune system, your body’s defence system, causing progressive damage and eventually making it unable to fight off infections. The virus enters the cells in the immune system called CD4 cells + ve lymphocyte cells, which protect your body against various bacteria, viruses and other germs. It uses the CD4 cells to make thousands of copies of itself. These copies then leave the CD4 cells, killing them in the process. This process continues until eventually the number of CD4 cells, also called your CD4 count, drops so low that your immune system stops working. This can take about 10 years, during which time you will feel and appear well. 2

How to get tested for HIV?
The only way to find out if you have HIV is to have an HIV test. The earlier HIV is detected, the more likely it is that treatment will be successful. There are various places you can go to for an HIV test, including:2
– sexual health or genitourinary medicine (GUM) clinics
– clinics run by charities such as the Terrence Higgins Trust
– some GP surgeries
– some contraception and young people’s clinics

– local drug dependency services
– an antenatal clinic, if you’re pregnant
– a private clinic, where you will have to pay

Most HIV tests in the UK involve taking a small sample of blood to detect the presence of antibodies to HIV. It may take up to three months for antibodies to show up in a test after a person has been infected.
If your test is positive, you will be referred to a specialist HIV clinic where you’ll have more blood tests to show what effect HIV is having on your immune system and be able to discuss treatment options.

How is HIV Treated?
HIV is treated with antiretrovirals (ARVs), which work against the HIV infection by slowing down the spread of the virus in the body. A combination of ARVs is used because HIV can quickly adapt and become resistant to one single ARV. Patients tend to take three or more types of ARV medication. This is known as combination therapy or antiretroviral therapy (ART). HIV treatment significantly reduces the risk of someone with HIV passing it on.

Useful Organisations
African HIV Policy Network
Tel:0208 555 5778
Email:deryck.ahpn@btconnect.com
Website: http://www.ahpn.org.uk/
The AHPN is an alliance of African community-based organisations working for fair policies for people living with HIV and AIDS in the UK.

Foodchain
Tel: 020 7843 1800
Website: http://www.foodchain.org.uk/
The Food Chain provides nutritional services including home delivered meals, essential groceries and nutrition advice to men, women and children who are living with HIV.

HIV Scotland
Tel: 0 131 558 3713
Website: http://www.hivscotland.com/
Working across all sectors and areas of Scotland, HIV Scotland seeks to improve the health and wellbeing of people living with HIV and affected communities, and to prevent the spread of HIV infection.

GMFA
Website: http://www.gmfa.org.uk/
GMFA is the UK’s leading gay men’s health charity.

LGBT Youth
Tel: 01387 255058
Email: julieann.karayilan@lgbtyouth.org.uk
Website: https://www.lgbtyouth.org.uk/

LGBT Youth Dumfries and Galloway provide a range of services for young people NAM
Tel: 020 7837 6988
Email: info@nam.org.uk
Website: http://www.aidsmap.com/
NAM is an award-winning community based HIV information provider.

National Aids Trust
Tel: 020 7814 6767
Email: info@nat.org.uk
Website: www.nat.org.uk

Positively UK
Tel: 020 7713 0444
Email: info@positivelyuk.org
Website: http://positivelyuk.org/
Positively UK is a national charity providing support for women, men and young people living with HIV.

Terrence Higgins Trust
Tel: 012 2444 3578
Email: info.scotland@tht.org.uk
Website: http://www.tht.org.uk/
Terrence Higgins Trust (THT) is the UK’s largest HIV and sexual health charity with centres across England, Scotland and Wales. THT provides information and advice about HIV and sexual health and offer a range of services including sexual health checks, counselling and support groups.

Waverly Care
Tel: 0131 558 1425
Email: contact@waverleycare.org
Website: http://www.waverleycare.org/
Waverley Care is Scotland’s leading charity providing care and support to people living with HIV and Hepatitis C and to their partners, families and carers.

1 Symptoms of HIV, HIV and AIDS, NHS Choices. http://www.nhs.uk/Conditions/HIV/Pages/Symptomspg.aspx

2 Causes of HIV, HIV and AIDS, NHS Choices. http://www.nhs.uk/Conditions/HIV/Pages/Causes.aspx