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To help you navigate the information provided in this resource, it has been grouped to reflect the different aspects of an NHS Health Check.

You can scroll down to find the information you are interested in. It is provided in the following order:

Accessing the NHS Health Check in Surrey

What services are still available to you if you are not eligible for an NHS Health Check

Why is knowing your cardiovascular disease risk so important

What does your heart disease risk score mean

Obesity and weight management services and resources

Smoking services and resources

Alcohol and substance misuse services and resources

What is hypertension (high blood pressure)

What is cholesterol and what causes it to be high

Blood glucose and diabetes explained

How dementia and heart disease can be linked

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Use this section to:

learn about the FREE services available to support you to quit smoking and benefit from becoming smoke free.

find out simple ways of helping or assisting your quit journey.

explore the harm that smoking can have during pregnancy and how to access support.

explore the benefits of switching from smoking to vaping as a quit tool, and how to quit vaping if you are at this stage in your quit journey.

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Image Description: A man and a child playing, depicting a happy and healthy lifestyle. Branding for One You Surrey smoking service displaying text that promotes the benefits of quitting smoking.

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If you are a smoker, you can access FREE 12 weeks of support and quit aids with a qualified stop smoking advisor!

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Go Smoke Free in Surrey: Quit smoking today to enhance your health and wellbeing. Begin your journey to a healthier future now.

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Image Description: three examples of what the Smoke Free mobile phone application will look like during use.

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Download the Smoke Free App for FREE access to pro features, 24/7 support and quit aids posted to your door to help you quit smoking for good.

Use the following link to download today:

Smoke Free App - Subscription Activation

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Use this section to:

learn what vascular dementia is and why we should all be aware of its risks to our long term health.

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Use this section to:

learn what cholesterol is and what effect is has on your cardiovascular disease risk.

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Use this section to:

understand what blood pressure is and what your NHS Health Check result means.

learn about the risks high blood pressure can cause for your heart, and how to reduce this risk.

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Image Description: NHS Digital Weight Management programme branding.

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If you have high blood pressure and/or diabetes, along with obesity then you can access the free NHS Digital Weight Management programme.

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The NHS Digital Weight Management Programme supports adults living with obesity who also have a diagnosis of diabetes, hypertension or both, to manage their weight and improve their health.

It is a 12-week online behavioural and lifestyle programme that people can access via a smartphone or computer with internet access

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The NHS Digital Weight Management Programme

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The NHS Digital Weight Management Programme supports adults living with obesity who also have a diagnosis of diabetes, hypertension or both, to manage their weight and improve their health. It is a 12-week online behavioural and lifestyle programme that people can access via a smartphone or computer with internet access

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Image Description: patient having their blood pressure taken during an examination.

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If you are not eligible for an NHS Health Check, you can (and should) still get your blood pressure checked!

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What is blood pressure?

Blood pressure is the pressure of blood in your arteries. Your arteries are the vessels (tubes) that carry blood from your heart to your brain and the rest of your body. You need a certain amount of pressure to get the blood moving around your body.

Your blood pressure naturally goes up and down throughout the day and night, and it's normal for it to go up while you're moving about. It's when your overall blood pressure is always high, even when you are resting, that you need to do something about it.

Blood pressure is measured using two numbers:

Systolic pressure: this is the higher of the two numbers. It's the pressure against your arteries when your heart is pumping blood around your body.

Diastolic pressure: this is the lower of the two numbers. It shows how much pressure is in your arteries when your heart relaxes between beats.

What is high blood pressure (hypertension)?

The medical term for high blood pressure is 'hypertension', and it means your blood pressure is always too high. This means your heart is working harder when pumping blood around your body.

High blood pressure ( hypertension) affects more than one in four adults in England. High blood pressure is not typically something you can feel.

However, you are more likely to develop coronary heart disease or have a stroke if you have high blood pressure. In England, high blood pressure is the number one risk factor for cardiovascular disease related death and disability. This is why it is important to know your blood pressure numbers.

What is a healthy or normal blood pressure?

There are two categories of normal blood pressure:

Normal blood pressure is usually considered to be between 90/60 mmHg and 120/80 mmHg. For over-80s, because it's normal for arteries to get stiffer as we get older, the ideal blood pressure is under 150/90 mmHg (or 145/85 mmHg at home).

High-normal blood pressure, sometimes called 'pre-hypertension', is when you don't have an ideal blood pressure but you also don't have high blood pressure. It's usually considered to be between 120/80 mmHg and 140/90 mmHg. Being at this level might prompt you to live a healthier lifestyle so you don't develop high blood pressure.

The NHS has a handy tool to show where your blood pressure is on a chart.

What causes high blood pressure?

In most cases, there isn't a specific reason for the cause of high blood pressure, but most people develop it because of their diet, lifestyle or medical condition.

You might be more at risk if you:

are over the age of 65

have someone in your family with high blood pressure

are someone who smokes

drink too much alcohol

eat too much salt and not enough fruit and vegetables

don't get enough exercise

are overweight, especially around your mid-section.

People living in deprived areas are also at higher risk of having high blood pressure, as well as people who are of black African or black Caribbean descent. Changes in your diet and increasing activity levels will help improve your blood pressure.

How do I get a blood pressure check?

That is easy! You can have your blood pressure checked at your GP practice or at your local pharmacy. The check only takes 10 minutes and it could save your life.

A new service finder on NHS.uk allows healthcare professionals and patients to search for and find a pharmacy that offers free blood pressure checks. The tool explains who is eligible to go to a pharmacy to get their blood pressure checked and can be searched using a postcode, with the nearest pharmacy listed first.

You can also view this map to find a pharmacy providing BP checks in Surrey, make sure you contact them to double check their availability.

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Information on blood pressure and atrial fibrillation checks and where to get a blood pressure check in Surrey

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Use this section to:

learn what a QRISK score is and why it is such an important part of your NHS Health Check.

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Use this section to:

explore the effects of alcohol on your heart health.

access simple advice on how to reduce your alcohol intake.

learn what NHS support is available if you are suffering with drug addiction, particularly if your mental health is being affected.

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Use this section to:

learn what blood glucose is and what effect it has on your diabetes risk.

find out more about the NHS Diabetes Prevention Programme which is free for all patients who have been identified as pre-diabetic.

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Image Description: text that reads Non-HDL Non-High Density Lipoproteins, on a red background.

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A short British Heart Foundation video explaining what cholesterol is.

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Image Description: image displaying a cartoon blood pressure monitor.

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A short video explaining your blood pressure results and what they mean.

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Image Description: A man in a lab coat. The photo depicts the individual who is explaining his research on dementia and heart disease for which this link leads to.

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A short overview of what vascular dementia is, and why it is so important to be aware of early signs. The NHS Health Check should provide advice to all individuals aged 65-74.

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Key cause of restricted blood flow to the brain in vascular dementia discovered

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Use this section to:

learn more about what obesity is and how it effects cardiovascular disease risk.

access resources for losing weight and getting active with simple and effective changes in lifestyle.

learn about nutritional guidance when living with a variety of different medical conditions.

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Image Description: i-access drug and alcohol services logo. They are the provider of the drug and alcohol free provision in Surrey.

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Access support to stop drinking, reduce drug misuse, or if you want to support someone close to you in these areas.

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i-access Drug & Alcohol Service : Surrey and Borders Partnership NHS Foundation Trust

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i-access is a drug and alcohol service for people in Surrey.

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Explore what high blood sugar means, and what your NHS Health Check results may signify.

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Find out about high blood sugar (hyperglycaemia), including what the symptoms are, what a high blood sugar level is and how to control your blood sugar.

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Image Description: Lady celebrating with both arms flexing their muscles.

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Explore the three free services that are available to eligible individuals who are looking for help with their weight management!

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Free Surrey weight loss services for lasting health and wellbeing. Benefit from Health coach guidance and tailored nutrition and exercise plans.

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Image Description: an image displaying alcoholic drinks with colourful animations seeping out of the drinks.

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Explore the effects alcohol can have on your health, particularly in relation to your heart.

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Too much alcohol can raise blood pressure and weight, increasing risk of a heart attack, stroke and type 2 diabetes. Senior Cardiac Nurse Christopher Allen finds out more from Professor Sir Ian Gilmore, Consultant Physician and Gastroenterologist at Royal Liverpool University Hospitals.

1. What is alcohol?

Alcohol is a 'depressant' drug, meaning your brain's control of your body is being slowed down.

Even a small amount can affect important functions like speech and movement. Drinking very large amounts all at once can slow your heart rate and breathing down to a dangerously low level.

If you drink regularly, you might feel like alcohol doesn't affect you as much, but this usually means you've developed a tolerance to some of the effects.

Remember, the more you drink, the more damage you can cause.

Want to get fit and healthy?

Sign up to our fortnightly Heart Matters newsletter to receive healthy recipes, new activity ideas, and expert tips for managing your health. Joining is free and takes two minutes.
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2. How does alcohol affect my heart?

There is a very clear link between regularly drinking too much alcohol and having high blood pressure. Over time, high blood pressure (hypertension) puts strain on the heart muscle and can lead to cardiovascular disease (CVD), which increases your risk of heart attack and stroke.

Those who drink regularly and consume more than the lower risk guidelines are likely to be advised to cut down or stop drinking completely.

3. How much can I drink safely?

There is no drink, such as red wine or beer, that can be proven 'better' than another

New guidance published in January 2016 by the UK Chief Medical Officers says that both men and women are safest not to drink regularly more than 14 units per week, to keep health risks from drinking alcohol to a low level, and that if you do drink as much as 14 units per week, it is best to spread this evenly over 3 days or more.

Drinking alcohol to excess can cause other serious health conditions, such as cardiomyopathy (where the heart muscle is damaged and can't work as efficiently as it used to) and arrhythmias ( abnormal heart rhythms). Some of these conditions can increase your risk of stroke.

4. Aren't there some benefits to drinking alcohol?

Overall, the risks far outweigh any possible benefits.

The newest evidence suggests benefits for heart health of drinking alcohol are less and apply to a smaller group of the population than previously thought. The only group who might see some benefit overall in the UK is women over the age of 55, but and even then only at low levels of drinking - around 5 units a week or less.

There is certainly no reason to start drinking alcohol if you don't already. There is also no drink, such as red wine or beer, that can be proven 'better' than another.

5. I have a heart condition. Should I give up alcohol?

If you already have a condition that causes arrhythmias, alcohol may increase that risk. This can be especially dangerous in those who have inherited heart rhythm conditions.

Heavier drinking (binge drinking) can also bring on a first episode of arrhythmia; once this has happened for the first time, you're at an increased risk in the future.

When you stop drinking, or reduce the amount you drink, you'll see rapid improvement in your blood pressure (you should see a reduction within a few days).

If you have alcoholic cardiomyopathy, stopping drinking can lead to improvement or even recovery for many.

6. I've had heart surgery. When can I drink alcohol again?

In hospital, your medications are adjusted to control your blood pressure, but you aren't drinking alcohol at that time. Back home, if you start drinking regularly again and your blood pressure changes, your GP can alter your medications.

Your doctor will often advise you when it's safe to start drinking alcohol again, from a medical perspective. Psychologically, however, many people feel low in mood after they're discharged home, especially following open heart surgery.

Until this feeling passes, it's usually best not to start drinking alcohol again, as it can make these feelings much worse and last for longer.

7. Will alcohol interact with my heart medications?

For a lot of people on long-term medications, alcohol can make the drug less effective.

If you take medications for diabetes, or you're on an anticoagulant like warfarin, drinking alcohol can affect the way these drugs work, so it's important to speak to your doctor.

Alcohol also causes damage to the liver over time, especially if you drink too much.

Medications such as statins that act directly on the liver can cause further damage when combined with alcohol. If you do drink, stay within the low-risk limits.

8. What about alcohol and my weight?

Often, people only associate calories with food, forgetting that many alcoholic drinks are high in calories.

In its purest form, alcohol contains around 7kcal per gram. One unit of alcohol is around 8g, which is 56kcal or the equivalent calories of one custard cream. In comparison, carbohydrates contain 4kcal per gram. Your drink or mixer may also have added sugars, increasing the number of calories it contains.

Regularly consuming too many calories can lead to weight gain and therefore obesity, which is a risk factor for heart attack, stroke and type 2 diabetes.

Alcohol can also make you eat more than you usually would, or make less healthy food choices.

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Too much alcohol can raise blood pressure and weight, increasing risk of a heart attack, stroke and type 2 diabetes. Senior Cardiac Nurse Christopher Allen finds out more from Professor Sir Ian Gilmore, Consultant Physician and Gastroenterologist at Royal Liverpool University Hospitals. Alcohol is a 'depressant' drug, meaning your brain's control of your body is being slowed down.

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Use this section to:

understand more about what cardiovascular disease is and how it can impact your life.

find out how to reduce your risk to cardiovascular disease.

see the damage cardiovascular disease has on the UK public.

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Over 20,000 people had an NHS Health Check in Surrey over the last year!

Use this section to:

find out what the NHS Health Check is.

find out how, and where you can access the NHS Health Check in Surrey.

access further information about the NHS Health Check and its importance in understanding your health.

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Image Description: NHS Digital Weight Management programme branding.

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If you have high blood pressure and/or diabetes, along with obesity then you can access the NHS Digital Weight Management programme.

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The NHS Digital Weight Management Programme supports adults living with obesity who also have a diagnosis of diabetes, hypertension or both, to manage their weight and improve their health.

It is a 12-week online behavioural and lifestyle programme that people can access via a smartphone or computer with internet access

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The NHS Digital Weight Management Programme

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The NHS Digital Weight Management Programme supports adults living with obesity who also have a diagnosis of diabetes, hypertension or both, to manage their weight and improve their health. It is a 12-week online behavioural and lifestyle programme that people can access via a smartphone or computer with internet access

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Image Description: Healthier You Diabetes Prevention Programme branding.

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Refer yourself to the NHS Diabetes Prevention Programme if you have been identified as 'pre-diabetic'.

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Healthier You | Diabetes Prevention Programme

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Healthier You: The NHS Diabetes Prevention Programme, which helps local residents be aware of the signs and symptoms of diabetes to aid in prevention.

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Image Description: a diagram displaying body mass index scoring and images of possible body types.

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The NHS explore what obesity is, how it can be treated, and the complications it can cause to your health.

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The term obese describes a person who has excess body fat.
In the UK it's estimated that around 1 in every 4 adults and around 1 in every 5 children aged 10 to 11 are living with obesity.

How to tell if you're living with obesity

The most widely used method to check if you're a healthy weight is body mass index (BMI).

BMI is a measure of whether you're a healthy weight for your height. You can use the NHS BMI healthy weight calculator to find out your BMI.

For most adults, if your BMI is:

below 18.5 - you're in the underweight range

18.5 to 24.9 - you're in the healthy weight range

25 to 29.9 - you're in the overweight range

30 to 39.9 - you're in the obese range

40 or above - you're in the severely obese range

If you have a South Asian, Chinese, other Asian, Middle Eastern, Black African or African-Caribbean family background you'll need to use a lower BMI score to measure overweight and obesity:

23 to 27.4 - you're in the overweight range

27.5 or above - you're in the obese range

BMI score has some limitations because it measures whether a person is carrying too much weight but not too much fat. For example, people who are very muscular, like professional sportspeople, can have a high BMI without much fat.

But for most people, BMI is a useful indication of whether they're a healthy weight.

Another measure of excess fat is waist to height ratio, which can be used as an additional measure in adults who have a BMI under 35.

To calculate your waist to height ratio, measure around your waist just above your belly button, and divide it by your height, measured in the same units (for example, centimetres or inches).

A waist to height ratio of 0.5 or higher means you may have increased health risks.

Risks of living with obesity

Obesity is a serious health concern that increases the risk of many other health conditions.

These include:

Living with overweight and obesity can also affect your quality of life and contribute to mental health problems, such as depression, and can also affect self-esteem.

Causes of obesity

Obesity is a complex issue with many causes. Obesity and overweight is caused when extra calories, particularly those from foods high in fat and sugar, are stored in the body as fat.

Obesity is an increasingly common problem because the environment we live in makes it difficult for many people to eat healthily and do enough physical activity.

Genetics can also be a cause of obesity for some people. Your genes can affect how your body uses food and stores fat.

There are also some underlying health conditions that can occasionally contribute to weight gain, such as an underactive thyroid gland (hypothyroidism), although these types of conditions do not usually cause weight problems if they're effectively controlled with medicines.

Some medicines can also make people more likely to put on weight, including steroids and some medicines for high blood pressure, diabetes or mental health conditions.

Treating obesity

The best way to treat obesity is to eat a healthy reduced-calorie diet and exercise regularly.

To do this, you can:

eat a balanced calorie-controlled diet as recommended by a GP or weight loss management health professional (such as a dietitian)

take up activities such as fast walking, jogging, swimming or tennis for 150 to 300 minutes (2.5 to 5 hours) a week

You may benefit from joining a local weight management programme with group meetings or online support. Your GP can tell you about these.

You may also benefit from receiving support and counselling from a trained healthcare professional to help you better understand your relationship with food and develop different eating habits.

If you're living with obesity and lifestyle and behavioural changes alone do not help you lose weight, a medicine called orlistat may be recommended.

If taken correctly, this medicine works by reducing the amount of fat you absorb during digestion. Your GP will know whether orlistat is suitable for you.

A specialist may prescribe other medicines called liraglutide or semaglutide. They work by making you feel fuller and less hungry.

For some people living with obesity, a specialist may recommend weight loss surgery.

Other obesity-related problems

Living with obesity can cause a number of further problems, including difficulties with daily activities and serious health conditions.

Day-to-day problems related to obesity include:

breathlessness

increased sweating

difficulty doing physical activity

often feeling very tired

joint and back pain

low confidence and self-esteem

feeling isolated

The psychological problems associated with living with obesity can also affect your relationships with family and friends, and may lead to depression.

Serious health conditions

Living with obesity can also increase your risk of developing many potentially serious health conditions, including:

type 2 diabetes

high blood pressure

high cholesterol and atherosclerosis (where fatty deposits narrow your arteries), which can lead to coronary heart disease and stroke

metabolic syndrome, a combination of diabetes, high blood pressure and obesity

several types of cancer, including bowel cancer, breast cancer and womb cancer

gastro-oesophageal reflux disease (GORD), where stomach acid leaks out of the stomach and into the gullet

gallstones

reduced fertility

osteoarthritis, a condition involving pain and stiffness in your joints

sleep apnoea, a condition that causes interrupted breathing during sleep, which can lead to daytime sleepiness with an increased risk of road traffic accidents, as well as a greater risk of diabetes, high blood pressure and heart disease

liver disease and kidney disease

pregnancy complications, such as gestational diabetes or pre-eclampsia, when a woman experiences a potentially dangerous rise in blood pressure during pregnancy

Obesity reduces life expectancy by an average of 3 to 10 years, depending on how severe it is.

Outlook

Managing a complex issue like obesity can be hard. Losing weight takes time and commitment.

The healthcare professionals involved with your care can provide encouragement and advice about how to mange your weight, build healthy lifestyle habits and maintain weight loss achieved.

Completing a weight management programme, regularly monitoring your weight, setting realistic goals, and involving your friends and family with ways to lose weight can also help.

It's important to remember that losing what seems like a small amount of weight, such as 3% or more of your original body weight, and maintaining this for life, can significantly reduce your risk of developing obesity-related complications like diabetes and heart disease.

Social care and support guide

If you:

need help with day-to-day living because of illness or disability

care for someone regularly because they're ill, disabled or because of their age (including family members)

Our guide to care and support explains your options and where you can get support.

Couch to 5K

If it's been a long time since you did any exercise, you should check out the Couch to 5K running plan.

It consists of podcasts delivered over the course of 9 weeks and has been specifically designed for absolute beginners.

To begin with, you start running for short periods of time, and as the plan progresses, gradually increase the amount.

At the end of the 9 weeks, you should be able to run for 30 minutes non-stop, which for most people is around 5 kilometres (3.1 miles).

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Read about obesity and how it can seriously affect your health. Ways to lose weight safely include eating a healthy, reduced-calorie diet and exercising regularly.

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Image Description: an image of the website that this link will take you to. The page is explaining alcohol-disorders and the test taken to identify these.

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Learn more about what the AUDIT test is that you undertake during the NHS Health Check, and why it is important.

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Understanding whether alcohol is causing risks for your health is a great way to look after yourself. Find out more about how the Alcohol-Use Disorders Identification Test (AUDIT) is used.

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Understanding the alcohol-use disorders identification test (AUDIT)

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Understanding whether alcohol is impacting your health is important. Find out more about how alcohol-use disorders identification tests (AUDIT) are used.

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Image Description: A page of text displaying the article that the link will take you to. The text gives an understanding of your heart disease risk score.

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Your own personal QRISK score is very important to help identify your risk to cardiovascular disease. This article explains in simple terms what defines your score!

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Understanding Your Heart Disease Risk ScoreIf you’ve recently had a health check or spoken with your GP about your heart health, you may have heard the term “QRISK”. But what is a QRISK, and why does it matter?Simply put, QRISK is a clinical tool used by healthcare professionals in the UK to estimate your risk of developing cardiovascular disease (CVD) over the next 10 years. This includes conditions like heart attacks, strokes, and other forms of heart disease.I’ll explain what QRISK is, how it

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This short 2 minute video explains what heart disease is in simple terms.

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Mayo Clinic Minute: What is heart disease?

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Do not worry if you are not eligible for an NHS Health Check.

You can still get your blood pressure checked at local pharmacies and most general practices.

You can also still utilise any of the FREE services listed below if you fit their eligibility criteria. All of these services can be accessed digitally! Use this section to navigate the services that are available to you as a Surrey resident for the following:

Weight management and nutrition

Diabetes

Alcohol and Substance Misuse

Smoking (including two videos of Surrey residents journey to quitting)

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Image Description: NHS Health Checks branding, explaining its ambition of helping to prevent diabetes, heart disease, kidney disease, stroke and dementia.

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Follow this link to find out more about the national NHS Health Check programme!

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The NHS Health Check is a health check-up for adults in England aged 40 to 74.

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Image Description: Healthy Surrey logo. Healthy Surrey has lots of information and free resource on how to look after your health.

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Check if you are eligible for an NHS Health Check in Surrey, and where you can access them!

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Updated 19 March 2025.

Contents

What is an NHS Health Check?

If you're aged between 40 and 74 years old with no pre-existing conditions, you can have an NHS Health Check. It's completely free and easy to sign up for.

The NHS Health Check has been designed to spot early signs of kidney disease, stroke, type 2 diabetes, heart disease or dementia. As we get older, we are at higher risk of developing one of these conditions, so early detecting can help with prevention.

The check involves easy questions about your health and some simple tests conducted by a health professional. Most people will find that they are perfectly well, but a few people may find they need to make a few small lifestyle changes to ensure they stay healthy.

Why should I get checked?

As you get older, your risk of having a stroke or developing problems such as kidney disease, type 2 diabetes or heart disease increases. If you don't have a test, these symptoms could go undetected. However, if you get your check, we can spot early signs of any illnesses and get started on taking action to prevent them and lower your risk - so you can enjoy your life for longer! It's free, easy to do and can make a big difference later in your life.

In the meantime, why don't you take the heart age test to see how healthy your heart is?

Am I eligible for a health check?

Are you aged between 40 and 74 years?

Do you live in Surrey or are you registered with a Surrey GP?

If you answered 'Yes' to these 2 questions please answer the following:

Have you ever been diagnosed with high cholesterol?

Have you ever been diagnosed with high blood pressure?

Have you ever been diagnosed with diabetes?

Have you ever been diagnosed with angina?

Have you ever been diagnosed with a heart attack?

Have you ever been diagnosed with a stroke?

Have you ever been diagnosed with kidney problems?

Have you had an NHS Health Check in the last 5 years?

If you answered 'No' to these 8 questions you will be eligible for a free NHS Health Check.

Where can I have an NHS health check?

Community pharmacies across Surrey offer a number of free public health services for residents to access. Please call and check with your local pharmacy to see which services they provide.

Addlestone

Addlestone Pharmacy, 92A Station Road, Addlestone, KT15 2AD. Telephone: 01932 842592

Banstead

Pearl Chemist, 30 High Street, Banstead, SM7 2LS. Telephone: 01737 354720

Victoria Chemist, 80 High Street, Banstead, SM7 2NN. Telephone: 01737 357473

Caterham

Chemitex Ltd, 4b High Street, Caterham, CR3 6QA. Telephone: 01883 343305

Vitaltone Pharmacy, 14 The Square, Caterham, CR3 6QA. Telephone: 01883 345500

Chertsey

Honeycomb Pharmacy, 100 Guildford Street, Chertsey, KT16 9AD. Telephone: 01932 564400

Cobham

Pearl Chemist, 16 High Street, Cobham, KT11 3DY. Telephone: 01932 862113

Dorking

Frith Pharmacy, 40 South Street, Dorking, RH4 2HQ. Telephone: 01306 882728

Egham

Jays Pharmacy, 56 High Street, Egham, TW20 9EX. Telephone: 01784 435588

Epsom

Horton Pharmacy, Horton Retail Park, Pelman Way, Epsom KT19 8HJ. Telephone: 01372 721749

Esher

Wallis Jones Pharmacy, 6 Manor Road, Hinchley Wood, Esher, KT10 0SJ. Telephone: 020 8398 2494

Godalming

Kamsons Pharmacy, Cattershall Road, Godalming, GU7 1NJ. Telephone: 01483 420002

Godstone

Godstone Pharmacy, 72 High Street, Godstone, RH9 8LW. Telephone: 01883 742345

Guildford

Direct Pharmacy, 2-8 Madrid Road, Guildford, GU2 7NT. Telephone: 01483 504461

Oxshott

Oxshott Village Pharmacy, Oxshott Village stores, 50 High Street, Oxshott, Leatherhead, KT22 0JP. Telephone: 01372 849988

Redhill

Day Lewis Pharmacy, 27a Bletchingley Road, Merstham, Redhill, RH1 3HU. Telephone: 01737 642805

Warlingham

Warlingham Pharmacy, 46-48 The Green, Warlingham, CR6 9NA. Telephone: 01883 622065

West Molesey

Courts Pharmacy, 10 High Street, West Molesey, KT8 2NA. Telephone: 020 8979 9022

Woking

Horsell Pharmacy, 91 High Street, Horsell, Woking, GU21 4SY. Telephone: 01483 772494

May & Thomson, 51 Dartmouth Avenue, Sheerwater, Woking, GU21 5PE. Telephone: 01932 346186

YMCA Leisure - Community NHS Health Checks

YMCA East Surrey offers an outreach service in the workplace and in community groups upon arrangement in Redhill, Reigate, Guildford and Epsom and Ewell. Please get in touch if you would like to discuss these options further. Address: YMCA East Surrey, YMCA Sports and Community Centre, Princes Road, Redhill, Surrey, RH1 6JJ. Telephone: 01737 779979

For full pharmacy services visit NHS find a pharmacy.

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What is a health check? It is a free midlife MOT to check that your important circulatory and vascular systems are healthy.

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Image Description: Front cover of an EasyRead version of the NHS Health Check information leaflet.

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Access information leaflets on the importance of the NHS Health Check. Available in easy read and multiple different languages.

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National Materials

Hard copies of alternative formats of the information leaflet, including Braille, BSL and Easy Read versions are available for order here but where possible, we have made these resources available below.

Information Leaflets

If you have any locally developed resources please contact: nhshealthcheck@dhsc.gov.uk.
Page updated: 16/10/2022

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Hard copies of alternative formats of the information leaflet, including Braille, BSL and Easy Read versions are available for order here but where possible, we have made these resources available below. If you have any locally developed resources please contact: nhshealthcheck@dhsc.gov.uk. Page updated: 16/10/2022

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Discover what cardiovascular disease is and what the key risk factors are that can lead to the development of poor health outcomes!

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Cardiovascular disease (CVD) includes all the diseases of the heart and circulation. Discover how they all these diseases are linked, and what risk factors increases your risk of CVD.

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The NHS further explore the different types of cardiovascular disease and key risk factors.

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Cardiovascular disease (CVD) is a general term for conditions affecting the heart or blood vessels.
It's usually associated with a build-up of fatty deposits inside the arteries ( atherosclerosis) and an increased risk of blood clots.

It can also be associated with damage to arteries in organs such as the brain, heart, kidneys and eyes.

CVD is one of the main causes of death and disability in the UK, but it can often largely be prevented by leading a healthy lifestyle.

Types of CVD

There are many different types of CVD. 4 of the main types are described on this page.

Coronary heart disease

Coronary heart disease occurs when the flow of oxygen-rich blood to the heart muscle is blocked or reduced.

This puts an increased strain on the heart, and can lead to:

angina - chest pain caused by restricted blood flow to the heart muscle

heart attacks - where the blood flow to the heart muscle is suddenly blocked

heart failure - where the heart is unable to pump blood around the body properly

Read more about coronary heart disease.

Strokes and TIAs

A stroke is where the blood supply to part of the brain is cut off, which can cause brain damage and possibly death.

A transient ischaemic attack (also called a TIA or "mini-stroke") is similar, but the blood flow to the brain is only temporarily disrupted.

The main symptoms of a stroke or TIA can be remembered with the word FAST, which stands for:

Face - the face may have drooped on one side, the person may be unable to smile, or their mouth or eye may have dropped.

Arms - the person may not be able to lift both arms and keep them there because of arm weakness or numbness in one arm.

Speech - their speech may be slurred or garbled, they may not be able to talk at all or they may not be able to understand what you are saying to them.

Time - it's time to dial 999 immediately if you see any of these signs or symptoms.

Read more about stroke and TIAs.

Peripheral arterial disease

Peripheral arterial disease occurs when there's a blockage in the arteries to the limbs, usually the legs.

This can cause:

dull or cramping leg pain, which is worse when walking and gets better with rest

hair loss on the legs and feet

numbness or weakness in the legs

persistent ulcers (open sores) on the feet and legs

Read more about peripheral arterial disease.

Aortic disease

Aortic diseases are a group of conditions affecting the aorta. This is the largest blood vessel in the body, which carries blood from the heart to the rest of the body.

One of most common aortic diseases is an aortic aneurysm, where the aorta becomes weakened and bulges outwards.

This doesn't usually have any symptoms, but there's a chance it could burst and cause life-threatening bleeding.

Read more about aortic aneurysm.

Causes of CVD

The exact cause of CVD isn't clear, but there are lots of things that can increase your risk of getting it. These are called "risk factors".

The more risk factors you have, the greater your chances of developing CVD.

If you're over 40, you'll be invited by your GP for an NHS Health Check every 5 years.

Part of this check involves assessing your individual CVD risk and advising you how to reduce it if necessary.

High blood pressure

High blood pressure (hypertension) is one of the most important risk factors for CVD. If your blood pressure is too high, it can damage your blood vessels.

Read more about high blood pressure.

Smoking

Smoking and other tobacco use is also a significant risk factor for CVD. The harmful substances in tobacco can damage and narrow your blood vessels.

High cholesterol

Cholesterol is a fatty substance found in the blood. If you have high cholesterol, it can cause your blood vessels to narrow and increase your risk of developing a blood clot.

Read more about high cholesterol.

Diabetes

Diabetes is a lifelong condition that causes your blood sugar level to become too high.

High blood sugar levels can damage the blood vessels, making them more likely to become narrowed.

Many people with type 2 diabetes are also overweight or obese, which is also a risk factor for CVD.

Inactivity

If you don't exercise regularly, it's more likely that you'll have high blood pressure, high cholesterol levels and be overweight. All of these are risk factors for CVD.

Exercising regularly will help keep your heart healthy. When combined with a healthy diet, exercise can also help you maintain a healthy weight.

Being overweight or obese

Being overweight or obese increases your risk of developing diabetes and high blood pressure, both of which are risk factors for CVD.

You're at an increased risk of CVD if:

Read more about obesity.

Family history of CVD

If you have a family history of CVD, your risk of developing it is also increased.

You're considered to have a family history of CVD if either:

your father or brother were diagnosed with CVD before they were 55

your mother or sister were diagnosed with CVD before they were 65

Tell your doctor or nurse if you have a family history of CVD. They may suggest checking your blood pressure and cholesterol level.

Ethnic background

In the UK people of south Asian and Black African or African Caribbean background have an increased risk of getting CVD.

This is because people from these backgrounds are more likely to have other risk factors for CVD, such as high blood pressure or type 2 diabetes.

Other risk factors

Other factors that affect your risk of developing CVD include:

age - CVD is most common in people over 50 and your risk of developing it increases as you get older

gender - men are more likely to develop CVD at an earlier age than women

diet - an unhealthy diet can lead to high cholesterol and high blood pressure

alcohol - excessive alcohol consumption can also increase your cholesterol and blood pressure levels, and contribute to weight gain

Preventing CVD

A healthy lifestyle can lower your risk of CVD. If you already have CVD, staying as healthy as possible can reduce the chances of it getting worse.

Stop smoking

If you smoke, you should try to give up as soon as possible. The NHS Better Health website can provide information, support and advice to help.

Your GP can also provide you with advice and support. They can also prescribe medication to help you quit.

Read more about stopping smoking and stop smoking treatments.

Have a balanced diet

A healthy, balanced diet is recommended for a healthy heart.

A balanced diet includes:

low levels of saturated fat - try to include healthier sources of fat, such as oily fish, nuts and seeds, and olive oil, and avoid unhealthy fats such as fatty cuts of meat, lard, cream, cakes and biscuits

low levels of salt - aim for less than 6g (0.2oz or 1 teaspoon) a day

low levels of sugar

plenty of fibre and wholegrain foods

plenty of fruit and vegetables - eat at least 5 portions of fruit and vegetables a day

Read more about healthy eating.

Exercise regularly

Adults are advised to do at least 150 minutes of moderate activity a week, such as cycling or brisk walking.

If you find it difficult to do this, start at a level you feel comfortable with and gradually increase the duration and intensity of your activity as your fitness improves.

Visit your GP for a health check if you haven't exercised before or you're returning to exercise after a long break.

Read advice about starting exercise.

Maintain a healthy weight

If you're overweight or obese, a combination of regular exercise and a healthy diet can help you lose weight.

If you're struggling to lose weight, your GP or practice nurse can help you come up with a weight loss plan and recommend services in your area.

Read more about losing weight and how your GP can help.

Cut down on alcohol

If you drink alcohol, try not to exceed the recommended limit of 14 alcohol units a week for men and women.

If you do drink this much, you should aim to spread your drinking over 3 days or more.

A unit of alcohol is roughly equivalent to half a pint of normal-strength lager or a single measure (25ml) of spirits. A small glass of wine (125ml) is about 1.5 units.

Your GP can give you help and advice if you're finding it difficult to cut down your drinking.

Medicine

If you have a particularly high risk of developing CVD due to high blood cholesterol, your GP may recommend taking medicines called statins to reduce your risk.

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Find out what cardiovascular disease (CVD) is, what problems it can cause, why it happens and how you can reduce your risk.

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Follow this link to discover the impact cardiovascular disease has on the UK.

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We collect the most comprehensive statistics on the effects, prevention, treatment, costs and causes of heart and circulatory diseases in the UK.

Our key statistics and information on heart and circulatory diseases for the UK and each nation:

For more detailed statistics on mortality, morbidity, treatments, costs and risk factors, please refer to the titles below.

Other key BHF statistical publications

A library of older titles can be accessed through the publications link on this page.

Other statistical publications

Heart health statistics in numbers

We collect the most comprehensive statistics on the effects, prevention, treatment, costs and causes of heart and circulatory diseases in the UK. Using health intelligence, we're now able to display these statistics visually.

See our new visualisations

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We collect the most comprehensive statistics on the effects, prevention, treatment, costs and causes of heart and circulatory diseases in the UK. Our key statistics and information on heart and circulatory diseases for the UK and each nation: For more detailed statistics on mortality, morbidity, treatments, costs and risk factors, please refer to the titles below.

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Simple and effective tips on good nutrition, physical activity and how to manage your weight to boost your health.

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Take steps to improve your health. Lose weight and feel better inside and out. Try our free NHS weight loss plan to get you started.

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Find out more about how people are identified as being overweight or obese.

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Obesity, Healthy Weight Loss and Nutrition

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In this section, you can read about about overweight and obesity, as well as some tips around diet and physical activity, for sensible weight management.

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Image Description: British Heart Foundation logo.

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The British Heart Foundation explore how your weight directly impacts your cardiovascular disease risk.

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Having a healthy weight can reduce your risk of developing heart and circulatory diseases like heart attacks, strokes and vascular dementia.
Jump straight to:

How do I measure my weight?

There are three main ways to measure your weight. They can help you work out if your weight could be affecting your health.

your Body Mass Index (BMI)

your waist measurement

your waist to height ratio.

Measuring your BMI

Body mass index (BMI) is a measurement that works out if you have a healthy weight by using your height and the amount you weigh. To work out your BMI, you can:

1. measure your height in feet and inches or centimetres

2. measure your weight in stones and pounds or kilograms

3. put those measurements into a BMI calculator.

Use our BMI calculator tool
A BMI calculator will tell you which weight range you are in. There are four BMI weight ranges:

underweight

healthy weight

overweight

obese.

For some people, BMI isn't an accurate way to measure if they have a healthy weight. This is because BMI can't tell the difference between excess fat, muscle or bone. And it doesn't consider age, gender, different body shapes or that muscle weighs more than fat. It might not be accurate for you if you are:

pregnant

a muscly or athletic person

an elderly person who may have lost some muscle as you've got older.

If you think measuring your BMI isn't suitable for you, your local GP or practice nurse can help you measure your weight.

How to measure your waist

Excess fat around your middle can increase your risk of developing health problems like diabetes, high blood pressure and coronary heart disease. Even if you have a healthy BMI, you might not have a healthy waist measurement.

To work out your waist measurement, you can:

1. Find the halfway point between the bottom of your ribs and the top of your hips - this is usually just above your belly button.

2. Place the tape around that point of your body and make sure the tape is tight but not digging into your skin.

3. Breathe out naturally and take your measurement where the tape meets.

4. Take your measurement again, just to be sure.

To work out if your waist measurement is healthy, you can use our tool.
Use our waist measurement tool
How to work out your waist-height ratio

If your BMI is less than 35, it is also recommended that you measure your waist to height ratio. This will help you work out if you are carrying excess fat around your middle. It's this type of fat (known as visceral fat) that increases your risk of health problems, because it sits around your organs.

You can use this simple calculator to work out your waist to height ratio.

It's healthy to keep your waist to less than half your height.

0.4 to 0.49 - Healthy

0.5 to 0.59 - Increased risk of health problems

0.6 or more - Highest risk of health problems

What weight should I be?

In the UK, the recommended weight for an adult to be healthy depends on your height, ethnicity and whether you are born male or female.

To have a BMI (body mass index) in the 'healthy weight' range, the BMI measurement should be between 18.5 and 24.9 for most adults:

Underweight Healthy weight Overweight Obese

White European

Less than 18.5

18.5-24.9

25-29.9

30 or higher

African-Caribbean, South Asian and some other minority ethnic groups

Less than 18.5

18.5-23

23-27.4

27.5 or higher

To have a healthy waist measurement, it should be:

Lower risk Increased risk Severe risk

Men (white European)

Less than 94cm (37")

over 94cm (37")

over 102cm (40")

Men (African-Caribbean, South Asian and some other minority ethnic groups)

Less than 90cm (35")

over 90cm (35.5")

Women (white European)

Less than 80cm (32")

over 80cm (32")

over 88cm (35")

Women (African-Caribbean, South Asian and some other minority ethnic groups)

Less than 80cm (32")

over 80cm (32")

Why does my ethnicity make a difference to my weight?

Research shows that ethnic background can affect how much fat you have compared to muscle. It can also affect where you carry the fat, like around your tummy. These traits are carried in your genes which are passed down through families. Your genes hold information that decides how you look and how your body works.

Some ethnic groups have a higher risk of developing health problems at a lower weight:

Chinese

South Asian

Other Asian

Middle Eastern

Black African

African-Caribbean.

The risk of heart and circulatory diseases for people with these ethnic backgrounds increases if their BMI (body mass index) is higher than 23.

What are the risks of having excess weight or obesity?

People living with excess weight or obesity have an increased risk of developing:

Having excess weight or obesity can contribute a slow build-up of a fatty substance (called atheroma) in your arteries. This narrows the space for blood to flow. When arteries can't deliver enough blood to the heart or the brain it can cause heart and circulatory diseases.

As well as having an increased risk of developing health conditions, many people with excess weight or obesity can experience:

poor sleep or snoring

joint pain or back pain

having a low mood or low energy

finding it difficult to be physically active.

Are you worried about your weight and the risks?

Most people change weight and body shape at some point during their life. If you think you have excess weight or obesity, it's important to remember you're not alone. Small changes to your diet and lifestyle can help you lose weight safely and reduce your risk of health problems.

If you're feeling concerned and would like emotional support, you can contact our Heart Helpline nurses. Or you can connect with other people in a similar situation to you on our online HealthUnlocked community.

I am living with excess weight or obesity; how can I lose weight safely?

Eating a balanced diet and being physically active can help you have a healthy weight and maintain it. You can try some easy changes that'll work for your lifestyle today.

To have a healthy balanced diet, you can:

Eat regular meals during the day will help you get essential nutrients and burn calories.

Not skipping meals, like breakfast, will reduce the temptation to snack on foods high in fat and sugar.

Try to have 5 portions of fruit or vegetables every day because they are low in fat and calories, and high in fibre which can support weight loss. You can buy frozen fruits and vegetables to keep your costs and food waste low.

Plan all your meals for the week and use a shopping list. This can help you avoid being tempted to buy things you don't need like sugary and savoury snacks. It can also help you stick to your food budget.

Cook food at home instead of eating ready meals or takeaways to help you control what goes into your meal. You can try making multiple portions at once and freezing some to save you time later in the week.

Read the labels on the food you're buying. Even if your food package says it's lower fat, it might not be better for you. You can check the amount of 'total fat' and 'saturated fat' (unhealthy fat) per serving. Or if the nutrition label uses the traffic-light colours, try to look for labels that are mostly green which are healthier.

To be physically active, you can:

Increase simple exercises that you might already do such as hoovering or pushing a lawn mower, taking the stairs instead of the lift, or walking your dog.

Fit moderately intense exercises into your daily routine like riding a bike, yoga, water aerobics or a brisk walk with your friends.

Try some more intense exercises like playing football, swimming or running. Intense exercise isn't suitable for everyone, your doctor will be able to advise what activities and intensity is safe for you.

Adults are recommended to get at least 150 minutes of moderately intense exercise every week. Or 75 minutes of intense exercise every week.

Being physically active can support weight loss, it can support your mental health too. Regular exercise can make you feel more energised and improve your mood. And it can be way to break up your daily routine or a chance to connect with friends and family.

Many people safely lose excess weight when they have support. If you would like support, you can:

join a weight loss support group in your local area

find simple, heart-healthy recipes in our recipe finder tool

visit your local GP or practice nurse to help you identify the cause of your weight gain and develop a plan to help you lose weight safely.

Managing weight with a disability

If you or someone you know would like tips and support for managing weight with a disability, you can visit the NHS website:

What are the benefits of having a healthy weight or BMI?

There's lots of good reasons to have a healthy weight and BMI, like:

it might improve your mood and your self-confidence

it can increase your energy levels and help you feel less tired

it may make it easier for you to move around and be physically active

it will reduce your risk of developing health problems like high blood pressure, cancer and heart and circulatory diseases.

Do you need help maintaining your weight?

Having a healthy weight can give you more energy, keep your heart healthy, and help you sleep better.

More than 3 in 5 people are living with extra weight or obesity in the UK. Our information hub is here to help. Find easy tips to lose weight gradually, simple recipes to fit around your routine and our 10 minute workout.
Visit the hub

You can trust our health information

We've followed an eight-step process to make sure this content is reliable, accurate and trustworthy. Learn how we make our health information reliable and easy to understand.
Page last reviewed: May 2022
Next review due: May 2025

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Having a healthy weight can reduce your risk of developing heart and circulatory diseases like heart attacks, strokes and vascular dementia.

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Blood pressure explained.

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Find out about high blood pressure, including how to find out if you have it, what causes it and what you can do to lower it.

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Image Description: a blood pressure monitor cuff around an individual's arm.

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Further risks of blood pressure are explained by the British Heart Foundation.

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What's on this page?

What is blood pressure?

Blood pressure is the pressure of blood in your arteries. Your arteries are the vessels (tubes) that carry blood from your heart to your brain and the rest of your body. You need a certain amount of pressure to get the blood moving around your body.

Your blood pressure naturally goes up and down throughout the day and night, and it's normal for it to go up while you're moving about. It's when your overall blood pressure is always high, even when you are resting, that you need to do something about it.

Blood pressure is measured using two numbers:

Systolic pressure: this is the higher of the two numbers. It's the pressure against your arteries when your heart is pumping blood around your body.

Diastolic pressure: this is the lower of the two numbers. It shows how much pressure is in your arteries when your heart relaxes between beats.

Learn what normal blood pressure readings look like.

What is high blood pressure (hypertension)?

The medical term for high blood pressure is 'hypertension', and it means your blood pressure is always too high. This means your heart is working harder when pumping blood around your body.

Why is it important to know your blood pressure?

High blood pressure is a serious condition.

Your arteries are normally stretchy, so they can cope with your blood pressure going up and down. But with high blood pressure, your arteries lose their stretchiness, becoming stiff or narrow.

This narrowing makes it easier for fatty material (atheroma) to build up. This narrowing and damage to the arteries lining your heart or brain could trigger a life-threatening heart attack or stroke.

If left untreated, high blood pressure can also lead to complications such as:

Learn more about how high blood pressure is treated.

We're here for you with information and support

Our fortnightly Heart Matters newsletter includes the latest updates about medications and treatments, as well as support for healthy eating, staying active and your emotional wellbeing.
I'd like to sign up

What causes high blood pressure?

In most cases, there isn't a specific reason for the cause of high blood pressure, but most people develop it because of their diet, lifestyle or medical condition.

You might be more at risk if you:

are over the age of 65

have someone in your family with high blood pressure

are someone who smokes

drink too much alcohol

eat too much salt and not enough fruit and vegetables

don't get enough exercise

are overweight, especially around your mid-section.

People living in deprived areas are also at higher risk of having high blood pressure, as well as people who are of black African or black Caribbean descent. Changes in your diet and increasing activity levels will help improve your blood pressure.

For some people, a cause of high blood pressure is found. This is known as 'secondary hypertension'.

Examples of secondary hypertension include:

kidney disease

diabetes

a condition called obstructive sleep apnoea, which can lead to disturbed sleep

some medicines, such as oral contraceptives

some over-the-counter and herbal medicines.

If you are worried that any medicine or remedy might affect your blood pressure, ask your doctor or pharmacist about it.

Visit the NHS website  for more information about the causes of secondary hypertension.

Can pregnancy lead to high blood pressure?

Around one in ten women develop high blood pressure during pregnancy. This increases the risk of long-term high blood pressure.

Research funded by the BHF found that lowering the blood pressure of birth mothers within six weeks of giving birth reduced their long-term risk.
Read about hypertension during pregnancy

What are the symptoms of high blood pressure?

Most people don't know they have high blood pressure because there aren't obvious symptoms. That's why it's so important to get your blood pressure checked regularly.

Rarely, it can cause symptoms like blurred vision, headaches and nosebleeds.

Where can I get my blood pressure measured or tested?

As many as 5 million adults in the UK have undiagnosed high blood pressure and don't know they are at risk. The only way to know whether you have high blood pressure is to have it measured.

You can get your blood pressure checked at:

GP surgeries

some pharmacies

some workplaces.

If you're a healthy adult aged 40 to 74, and live in England or Wales, you'll be invited to a free NHS Health Check every 5 years, which will include a blood pressure check.

You can also check your blood pressure at home. In England, a scheme called Blood Pressure @home is in place to support people with this, which you can ask your GP about. There is also a similar scheme in Scotland called the Scale-Up BP initiative.

How is blood pressure measured?

Your blood pressure is usually measured using a blood pressure monitor. This is usually an electronic monitor connected to an inflatable cuff, which is wrapped around your upper arm.

When you have your blood pressure measured, the reading is written as two numbers. The first is when the pressure is at its highest (or systolic pressure), and the second at its lowest (or diastolic pressure).

For example, your reading might be something like 140/90 mmHg, which you would say as "140 over 90" (mmHg is a unit for measuring blood pressure).

How is high blood pressure diagnosed?

Your blood pressure will usually need to be checked more than once to confirm a diagnosis of high blood pressure.

This is because blood pressure can go up and down a lot during the day. When people have their blood pressure checked in the clinic it can be higher than expected, especially if they feel nervous or anxious.

If your blood pressure is high in the clinic, you might be advised to:

Take additional readings at home using a 24-hour monitor that checks your blood pressure throughout the day (called ambulatory blood pressure monitoring, or ABPM).

Record additional readings at home using your own blood pressure monitor (called home blood pressure monitoring, or HBPM). You can also ask your GP practice if they are part of any schemes where you can loan a blood pressure monitor from them.

If you've been asked to monitor your blood pressure at home, your GP will ask you to check your blood pressure over several days. This can include taking a series of recordings (at least two), twice a day, in the morning and evening.

By looking at all your blood pressure readings over a few days, your GP can work out what your 'average' blood pressure is.

In some cases, your GP might want to run other tests as well. For instance, they might want to do blood tests to check your cholesterol levels and kidney function, or check your heart rhythm with a test called an electrocardiogram (ECG).

What is a healthy or normal blood pressure?

There are two categories of normal blood pressure:

Normal blood pressure is usually considered to be between 90/60 mmHg and 120/80 mmHg. For over-80s, because it's normal for arteries to get stiffer as we get older, the ideal blood pressure is under 150/90 mmHg (or 145/85 mmHg at home).

High-normal blood pressure, sometimes called 'pre-hypertension', is when you don't have an ideal blood pressure but you also don't have high blood pressure. It's usually considered to be between 120/80 mmHg and 140/90 mmHg. Being at this level might prompt you to live a healthier lifestyle so you don't develop high blood pressure.

The NHS has a handy tool to show where your blood pressure is on a chart.

What counts as high blood pressure?

There are three different stages of high blood pressure:

Stage one: this is when your blood pressure is between 140/90 mmHg and 160/100 mmHg in the clinic, or 135/85 mmHg to 150/95 mmHg at home.

Stage two: this is when your blood pressure is between 160/100 mmHg and 180/120 mmHg in the clinic, or over 150/95 mmHg at home.

Stage three: this is when your systolic blood pressure is over 180 mmHg or your diastolic blood pressure is over 120 mmHg in the clinic. This stage is also called 'severe hypertension', and your GP will need to assess you urgently for further investigations.

Discuss your readings with your healthcare team and ask any questions you have. Together, you might want to set a target blood pressure that's right for you and your health goals.

How is high blood pressure treated?

How your high blood pressure is managed depends on a range of things, such as your health goals and the stage of your condition. The healthcare team at your GP practice will help you create a plan to reduce your blood pressure.

By making lifestyle changes, you can lower your blood pressure and keep it at a healthy level. Recent evidence shows that tackling obesity and staying active are especially important. You'll feel the benefits right away with improved sleep, more energy, and a better mood. This useful tool developed by the NHS helps you make a plan that you can discuss with your GP.

If your blood pressure is high or very high, your GP will usually offer you medicines on top of lifestyle changes.

How to manage your blood pressure at home

We've worked with BHF nurses to make it easier to measure and manage your blood pressure at home by pulling all the information you'll need together in one simple place:
Manage your blood pressure at home

How often should my blood pressure be checked?

If you're a healthy adult aged 40 to 74, it's a good idea to get your blood pressure checked every five years (during an NHS Health Check if in England or Wales). If you're near the threshold for high blood pressure, your healthcare team may ask to monitor you more often.

If your blood pressure is well controlled, you'll normally be monitored yearly, along with reviewing any medication you take. When you start new medications or have dose changes to existing ones, your blood pressure will need to be checked more than once a year.

Check with your healthcare team how often to measure your blood pressure at home if you have your own monitor. Try keeping a diary of your readings - this will help your healthcare team spot patterns, and it might be motivating to see how your blood pressure improve over time.

Help and support

Get in touch with our expert cardiac nurses through our Heart Helpline, which is open Monday to Friday, 9am to 5pm. They can give you information and support about heart and circulatory diseases, as well as their risk factors.

If you have high blood pressure, it's important to know that you're not alone. It's a good idea to find support from the people around you and healthcare professionals. For example, our HealthUnlocked community is a free online space where you can connect with others affected by heart and circulatory disease.

Read our 6 top tips for reducing your blood pressure if you've been diagnosed with hypertension.

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High blood pressure or hypertension is when your blood pressure is higher than the recommended level, and can increase your chance of having a heart attack or stroke.

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What is high cholesterol and how is it tested? Find out how to lower yours.

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High cholesterol is when you have too much of a fatty substance called cholesterol in your blood.

It's mainly caused by eating fatty food, not exercising enough, being overweight, smoking and drinking alcohol. It can also run in families.

You can lower your cholesterol by eating healthily and getting more exercise. Some people also need to take medicine.

Too much cholesterol can block your blood vessels. It makes you more likely to have heart problems or a stroke.

High cholesterol does not usually cause symptoms. You can only find out if you have it from a blood test.

Heart UK has separate information about inherited high cholesterol that starts at a young age (familial hypercholesterolaemia).
Find out about familial hypercholesterolaemia on the Heart UK website

Page last reviewed: 13 July 2022
Next review due: 13 July 2025

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Find out what cholesterol is, what causes high cholesterol, why it's important to keep your cholesterol levels under control, and how to lower your cholesterol.

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Includes home workout videos, how to increase your physical activity and provides access to two of the NHS apps for weight management.

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Take steps to improve your health. Move more everyday with easy tips, support and special offers from Better Health.

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A more in-depth look at what high cholesterol means for your health. (Available in a few different languages)

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Having high cholesterol can increase your risk of heart and circulatory diseases such as heart attack, stroke and vascular dementia.

What is high cholesterol?

Cholesterol is a fatty substance found in your blood. It's produced naturally in the liver. Everyone has cholesterol. We need it to stay healthy because every cell in our body uses it. Some of this cholesterol comes from the food we eat.

High cholesterol is when you have too much cholesterol in your blood. This can increase your risk of heart and circulatory diseases such as heart attack and stroke.

What are the types of cholesterol?

There are two main types of cholesterol, one good and the other bad. Having too much 'bad' cholesterol can cause problems with your health. Cholesterol is carried in your blood by proteins. When cholesterol and proteins combine, they're called lipoproteins.

High-density lipoproteins or HDL is called 'good' cholesterol. This is because it gets rid of the 'bad' cholesterol from your blood. It takes cholesterol that you don't need back to the liver. The liver breaks it down so it can be passed out of your body.

Non-high-density lipoproteins or non-HDL is called 'bad' cholesterol. This is because when there is too much of it, it can build up inside the walls of the blood vessels. This clogs them up causing narrowing of the arteries which increases your risk of having a heart attack or stroke.

You may have also heard 'bad' cholesterol being called 'LDL' cholesterol. This was previously used as the main measure of bad cholesterol but we now know that other forms of non-HDL cholesterol are also harmful.

Triglycerides

Our blood also contains a type of fat called triglycerides. This is stored in the body's fat cells. Being very overweight, eating a lot of fatty and sugary foods or drinking too much alcohol can make you more likely to have a high triglyceride level. Triglycerides can also contribute to the narrowing of the artery walls, increasing your risk. You may see it on your cholesterol reading results, and your doctor will be able to tell you if it's too high.

You can have a normal level of HDL and non-HDL cholesterol but still have a high triglyceride level.

Why is high cholesterol bad for you?

Non-HDL take cholesterol from the liver to the cells around your body. Too much bad cholesterol (non-HDL) can be harmful because it sticks to the inside walls of your arteries. This can lead to fatty material (atheroma) building up - this process is known as atherosclerosis. It makes it harder for blood to flow through, which can lead to a heart attack or a stroke.

If your total cholesterol is high, it can mean that you have a lot of bad (non-HDL) cholesterol in your blood. A high level of good (HDL) cholesterol can help keep that bad cholesterol in check and remove it from your body.

What should my cholesterol level be?

There is no specific target cholesterol level because your doctor is looking at your overall risk of developing heart and circulatory diseases. Our nurse talks about cholesterol numbers in our below video:

What causes high cholesterol?

Anyone can get high cholesterol, and it can be caused by many different things. Some things you can control like lifestyle habits, others you can't. As long as you take care of the things you can control, you'll help lower your risk.

Things that cause high cholesterol you can control:

Smoking can lead to high cholesterol levels, and the build-up of tar it causes in your arteries makes it easier for cholesterol to stick to your artery walls.

If you are overweight or have diabetes, you are at greater risk of having high cholesterol.

Things that cause high cholesterol you can't control:

Signs and symptoms of high cholesterol

There aren't usually any typical signs you have high cholesterol which is why it's so important to get it checked out. It's a hidden risk factor which means it happens without us knowing until it's too late.

How is cholesterol measured?

Blood cholesterol levels are measured using a simple blood test. Your GP or practice nurse will take a blood sample, usually by pricking your finger or you might be asked to go for a blood test at your local hospital.

Your blood is then checked for levels of good (HDL) cholesterol, bad (non-HDL) cholesterol and triglycerides, as well as getting a total cholesterol result.

Cholesterol and triglycerides are measured in units called millimoles per litre of blood, usually shortened to 'mmol/Litre' or 'mmol/L'. Generally speaking, for a healthy heart the aim is to have a low non-HDL level and a higher HDL level.

If you have been told you have a high cholesterol level, you have too much 'bad' cholesterol in your bloodstream which increases your risk of having a heart attack or stroke. But a high level of 'good' (HDL) cholesterol can help keep that 'bad' (non-HDL) cholesterol in check.

What does having high cholesterol mean for my health?

Your risk of heart and circulatory disease is increased if you have high cholesterol as well as other risk factors, such as:

The more risk factors you have, the higher your risk of developing a heart or circulatory disease such as a heart attack, stroke or vascular dementia.

How can I lower my cholesterol levels?

Eat a healthy balanced diet, low in saturated fat

Get active

Quit smoking

Find out more about living a healthy lifestyle and simple swaps you can make to help reduce your cholesterol.
OUR 5 TOP WAYS TO LOWER CHOLESTEROL
Medications and treatments for high cholesterol

If your cholesterol is very high and if lifestyle changes are not enough, your doctor might suggest controlling it with medication.

Statins are the main type of medicine used to reduce cholesterol. Your doctor will let you know if you need to take any other drugs which help control your cholesterol levels. They may also refer you to a specialist called a lipidologist.

If you have questions about your medicines, speak with your doctor or call our Heart Helpline on 0300 330 3311. You can also look at our publications for more information.

Help and support

If you are aged 40-74 you can ask for an NHS health check in England only, but similar schemes are available in other parts of the UK. Your doctor should write to you every five years about this, but you can also just make an appointment to check your blood pressure.

If you have high cholesterol, it's important to know that you're not alone. Find support from healthcare professionals and the people around you.

Call our Heart Helpline at 0300 330 3311 to speak to one of our Cardiac Nurses. They can give you information and support about heart and circulatory diseases, and their risk factors.

Join our HealthUnlocked community.

Manage your cholesterol

Our cholesterol hub answers all your questions about cholesterol, including how to manage it, when to get checks and more about statins.
More about cholesterol
Order or download our publications:

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High Cholesterol - Causes, Symptoms & Treatments

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Having high cholesterol can increase your risk of heart and circulatory diseases such as heart attack, stroke and vascular dementia. Cholesterol is a fatty substance found in your blood. It's produced naturally in the liver. Everyone has cholesterol. We need it to stay healthy because every cell in our body uses it.

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Why is physical activity good for your heart health, and what can you do safely if you are living with cardiovascular disease?

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Exercise helps everyone live a happier and healthier life. If you have heart and circulatory disease, it can help manage your condition and get you feeling great.
What's on this page?

Why should I exercise?

It's well-known that exercise is good for your health. When it comes to your heart, it can reduce your risk of heart and circulatory diseases by up to 35% - giving you peace of mind and a longer life. Getting active can also help you:

control your weight

boost energy and improve sleep

improve mental health

improve symptoms of heart and circulatory conditions like angina pain in the long-term - making everyday life easier and letting you do more

reduce blood pressure and cholesterol, which lowers your risk of getting heart and circulatory diseases like heart attacks, strokes and vascular dementia

reduce feelings of stress.

Should I exercise?

It's normal to worry whether you should exercise if you've got a heart problem. Most people will still be able to and feel the benefits of staying active. In most cases, getting your muscles and lungs working better helps put less strain on your heart. However, there are some things to keep in mind before getting active:

heart conditions - with some conditions, you may have to think about whether you can use weights, or how intense your exercise can be. If you use GTN spray to manage your chest pain, speak to your doctor or pharmacist about how you can use it alongside exercise

medications - some may affect your exercise. For example, beta blockers affect your heart rate and may make you feel more tired. Talk with your doctor to find the medication that works for you

implantable cardioverter defibrillator (ICD) & pacemakers - most people with these implanted devices can exercise safely and your doctor should tell you if you have any limits to what you should do. This often means sticking to moderate intensity exercise (like walking and gardening) and avoiding contact sports like rugby

listen to your body - you should only exercise if you're feeling well enough to do so. If you start to feel symptoms such as chest pain, palpitations (the feeling like your heart is pounding, or skipping a beat) or unusual shortness of breath, you may need to scale back your exercise. Speak to your doctor If you're experiencing this

the weather - if it's too hot or too cold, your heart may be under more strain to exercise. If this is the case, try a low-stress activity like stretching instead.

If your doctor is happy for you to exercise, you can start by choosing an activity that's right for you. We can help you with cardiac rehab, chair-based workouts, top tips about running and much more. Get started with our guide on starting exercise after a heart attack or surgery.

It's important that you speak to your doctor before beginning any physical activity for the first time. They can answer any questions you may have, tell you about exercising with your condition and provide you with specific information to help you safely get active.

You should not start any exercise if you are currently feeling symptoms and should stop and rest if you notice them during your exercise. If this happens, you may need to scale back the intensity of your exercise until you've spoken to your doctor.

If you have chest pain that's not gone away or any other symptoms of a heart attack, call 999.

What type of exercise should I do?

Not all exercise is the same and the different types of exercise you do have different benefits for your body. The recommended types of exercise for improving heart health are:

aerobic exercise - when you're moving your body in a way that makes you warm and slightly out of breath like when walking, cycling, doing housework or gardening. Over time, this type of exercise helps your heart and circulatory system to work better by helping to lower your blood pressure and resting heart rate, improving cholesterol levels and helping you maintain a healthy weight

balance and flexibility exercise - exercise like yoga, tai chi and Pilates where we hold our bodies in less stable positions. These exercises make sure our muscles don't get too tight and keep us flexible, helping avoid pain or injury and reduce the risk of having falls

resistance exercise - resistance training like lifting weights or using resistance bands and cables to strengthen your muscles. The stronger your muscles are, the harder they can work which takes the strain off your heart making it easier to do everyday tasks. Check in with your doctor before you start any resistance training as it may not be suitable for some people with heart conditions.

It's important to remember that getting active doesn't have to mean spending lots of time doing an activity that you may not enjoy. It can be something as simple as playing with your grandkids, walking to the shop or gardening. If it gets you a little out of breath, you're being active.

For most people, your weekly exercise should be a combination of aerobic, resistance and flexibility and balance activities for well-rounded health. Not sure where to start? Find out which activity suits you best by taking our quiz.

How much exercise should I do?

It's recommended that you do at least 150 minutes of moderate intensity exercise per week. Moderate exercise is when you feel warm and comfortably breathless like when walking or pushing a lawn mower. Intense exercise is when you breathe hard and fast like when running, swimming or cycling.

What one person finds moderate may be intense to another. That's why it's helpful to do the 'talk test' while you're exercising to find the right level for you. The talk test:

if you can comfortably talk while being active

feel warm and are breathing a little more heavily than normal

you're moving at the right pace.

Whether it's walking or weights, it's important to start low and slow and to 'listen' to your body. A session could be as little as five or 10 minutes. Even the smallest changes can have great results.

It's best to spread your exercise evenly over the week, making sure you have some rest days to ensure your body recovers. Recovery can be just as important for improving your fitness as the exercise itself. Being active is about living a happier, healthier life and should fit into it how you live.

How do I prepare for exercise?

Setting yourself up properly can make the difference to how you feel when you exercise. To get the most out of your activity, prepare by:

eating early and right - eat carbohydrate-based foods in plenty of time before exercising for energy and to avoid feeling too full

getting the essentials together - get your equipment ready, wear light, loose clothing and have a bottle of water and towel to hand

preparing your space - if you're at the gym, know what equipment you plan on using and where those things are. If at home, make sure there's enough room to exercise, move anything in your way and that you won't be interrupted

warming up and cooling down - stretching and starting slow helps loosen you up, lowering the chance of getting hurt and improving your movement.

Hill walking after triple bypass surgery

Read about Martin, who returned to his passion of hill walking six months after his surgery.
Read Martin's Story

Why should I warm up and cool down?

It's easy to skip if you're tired or in a rush but warming up and cooling down is important to staying safe and getting the most out of your workout. Warming up and cooling down helps by:

getting you in the right mood to exercise

preparing your body by raising your heart rate slowly, so there isn't a sudden increase in workload for your heart

sending blood to the active areas of your body

stretching to keep your muscles from shortening and increasing flexibility

warming up your muscles and preparing the joints for movement.

If you have a heart condition, a warmup should last at least 15 minutes and a cool down should last at least 10 minutes. Older adults may need 15 - 20 minutes.
What should I eat and drink?

Whatever your activity level, to stay fit and healthy everyone needs a good balance and variety of foods. This means choosing healthy carbohydrates, lean proteins, eating more fruit and vegetables and keeping hydrated.

carbohydrates - these are your body's main source of energy when you're exercising. It's best to choose high fibre, wholegrain varieties of oats, pasta, rice, breads and cereals. Carbohydrates provide the slow release of energy you need to fuel your exercise. There's no need to eat extra carbohydrates if you're active unless you're training for longer events

fruit and vegetables - these are packed with vitamins, minerals, and fibre which help keep your body and immune system healthy when you exercise. Aim for at least five portions a day

protein - known as the building blocks of life, these help your body grow and repair. You should try and include a portion of protein like lean meat, fish, eggs, dairy or alternatives sources like peas, pulses or beans with most meals

fluids - exercising raises your body temperature and your body tries to cool down by sweating. This causes a loss of water and salts through the skin. How much fluid you need depends on how long you exercise for, the temperature, and the amount you sweat. For most people, unless you are exercising for more than an hour, drinking 6-8 glasses of fluid (water, squash, fruit juice, caffeine-free teas) a day is a good idea.

Allow enough time to eat and drink before exercising to ensure your food is fully digested and avoid feeling sick or uncomfortable during exercise. Try to have a balanced meal 2-3 hours before exercising.

It's just as important to have a healthy diet as it is to exercise. Use our recipe finder for hundreds of delicious and healthy meal ideas packed with the nutrients you need for being active.

Exercise tips

You may find it hard to be more active at first, but as time goes on it'll get easier as your body gets used to activity. You may only notice small improvements, but it all adds up. Here are our top tips to get you started:

breathe - remember to breathe deeply throughout an activity to keep oxygen coming into your body and to help keep your blood pressure under control

be sociable - go for a walk with a friend, join a group or get active for charity to meet like-minded people and have fun

keep an eye on your progress - many smart phones count the number of steps you walk each day or time how long it takes you to swim a lap of the pool. Challenging yourself and getting better at an activity is fun

make exercise part of your day - plan a time to do some physical activity that fits in with the rest of your day like by walking or cycling instead of driving. It could even be something as small as parking your car further from the shop or getting off the bus a stop early. If you miss a day, don't worry - just make sure you start again when you can

keep moving - everyday activities count, so look out for opportunities to be active during the day while you're inside or outdoors. Whilst moving, don't change position too quickly as this can cause dizziness

start small - try breaking down your exercise into short sessions throughout the day and build up from there. You could start by taking a five minute walk every day or trying our 10-minute workout

set realistic goals - setting goals like doing a short walk outside every day is fun and makes you feel great when you achieve them. If you want to keep setting new goals, read about using the FITT principle

set reminders where you can see them - stick post-it notes on the fridge or set daily reminders on your phone so you don't forget (it's easily done)

get variety - make a list of enjoyable activities you can do such as dancing or cycling and do a different activity each week. This way you're less likely to get bored and lose interest

be proud of yourself - pat yourself on the back when you hit a goal. You've looked after your heart and that's something to be proud of.

Want to know more?

Order or download our Understanding physical activity leaflet to help you get moving.

Heart Helpline & other support:

speak to our cardiac nurses by phone, callback, email or online chat on Heart Helpline (Monday to Friday, 9am to 5pm)

contact us to talk to our customer care advisors, find your local BHF shop and for any comments, compliments and complaints you may have

sign up to our Heart Matters magazine for online information packed with health and lifestyle advice.

You can trust our health information

We've followed an eight-step process to make sure this content is reliable, accurate and trustworthy. Learn how we make our health information reliable and easy to understand.

Updated: October 2022

Next update due: October 2025

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Exercise helps everyone live a happier and healthier life. If you have heart and circulatory disease, it can help manage your condition and get you feeling great.

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Information about the NHS Diabetes Prevention Programme.

Further information and how to refer yourself can be found in the 'What Do I Do if I am Not Eligible for an NHS Health Check?' section.

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Preventing type 2 diabetes

Whilst type 1 diabetes cannot be prevented, type 2 diabetes is largely preventable through lifestyle changes. Around nine out of 10 people with diabetes have type 2 and there are currently two million people in England at high risk of developing type 2 diabetes, which is a leading cause of preventable sight loss in people of working age and is a major contributor to kidney failure, heart attack, and stroke. For people living with type 2 diabetes, the risk of dying in hospital with COVID-19 is also twice that of people who don't have the condition.

As well as the human cost, type 2 diabetes treatment accounts for around 10% of the annual NHS budget.

Healthier You NHS Diabetes Prevention Programme

The Healthier You NHS Diabetes Prevention Programme, also known as the Healthier You programme, identifies people at risk of developing type 2 diabetes and refers them onto a nine-month, evidence-based lifestyle change programme.

The Healthier You programme is available both as a face-to-face group service and as a digital service. When referred into the programme, people are free to choose between the two.

People on the face-to-face group service receive personalised support to manage their weight, eat more healthily and be more physically active - which together have been proven to reduce a person's risk of developing type 2 diabetes.

The digital service offers similar support but through the use of digital tools such as wearable technologies that monitor levels of exercise, apps where users can access health coaches, online peer support groups and the ability to set and monitor goals electronically.

Research shows the Healthier You NHS Diabetes Prevention Programme has reduced new diagnoses of type 2 diabetes in England, saving thousands of people from the potentially serious consequences of the condition. It cuts the risk of developing type 2 diabetes by more than a third for people completing the programme.

The Healthier You programme is delivered across England by a range of providers. Find contact details for the provider of the programme in your area.

Know your risk of type 2 diabetes

You can get help to make positive changes to your diet, weight and physical activity to significantly reduce your risk of developing type 2 diabetes.

Find out if you're at risk of developing type 2 diabetes by doing any of the following:

Answering a few simple questions on the 'Know Your Risk' tool at riskscore.diabetes.org.uk

Taking up the offer of a free NHS Health Check to assess your risk of type 2 diabetes, cardiovascular disease and other conditions such as high blood pressure (available for those aged 40-74)

Asking your GP Practice to check if you are at risk.

If you are at risk, you may be eligible for referral to the Healthier You NHS Diabetes Prevention Programme by your GP Practice.

Contact us

If you have any general queries about the Healthier You programme, please email england.ndpp@nhs.net.

Please note that we will not be able to refer you onto the programme or answer individual questions about your eligibility. Instead, find contact details for the provider of the programme in your area.

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NHS Diabetes Prevention Programme (NHS DPP)

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Whilst type 1 diabetes cannot be prevented, type 2 diabetes is largely preventable through lifestyle changes. Around nine out of 10 people with diabetes have type 2 and there are currently two million people in England at high risk of developing type 2 diabetes, which is a leading cause of preventable sight loss in people of working age and is a major contributor to kidney failure, heart attack, and stroke.

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In-depth look at how smoking can cause cardiovascular disease.

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Health Effects of Cigarettes: Cardiovascular Disease

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Learn more about how tobacco use effects cardiovascular disease (CVD).

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The British Heart Foundation explore what benefits quitting smoking will have on your heart health.

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Smoking is very harmful to your heart. It seriously increases your risk of developing heart and circulatory diseases.

To keep your heart healthy, you can make small lifestyle changes to help you quit smoking.

What does smoking do to my heart and circulatory system?

The chemicals in cigarettes make the walls of your arteries sticky. This causes fatty material to stick to the walls. The fatty material can begin to clog your arteries and reduce the space for blood to flow properly.

If the arteries that carry blood to your heart get clogged, it can lead to a heart attack.

If the arteries that carry blood to your brain get clogged, it can lead to a stroke.

Smoking can also affect your heart and blood vessels by:

increasing your risk of blood clots

causing an instant rise to your heart rate

causing an instant rise to your blood pressure

reducing the amount of oxygen delivered to the rest of your body.

What are the benefits of quitting smoking?

You might notice benefits sooner than you think:

your heart rate and blood pressure will begin to return to normal after 20 minutes

your sense of smell and taste will begin to improve after 2-3 days

your risk of a heart attack is half that of a smoker after 1 year.

Quitting smoking also has other benefits like:

you will have fresher breath and whiter teeth

your skin might look younger and age less quickly

you might have more energy, feel less tired and get less headaches

your immune system will find it easier to fight off colds and flu

your sex drive may increase, and it can improve your fertility

you will protect the health of your children, family and friends.

It's never too late to benefit from stopping smoking. On average, smokers who quit in their 30s will add 10 years to their life. Even quitting at 60 will add 3 years. Being a non-smoker can also improve your chances of being more physically active and healthier as you get older.

What is in a cigarette?

Cigarettes contain many toxic chemicals that harm your body even after you've finished your cigarette. Some of the harmful chemicals used in cigarettes are:

Carbon monoxide

Carbon monoxide is a poisonous gas. It prevents your blood from carrying oxygen around your body properly. This forces your heart to work harder than it should. It also stops your lungs working as well as they should.

Tar

Tar stains smokers' teeth and fingers a yellow-brown colour. It is very harmful to your health, it can cause:

cancer

lung disease

heart and circulatory diseases

your lungs to be more vulnerable to infections

Nicotine

Nicotine is the addictive chemical found in regular cigarettes, most e-cigarettes and shisha. It increases your heart rate and blood pressure. Untreated high blood pressure can increase the risk of:

Are smoking alternatives less harmful than cigarettes?

No smoking alternatives are risk-free but some are less harmful than cigarettes.

E-cigarettes

E-cigarettes, or vapes, are less harmful than regular cigarettes and they can be used to help you quit smoking. An e-cigarette is a device that you breath in vapour (steam) from rather than smoke.

The vapour contains nicotine, the addictive chemical used in cigarettes. E-cigarettes don't burn tobacco and they don't produce tar or carbon monoxide.

E-cigarettes can help you quit smoking by managing your cravings for nicotine. But because they use nicotine, e-cigarettes can be addictive. You should only use your e-cigarette when you really need it. If you have used e-cigarettes to successfully quit smoking normal cigarettes, you should consider quitting these as well.

E-cigarettes should not be used by non-smokers or young people.

Shisha

Shisha is not safer than smoking cigarettes. A specially prepared tobacco is heated to produce smoke. The smoke bubbles through a bowl of water and into a long hose-like pipe to be breathed in.

Despite what some believe, shisha isn't an alternative to cigarettes. Like cigarettes, shisha tobacco can contain:

nicotine

tar

carbon monoxide

heavy metals such as arsenic and lead.

Even if you use tobacco-free shisha, the smoke still produces harmful levels of toxins. This can be either just as bad for you or even more harmful than smoke from tobacco-based shisha.

In a shisha session (which usually lasts 20-80 minutes), a shisha smoker can inhale the same amount of smoke as a cigarette smoker consuming over 100 cigarettes. Find out more about shisha

Smokeless tobacco

Smokeless tobacco is not safer than smoking cigarettes. It's a type of tobacco that can either be chewed, sucked, or inhaled without producing smoke.

Most smokeless tobaccos have the same amount of nicotine as cigarettes. They can also have more than 25 chemicals that are known to cause cancer. Using smokeless tobacco can also increase your risk of having:

complicated pregnancies

mouth and tooth problems

heart and circulatory diseases.

You might see smokeless tobacco being called snuff, snus or spit tobacco.

Low tar cigarettes

Smoking 'low tar' cigarettes is not safer than smoking regular cigarettes. Some cigarette packages describe the product as 'low tar', but this is misleading. Most 'low tar' cigarettes have the same amount of harmful chemicals as regular cigarettes.

'Low tar' cigarettes are often found in countries where the process of making cigarettes is less regulated than in the UK.

Around half of all long-term smokers die early from smoking-related conditions, like heart and circulatory diseases. Even if you've smoked for years, it's never too late to stop. If you quit today, you might feel more energised to play with your children or grandchildren in just a couple of weeks.
Read our top 10 tips

Is second-hand smoke harmful?

Yes, second-hand smoke is harmful. Second-hand smoke (also known as passive smoke) is when you breathe in the smoke in the air from someone else's cigarette and the smoke they breathe out.

When the people around you breathe in your cigarette smoke, it increases their risk of developing:

breathing problems

cancers like lung cancer

heart and circulatory diseases like strokes and heart attacks.

Second-hand smoke is very dangerous and can increase the risk of lung cancer by up to 30%.

Children who live in a home with smokers can have double the risk of getting illnesses like:

pneumonia

ear infections

wheezing and asthma.

You can help to protect your loved ones, friends and colleagues from the dangers of second-hand smoke by quitting.

How can I quit smoking?

If you quit smoking, you will greatly improve your health and the health of everyone around you. Beating a smoking habit is a challenge for many and it's totally normal to have cravings while trying to quit. It may feel hard to resist the temptation to smoke sometimes. But you can make small changes to make it easier to stick to it:

Try to think positively - even if you've tried to quit before and didn't manage it, don't let it put you off trying again.

Set a date to quit and tell your family, friends and colleagues so they can help you stick to it.

Plan how you will deal with your cravings when you're at events and times where you would usually smoke.

If you usually smoke after meals, eat foods that can make cigarettes taste bad like cheese, fruit and vegetables. Or change your routine to keep your mind busy when you would usually smoke, like washing the dishes straight after eating.

Cravings usually last around 5 minutes. Plan things you can do in 5 minutes to stay busy for when you get cravings.

When you're out, hold your drink with the hand that used to hold cigarettes and use a straw. This will help to keep your hands and mouth busy.

When you get a craving, remind yourself of why you're quitting. You may want to carry a picture of your family with you to look at if you're tempted to smoke.

You are not alone. Aside from your family and friends, you can get support from healthcare professionals, stop smoking programmes and nicotine replacement therapy. Nicotine replacement therapies are designed to help you quit smoking, but they should only be used to quit for good.

Smoking cessation programs offer many useful resources and are often more effective than doing it on your own.

You can make an appointment with your GP, pharmacy or practice nurse. They will be able to help you find a way to stop smoking that works for you.

Help and support

You're more likely to quit if you have support:

You can trust our health information

We've followed an eight-step process to make sure this content is reliable, accurate and trustworthy. Learn how we make our health information reliable and easy to understand.
Page last updated: August 2023 Next update due: August 2026

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If you smoke, quitting is the single most important step you can take to protect the health of your heart. Find out more about how smoking affects your heart.

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Simple and effective advice on stopping smoking.

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If you smoke, you might be more at risk of having high blood pressure. If left untreated, high blood pressure can increase your risk of a heart attack or stroke.

High blood pressure does not usually have any symptoms, so the only way to know if you have it, is to get a check. If you are 40 or over, live in England and haven't had a check in the last 6 months, you can get your blood pressure checked for free at your pharmacy today.

If your blood pressure is high, then it can be managed through lifestyle changes or medication.

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When you stop smoking, good things start to happen to your health. Get free support from the NHS to become smoke free and help build a smokefree generation.

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Simple tips on how to reduce your alcohol intake!

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Feel healthier, lose weight and save money by picking your days to go drink-free.

One simple way to cut down is to have at least a few drink-free days every week, so choose yours and get practical support to stick with it.

With the app you can:

update and track your drink-free days

get simple and practical tips to help you control your drinking

receive reminders when you need it most

celebrate milestones when you reach your targets

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Cutting down on alcohol can be a really effective way to improve your health. See our simple tips and practical ideas to help you starting drinking less. Let's do this!

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Access the free Drink Coach application which can help individuals reduce their alcohol intake.

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Everything you need to #DrinkDifferently. Take the Alcohol Test to see how risky your drinking is, download our free DrinkCoach App to track your drinks on the go or book an online appointment with one of our alcohol specialists.

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The NHS provides information on where to access drug help and additional support for mental health issues associated with these addictions.

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If you need treatment for drug addiction, you're entitled to NHS care in the same way as anyone else who has a health problem.
With the right help and support, it's possible for you to get drug free and stay that way.

Where to get help for drugs

A GP is a good place to start. They can discuss your problems with you and get you into treatment.

They may offer you treatment at the practice or refer you to your local drug service.

If you're not comfortable talking to a GP, you can approach your local drug treatment service yourself.

Visit the Frank website to find support near you.

If you're having trouble finding the right sort of help, call the Frank drugs helpline on 0300 123 6600. They can talk you through all your options.

Charity and private drugs treatment

As well as the NHS, there are charities and private drug and alcohol treatment organisations that can help you.

Visit the Adfam website page, Finding Support, to see a list of useful organisations.

Private drug treatment can be very expensive, but sometimes people get referrals through their local NHS.

Your first appointment

At your first appointment for drug treatment, staff will ask you about your drug use. They'll also ask about your work, family and housing situation.

You may be asked to provide a sample of urine or saliva.

Staff will talk you through all of your treatment options and agree a treatment plan with you.

They can tell you about local support groups for drug users and their families or carers.

You'll also be given a keyworker, who will support you throughout your treatment.

What drug treatment involves

Your treatment will depend on your personal circumstances and what you're addicted to. Your keyworker will work with you to plan the right treatment for you.

Your treatment plan may include a number of different treatments and strategies.

Talking therapies

Talking therapies, such as CBT, help you to see how your thoughts and feelings affect your behaviour.

Treatment with medicines

If you're dependent on heroin or another opioid, you may be offered a substitute drugs, such as methadone or buprenorphine.

This means you can get on with your treatment without having to worry about withdrawing or buying street drugs.

Detoxification (detox)

This is for people who want to stop taking opioids like heroin completely. It helps you to cope with the withdrawal symptoms.

Self-help

Some people find support groups like UKNA (Narcotics Anonymous) helpful. Your keyworker can tell you where your nearest group is.

Reducing harm

Staff at your local drug service will help reduce the risks associated with your drug-taking. For example, you may be offered testing and treatment for hepatitis or HIV and AIDS.

Where you'll have your treatment

You may have your treatment while living at home or as a hospital inpatient.

If your drug-related problems are severe or complicated, you may be referred to a residential rehabilitation service.

For more information about residential rehabilitation, or to find a rehab near you, visit Rehab-Online.

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If you have a problem with drugs, there's a wide range of services that can help.

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If you are not eligible for an NHS Health Check, you can (and should) still get your blood pressure checked! See the options available to you by following this link.

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What is blood pressure?

Blood pressure is the pressure of blood in your arteries. Your arteries are the vessels (tubes) that carry blood from your heart to your brain and the rest of your body. You need a certain amount of pressure to get the blood moving around your body.

Your blood pressure naturally goes up and down throughout the day and night, and it's normal for it to go up while you're moving about. It's when your overall blood pressure is always high, even when you are resting, that you need to do something about it.

Blood pressure is measured using two numbers:

Systolic pressure: this is the higher of the two numbers. It's the pressure against your arteries when your heart is pumping blood around your body.

Diastolic pressure: this is the lower of the two numbers. It shows how much pressure is in your arteries when your heart relaxes between beats.

What is high blood pressure (hypertension)?

The medical term for high blood pressure is 'hypertension', and it means your blood pressure is always too high. This means your heart is working harder when pumping blood around your body.

High blood pressure ( hypertension) affects more than one in four adults in England. High blood pressure is not typically something you can feel.

However, you are more likely to develop coronary heart disease or have a stroke if you have high blood pressure. In England, high blood pressure is the number one risk factor for cardiovascular disease related death and disability. This is why it is important to know your blood pressure numbers.

What is a healthy or normal blood pressure?

There are two categories of normal blood pressure:

Normal blood pressure is usually considered to be between 90/60 mmHg and 120/80 mmHg. For over-80s, because it's normal for arteries to get stiffer as we get older, the ideal blood pressure is under 150/90 mmHg (or 145/85 mmHg at home).

High-normal blood pressure, sometimes called 'pre-hypertension', is when you don't have an ideal blood pressure but you also don't have high blood pressure. It's usually considered to be between 120/80 mmHg and 140/90 mmHg. Being at this level might prompt you to live a healthier lifestyle so you don't develop high blood pressure.

The NHS has a handy tool to show where your blood pressure is on a chart.

What causes high blood pressure?

In most cases, there isn't a specific reason for the cause of high blood pressure, but most people develop it because of their diet, lifestyle or medical condition.

You might be more at risk if you:

are over the age of 65

have someone in your family with high blood pressure

are someone who smokes

drink too much alcohol

eat too much salt and not enough fruit and vegetables

don't get enough exercise

are overweight, especially around your mid-section.

People living in deprived areas are also at higher risk of having high blood pressure, as well as people who are of black African or black Caribbean descent. Changes in your diet and increasing activity levels will help improve your blood pressure.

How do I get a blood pressure check?

That is easy! You can have your blood pressure checked at your GP practice or at your local pharmacy. The check only takes 10 minutes and it could save your life.

A new service finder on NHS.uk allows healthcare professionals and patients to search for and find a pharmacy that offers free blood pressure checks. The tool explains who is eligible to go to a pharmacy to get their blood pressure checked and can be searched using a postcode, with the nearest pharmacy listed first.

You can also view this map to find a pharmacy providing BP checks in Surrey, make sure you contact them to double check their availability.

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Information on blood pressure and atrial fibrillation checks and where to get a blood pressure check in Surrey

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If you are interested in knowing what you are putting in your body with each meal or snack, MyFitnessPal can help with just one scan of a barcode.

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From our experts

Essential Guide to Food Logging
Whether your goal is to lose weight, build strength, perform at your peak or improve your overall health, keeping an accurate food journal of what you eat and drink is essential. It provides valuable insight into your nutrition habits, so you can see trends and make adjustments as needed.
Read more on MyFitnessPal blog ›

Essential Guide to Healthy Eating
When you start learning more about nutrition, it can seem overwhelming. For people who are interested, there is definitely a lot to learn and explore, but, in the end, basic nutrition is quite simple. It's so simple, in fact, that we know you can eat better by focusing on these eight things.
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About MyFitnessPal

MyFitnessPal is one of the best weight loss apps and fitness apps, helping nearly 1 million members reach their nutrition and fitness goals every year. Members use it as a calories tracker and calorie counter to log their foods, and take advantage of the app's food database that contains over 18 million foods. It's not just a free calorie counter app - it's also the best calorie counter app for people who are looking to take back control of their health and fitness.

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Calorie Tracker & BMR Calculator to Reach Your Goals | MyFitnessPal

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Reach your health, fitness & weight goals with MyFitnessPal, the #1 nutrition tracking app. Macro & calorie calculator, food tracker, and fasting app in one. Download today!

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The British Heart Foundation explore further what your QRISK score means.

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QRISK: how it works and what your score means

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Your QRISK score is a valuable tool to understand your risk of heart disease. Discover what it is, how it works, and what it means for you and your health.

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If you have high blood pressure and/or diabetes, along with obesity then you can access the NHS Digital Weight Management programme.

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The NHS Digital Weight Management Programme supports adults living with obesity who also have a diagnosis of diabetes, hypertension or both, to manage their weight and improve their health.

It is a 12-week online behavioural and lifestyle programme that people can access via a smartphone or computer with internet access

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The NHS Digital Weight Management Programme

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The NHS Digital Weight Management Programme supports adults living with obesity who also have a diagnosis of diabetes, hypertension or both, to manage their weight and improve their health. It is a 12-week online behavioural and lifestyle programme that people can access via a smartphone or computer with internet access

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Image Description: Healthier You Diabetes Prevention Programme branding.

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Refer yourself to the NHS Diabetes Prevention Programme if you have been identified as 'pre-diabetic'.

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Healthier You | Diabetes Prevention Programme

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Healthier You: The NHS Diabetes Prevention Programme, which helps local residents be aware of the signs and symptoms of diabetes to aid in prevention.

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Start your fitness journey by embarking on the Couch to 5k journey!

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With a trainer guiding you through your headphones, you'll start with a mix of running and walking to ease you in. You can still play your favourite music in the background as you go.

In the first week, you'll start with 1-minute runs, followed by a 90 second walk, going at a pace that feels right for you. Each week you'll run a little more.

As the weeks go on, you'll build up your stamina and confidence and by the end you'll be running for 30 minutes without stopping.

You can complete the program in 9 weeks or longer, depending on what works best for you.

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Get running with Couch to 5K - Better Health

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NHS Couch to 5K will help you get off the couch and gradually work you up to running 5km in just 9 weeks.

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Explore the FREE One You Surrey services that are available to eligible individuals who are looking for help with their weight management!

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Free Surrey weight loss services for lasting health and wellbeing. Benefit from Health coach guidance and tailored nutrition and exercise plans.

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Image Description: i-access drug and alcohol services logo. They are the provider of the drug and alcohol free provision in Surrey.

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Access support to stop drinking, reduce drug misuse, or if you want to learn how to support someone close to you in these areas.

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i-access Drug & Alcohol Service : Surrey and Borders Partnership NHS Foundation Trust

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i-access is a drug and alcohol service for people in Surrey.

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Image Description: A man and a child playing, depicting a happy and healthy lifestyle. Branding for One You Surrey smoking service displaying text that promotes the benefits of quitting smoking.

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If you are a smoker, you can access 12 weeks of FREE support with a qualified stop smoking advisor via One You Surrey!

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Go Smoke Free in Surrey: Quit smoking today to enhance your health and wellbeing. Begin your journey to a healthier future now.

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Information provided about the benefits of quitting smoking during pregnancy, the harm it can cause if you do smoke during pregnancy and how to access the NHS helpine.

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Smoking and your unborn baby

Protecting your baby from tobacco smoke is one of the best things you can do to give your child a healthy start in life. It can be difficult to stop smoking, but it's never too late to quit.

Every cigarette you smoke contains over 4,000 chemicals, many of which are dangerous, so smoking when you are pregnant harms your unborn baby. Cigarettes can restrict the essential oxygen supply to your baby. As a result, their heart must beat harder every time you smoke.

Benefits of stopping smoking in pregnancy

Stopping smoking will help both you and your baby immediately. Harmful gases, such as carbon monoxide, and other damaging chemicals will clear from your body. When you stop smoking:

you will reduce the risk of complications in pregnancy and birth

you are more likely to have a healthier pregnancy and a healthier baby

you will reduce the risk of stillbirth

your baby is less likely to be born too early and have to face the breathing, feeding and health problems that often go with being premature

your baby is less likely to be born with a low birth weight. Babies of smokers are, on average, lighter than other babies, which can cause problems during and after labour. For example, they are more likely to have problems keeping warm and are more likely to get infections

you will reduce the risk of sudden infant death syndrome (SIDS), also known as "cot death"

Stopping smoking now will also help your baby later in life. Children whose parents smoke are more likely to suffer from asthma and other serious illnesses that may need hospital treatment.

The sooner you stop smoking, the better. But even if you stop in the last few weeks of your pregnancy this will benefit you and your baby.

Secondhand (passive) smoke harms your baby

If your partner or anyone else who lives with you smokes, their smoke can affect you and your baby before and after their birth. You may also find it more difficult to stop if someone around you smokes.

Secondhand smoke can also reduce your baby's birthweight and increase the risk of sudden infant death syndrome (SIDS), also known as "cot death". Babies whose parents smoke are more likely to be admitted to hospital for bronchitis and pneumonia during their first year.

To find out more about quitting and to get support, your partner can call the National Smokefree helpline on 0300 123 1044 from 9am to 8pm Monday to Friday, and 11am to 4pm Saturday and Sunday.

Nicotine replacement therapy

You can use nicotine replacement therapy (NRT) during pregnancy if it will help you stop smoking and you're unable to stop without it. Stop smoking tablets such as Champix (varenicline) or Zyban (bupropion) are not recommended during pregnancy and are not currently available.

NRT contains only nicotine and none of the damaging chemicals found in cigarettes, so it is a much better option than continuing to smoke. It helps you by giving you the nicotine you would have had from a cigarette.

You can be prescribed NRT during pregnancy by a GP or an NHS stop smoking adviser. You can also buy it over the counter without a prescription from a pharmacy.

NRT is available as:

If you have pregnancy-related nausea and vomiting, patches may be a better solution.

NRT patches should be used for no more than 16 hours in any 24-hour period. The best way to remember this is to remove the patch at bedtime.

Before using any of these products, speak to a midwife, GP, a pharmacist or a specialist stop smoking adviser.

By getting this specialist advice you can be sure that you're doing the best for your baby and for you.

Call the National Smokefree helpline on 0300 123 1044 from 9am to 8pm Monday to Friday, and 11am to 4pm Saturday and Sunday.

Remember, you are twice as likely to be successful at quitting if you get some support from a trained adviser.

Liquorice-flavoured nicotine products

Pregnant women are advised to avoid liquorice-flavoured nicotine products. Although there is no known risk with small amounts of liquorice flavouring, the manufacturers advise caution.

This caution is based on information about the adverse effects associated with excessive amounts of liquorice root. As other flavours are available, pregnant women are advised to choose an alternative, such as fruit or mint.

Find out more about stop smoking treatments.

E-cigarettes in pregnancy

E-cigarettes are fairly new and there are still some things we do not know. However, current evidence on e-cigarettes indicates they are much less risky than smoking.

Cigarettes deliver nicotine along with thousands of harmful chemicals. E-cigarettes allow you to inhale nicotine through a vapour rather than smoke. By itself, nicotine is relatively harmless.

E-cigarettes do not produce tar or carbon monoxide, the 2 main toxins in cigarette smoke. Carbon monoxide is particularly harmful to developing babies. The vapour from an e-cigarette does contain some of the potentially harmful chemicals found in cigarette smoke, but at much lower levels.

If using an e-cigarette helps you to stop smoking, it is much safer for you and your baby than continuing to smoke.

Unlike nicotine replacement therapy (NRT), such as patches or gum, e-cigarettes are not available on an NHS prescription. If you want to use an e-cigarette, you can still get free expert help from a stop smoking adviser.

Call the National Smokefree helpline on 0300 123 1044 for more information, or ask a midwife to refer you.

Find out more about using e-cigarettes to stop smoking.

National Smokefree helpline

The National Smokefree helpline offers free help, support and advice on stopping smoking and can give you details of local support services.

You can also sign up to receive ongoing advice and support at a time that suits you.

National Smokefree helpline: 0300 123 1044

9am to 8pm Monday to Friday, and 11am to 4pm Saturday and Sunday.

To find your nearest NHS Stop Smoking service talk to:

a midwife

a health visitor

a nurse at your GP surgery

a pharmacist

NHS Stop Smoking services can offer 1-to-1 or group sessions with trained stop smoking advisers and may have a pregnancy stop smoking specialist.

They can also offer advice about dealing with stress, weight gain and support the use of NRT (such as patches or gum), if appropriate, to help you manage your cravings.

Find out more about the effects of smoking in pregnancy, and getting support to quit, at Better Health: Start for Life

Find stop smoking services near you.

Get Better Health: Start for Life's pregnancy and baby emails

Sign up for Better Health: Start for Life's emails for expert advice, videos and tips on pregnancy, birth and beyond.

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Find out why you should stop smoking in pregnancy, and how smoking can harm your unborn baby. Plus where to go for support to help you quit.

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Additional support and resource on quitting smoking during pregnancy.

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Support to Quit Smoking in Pregnancy - Royal College of Midwives

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A professional organisation and trade union dedicated to serving the whole midwifery team

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Smoking fact sheets provided by Action on Smoking and Health (ASH).

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About one out of every eight people in the UK smokes (12.9%). In the UK, the chance that any one person is a smoker has been going down ever since records of it began in 1974. The number of cigarettes that smokers smoke has also gone down over time.

Here are some patterns in smoking in Great Britain:

Smoking is slightly more common in men than women

People aged over 60 are less likely than younger people to smoke now, but more likely to be an ex-smoker

People in lower-paid jobs are much more likely to smoke than people with higher-paid jobs

Unemployed people are more likely to smoke than employed people

Nearly half of smokers want to quit

Smoking is the biggest cause of death and disease that you can control. About half of all life-long smokers will die early, losing on average about 10 years of life. Most smoking-related deaths arise from one of three types of disease: lung cancer, chronic obstructive pulmonary disease (COPD) and coronary heart disease (CHD).

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This fact sheet includes statistics on tobacco consumption and smoking-related illness and death.

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Image Description: smoke lingering in the air.

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If you are struggling for quitting motivation, you can learn more about the impacts your habit may be having on close friends and family members through secondhand smoke impacts.

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Breathing other people’s smoke is called passive, involuntary or secondhand smoking. Health impacts range from eye irritation, headache, cough and sore throat, to heart disease and lung cancer.

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Image Description: a man with a vape in his hand.

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Learn why vaping is such an effective quit tool!

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Find out the facts about vaping from the NHS – including why it’s an effective way to quit smoking, the side effects, if it’s harmful and whether it’s safe to vape if you’re pregnant.

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Further information on vaping as a quit tool, via Healthy Surrey.

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Information about vaping, the health implications, and how to quit vaping including helpful resources for professionals

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Image Description: a man holding a vape.

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Filter out the noise and learn what the evidence says about vaping, and what information is incorrect.

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Vaping myths and the facts - Better Health

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There are lots of misconceptions about e-cigarettes and vaping. Here are some of the most common myths, and the facts based on scientific evidence and data.

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If you are ready to take the next step in your quit journey, or took up vaping but have never smoked, learn how to quit vaping through simple tips and advice.

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Quitting nicotine vaping can be a challenge. In this guide, we will provide practical tips to help you quit safely and successfully.

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Image Description: signpost indicating the direction to follow to quit smoking.

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Access a Smoke Free mobile phone app to help you on your quit journey!

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Smoke Free - The help you need to quit for good

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It feels so good to see your time smoke free we show it to the second. Watch the money you've saving go up and your cravings come down each day. Get an idea how your health is improving and how much life you've regained.

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Follow this link for a quick scan QR code to access the Smoke Free Application.

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Smoke Free App - Subscription Activation

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Smoke Free is the most popular stop smoking app available. More than four million people from 190 countries have used the app in the past six years and it is rated 4.7 stars on the App Store (with 150,000 5-star reviews).

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Understand what vascular dementia is and how the choices you make in your lifestyle can help reduce your risk.

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What's on this page?

What is vascular dementia?

Dementia is a word used to describe a set of mental (the mind) and neurological (the brain) symptoms which worsen over time, such as memory loss and difficulty concentrating. It mostly affects people who are over the age of 65.

Vascular dementia is a specific type of dementia. It is the second most common type of dementia after Alzheimer's disease.

Like other types of dementia, vascular dementia doesn't have any known cure. Although it's sometimes possible to slow down the development of symptoms, unfortunately they will get worse as the brain loses more and more of it functioning.

What is mixed dementia?

It's also possible to have more than one type of dementia.

Some people with vascular dementia have another type of dementia too, most often Alzheimer's disease. This is known as 'mixed dementia' and is more common in the oldest age groups.

This doesn't mean you need to worry about seeing a different doctor. Specialists in dementia care will be able to support you or your loved one in managing the symptoms of both vascular and mixed dementia.

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What causes vascular dementia?

Vascular dementia is caused by a lack of blood supply to your brain. This stops the surrounding brain cells from working properly, causing them to die over time.

The causes of a reduced blood supply to your brain include:

small vessel disease - narrowing of small blood vessels deep inside your brain, often as a result of atherosclerosis (a build-up of fatty material inside your arteries)

a stroke - where the blood supply to part of your brain is suddenly cut off, due to a blood clot or haemorrhage (a bleed)

mini-strokes - known as transient ischaemic attacks (TIAs). These can cause tiny but widespread damage over time.

How is vascular dementia linked to atrial fibrillation and stroke?

Atrial fibrillation (AF) is an irregular heart rhythm which increases your risk of stroke.

AF can cause a blood clot to form in one of the top chambers of your heart. This can be pumped out of your heart to your brain where it can cause a stroke.

As vascular dementia often develops after a stroke, people with AF are at higher risk.

What are the risk factors for vascular dementia?

Risk factors are conditions or habits that increase your risk of developing a disease. Things that can increase your chances of getting vascular dementia include:

High blood pressure is a risk factor for developing vascular dementia. This is because a high amount of pressure in the blood vessels in your brain can damage your brain and lead to the causes of dementia. However, there's currently no evidence to say that lowering blood pressure will prevent someone from developing vascular dementia.

Find out more about high blood pressure and the risk of dementia.

What are the symptoms of vascular dementia?

The symptoms of vascular dementia can develop suddenly or gradually.

Your early symptoms will depend on which part of your brain has been affected. This means different people can experience different symptoms.

Vascular dementia can affect people of all ages, although it's often associated with growing older. If you're under 65 years old, it's known as 'young onset' or 'early onset' vascular dementia.

Early signs of vascular dementia include:

concentration problems, such as struggling to focus during a conversation

mood and personality changes, such as irritability or feeling low

poor short-term memory

difficulty with everyday skills, such as reading or driving

difficulty with decision making and planning

slowing down of thought processes

difficulty saying your thoughts clearly.

In the later stages, you may experience symptoms such as:

becoming increasingly confused and disorientated

long-term memory loss and difficulty concentrating

increasing difficulty remembering words and communicating

difficulty with balance or falling frequently

depression and personality changes

in some cases, loss of bladder control.

Help and support on healthy living

How is vascular dementia diagnosed?

If you suspect you or a loved one might have vascular dementia, it's important to talk to your GP as soon as possible.

The GP will:

explore what your issues are, when they started and how often they have been happening

ask how these issues have been affecting your life and those around you

carry out physical examinations, mental ability tests and other routine tests to help them rule out other physical or mental health causes.

Consider taking a loved one to you to the appointment, not only for support, but also to help the GP get a complete picture of how things have been for you.

If you can't take a loved one, your GP may want to reach out to them on the phone so they can better understand your daily routine and skills. This will only happen with your permission.

If your GP suspects vascular dementia, they will refer you to a specialist or memory clinic. You may then have a CT or MRI scan of your brain to check for any abnormalities.

Unfortunately, getting an accurate diagnosis can sometimes take time. But it's important you receive this so you can get the correct treatment and support.

The Ticker Tapes Podcast

Lesley's life took an unexpected turn when she was diagnosed with vascular dementia at age 50. Hear her story and other real experiences from people living with heart and circulatory diseases.

How is vascular dementia treated?

Although we're funding research to find new treatments, there's currently no cure for vascular dementia. However, there's lots of help and support to help you to continue to live well.

Medication

You might be given medication to control high blood pressure or high cholesterol. This may have contributed to your condition and controlling it can help slow down the progression.

If you have vascular dementia, medication given for Alzheimer's disease isn't recommended. However, you could be given this medication if you have a mixed diagnosis of vascular dementia and Alzheimer's disease.

Lifestyle changes

Research has shown that improving your lifestyle can help slow down the progression of vascular dementia. There are some small changes you can make that might reduce the chance of more damage to the blood vessels in your brain:

Support programmes

Your healthcare team may also suggest a range of social activities to improve your wellbeing and slow down the progression as much as possible.

Some examples include:

group cognitive (this means the process of thinking, reasoning, or remembering) stimulation therapy - taking part in group activities and discussions to help with memory and connecting with others

group reminiscence therapy - sharing life experiences, memories and stories from the past to help improve your wellbeing

cognitive rehabilitation or occupational therapy - getting support in carrying out everyday tasks independently for as long as possible.

BHF research into vascular dementia and stroke

Professor Joanna Wardlaw and her team at the University of Edinburgh are trying to predict who's at risk of developing vascular dementia after suffering a stroke.

The team are collecting information from hospital records, and performing thinking and memory tests on 2,000 people who have suffered a stroke. They're also collecting blood samples and carrying out brain scans to look for measurements that could act as markers for vascular dementia.

This work could help doctors better detect cognitive problems and help them decide on the best care for each individual patient.
Learn more about vascular dementia research

Living with vascular dementia

Some people diagnosed with vascular dementia are able to live well for many years. However, it's understandable if you feel overwhelmed and worried about how to cope.

On a practical level, there are many things you can do to support yourself, or someone diagnosed with vascular dementia. Some examples include:

break complex tasks down into small steps

use reminders, pill boxes or automatic medication dispensers so you don't forget to take medications

be aware of the things that make your symptoms worse, like noisy places

keep to a regular routine and be sure to include activities you enjoy.

Vascular dementia is a progressive condition (this means it gets worse over time), so it's likely you'll need further support at some point. People involved in your ongoing care might include:

healthcare professionals - your GP, physiotherapist, occupational therapist, or a specialist dementia nurse (such as an Admiral Nurse)

social services - you and your loved ones or carer might be able to access support by having an assessment of your needs

charities like Dementia UK can offer information, emotional support or advocacy services

private care and support services, such as paid care workers or your council. Other local organisations may provide meals delivered to your home, if you are eligible.

It's important for you and your family to discuss any help you might need, both now and in the future. It's also important that your wishes are considered at every step along the way.

Support for you and your loved ones

Whether vascular dementia is affecting you or someone you love, it's completely normal for the diagnosis to trigger a range of difficult emotions and questions about the future. Give yourself time to let the information sink in and try to seek support from loved ones.

While this page has covered some of the basics, here are some additional sources of information and support which may be of use to you:

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Page last updated: March 2023 Next update due: March 2026

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