By Dr Zamiel Hussain, Lead GP at AccessGP
Reading time: 7 minutes
As the year draws to a close, many people in the UK are juggling darker mornings, packed commuter trains, year end deadlines and planning for the festive season. It is exactly the time of year when blood pressure can quietly creep up.
Cold weather can cause blood vessels to tighten, which raises blood pressure and increases the risk of heart attacks and strokes. At the same time, stress, less daylight, comfort eating, alcohol and less movement can all add extra strain on the cardiovascular system.
Hypertension is common, treatable and usually silent. The earlier it is found and the more consistently it is monitored, the more chance you have to prevent long term complications.
What is high blood pressure?
Blood pressure is the force of blood pushing against the walls of your arteries. It is recorded with two numbers, for example 120/80 mmHg.
- The top number (systolic) is the pressure when your heart pumps.
- The bottom number (diastolic) is the pressure when your heart relaxes between beats.
High blood pressure, or hypertension, means this pressure is consistently higher than it should be, which gradually damages blood vessels in the heart, brain, kidneys and eyes.
In England, around 30 to 33 percent of adults are estimated to have hypertension, and a significant proportion do not know they have it.
Why late autumn and winter are a riskier time
Several seasonal factors combine between November and February.
1. Cold temperatures
Exposure to cold causes blood vessels to constrict. This increases blood pressure and can also raise clotting factors and cholesterol levels, which together raise the risk of heart attacks and strokes, particularly in older adults and those with existing cardiovascular disease.
2. Less daylight and lower activity
Shorter days and poor weather often mean:
- Fewer outdoor walks
- More time spent sitting at a desk or on the sofa
- Reliance on convenience foods that may be higher in salt and fat
Lower activity and weight gain both increase blood pressure over time.
3. Festive habits
From work Christmas parties to family gatherings, the end of the year often brings:
- More alcohol
- Larger meals
- Extra salt in processed foods, snacks and sauces
Regularly drinking above recommended limits and eating a high salt diet are both well recognised risk factors for hypertension.
The role of work stress
Work stress is a key theme at this time of year. Many people report:
- Tight deadlines before the end of the quarter or financial year
- Long hours at a desk
- High pressure email and meeting culture
- Difficulty switching off after work
Acute stress can cause temporary spikes in blood pressure through adrenaline and cortisol. When stress becomes chronic, it contributes to long term hypertension, partly through these hormones and partly through associated habits such as poor sleep, caffeine, smoking, alcohol and comfort eating.
Hypertension is often called a silent condition. You may feel absolutely fine while blood pressure remains high at work, in the car or late at night. Without checking, you will not know there is a problem until complications appear.
How high blood pressure is diagnosed
In the UK, diagnosis follows NICE guideline NG136.
- Clinic blood pressure
- If a reading in clinic is 140/90 mmHg or higher, it should be repeated two or three times, and the lowest of the last two readings is recorded.
- Ambulatory or home monitoring
- If clinic blood pressure is 140/90 mmHg or above, ambulatory blood pressure monitoring (ABPM) over 24 hours, or structured home blood pressure monitoring (HBPM), is recommended to confirm the diagnosis.
- Thresholds used in practice
- Clinic readings of 140/90 to 159/99 mmHg with confirmed average daytime ABPM or HBPM of 135/85 mmHg or higher usually fall into what is called stage 1 hypertension.
The key point is that a single raised reading in a busy surgery or a stressful day at work does not automatically mean you need lifelong treatment. Confirming the pattern with ABPM or well structured home readings is important.
Why early detection matters
High blood pressure significantly increases the risk of:
- Heart attack and heart failure
- Stroke and transient ischaemic attack
- Kidney disease
- Vascular dementia and some eye problems
Because hypertension rarely causes symptoms, many people only discover it after a serious event. In England, millions of adults are thought to have undiagnosed hypertension. Detecting raised readings in your forties or fifties gives time to reduce risk with lifestyle changes and, when appropriate, medication.
Why regular monitoring makes such a difference
Once hypertension is diagnosed, the goal is long term control, not simply a good reading on the day of the appointment.
A number of studies and meta analyses have shown that:
- Home blood pressure monitoring predicts cardiovascular outcomes and target organ damage better than occasional readings.
- Self monitoring at home, when combined with appropriate support, leads to better blood pressure control compared with usual care alone.
Regular monitoring helps to:
- Identify white coat or masked hypertension
- See how blood pressure responds through the working week
- Check whether lifestyle changes are having an effect
- Optimise medication doses without over treating
In the context of work stress, reviewing patterns across weekdays and weekends can be particularly revealing.
Who should get their blood pressure checked and how often
As a general guide in UK primary care:
- All adults should have their blood pressure checked at least every five years, and more often if readings are borderline or high.
- Adults over 40 are invited for periodic cardiovascular risk checks, which usually include blood pressure measurement.
- You should have checks more regularly if you:
- Have had raised readings in the past
- Have diabetes, kidney disease, high cholesterol or established cardiovascular disease
- Have a strong family history of early heart disease or stroke
- Are of South Asian or African or Caribbean heritage
- Are overweight, smoke, or drink above recommended limits
Home monitors can be very helpful, but it is important to choose a validated device, use the correct cuff size and follow a structured protocol.
Practical ways to protect your blood pressure this season
1. Look after the basics
Evidence based lifestyle measures remain the foundation of blood pressure control:
- Salt awareness
Aim to limit salt, especially from processed foods, sauces, snacks and ready meals. - Plant rich, heart healthy diet
Include vegetables, fruit, whole grains, pulses, nuts and seeds, with lean protein and healthy fats. - Weight management
Even modest weight loss can reduce blood pressure. - Alcohol and smoking
Stay within weekly alcohol limits and seek support to stop smoking if needed.
2. Manage work stress more deliberately
- Build short, protected breaks into your working day.
- Use simple breathing exercises, brief walks or stretching to decompress.
- Create a clear end of day routine to help you switch off from work.
- Protect sleep time by limiting late emails, screens and caffeine.
If work stress feels overwhelming or is affecting your mental health, speak to your GP or occupational health team.
3. Take readings in a consistent, calm way
If you monitor blood pressure at home:
- Sit quietly for 5 minutes before checking.
- Take two readings, one to two minutes apart, morning and evening for at least four to seven days, then average them.
- Avoid caffeine, smoking and exercise for 30 minutes beforehand.
Share the readings with your GP so that decisions about treatment are based on accurate patterns rather than isolated numbers.
When to seek urgent medical help
High blood pressure itself usually does not cause symptoms. However you should seek urgent assessment (for example via NHS 111 or same day services) if you have:
- New or severe chest pain
- Sudden weakness in the face, arm or leg, especially on one side
- Difficulty speaking, sudden confusion or loss of vision
- Severe breathlessness or sudden, severe headache
- Any concerning symptom that feels unusual or serious for you
Always call 999 if you think you or someone else may be having a heart attack or stroke.
How AccessGP can help
At AccessGP we see high blood pressure as one of the most important long term health issues to address proactively.
Through our private GP service we can:
- Arrange structured blood pressure checks in a safe and convenient format
- Review your cardiovascular risk in detail, including cholesterol and relevant blood tests
- Support lifestyle changes tailored to your work, family life and preferences
- Optimise medication when it is needed, with close follow up and remote review
- Work alongside NHS care where needed
For many people, a focused review in late autumn is a good way to check where things stand before the winter period and to put a clear plan in place.
If you are concerned about your blood pressure, or if you simply have not had it checked for a while, booking a consultation can be a very effective first step.
Key sources: Health Survey for England – Adult hypertension data; NICE NG136 – Hypertension in adults; NHS UK – High blood pressure overview; ONS – Undiagnosed high blood pressure in England; BMJ – Clinic versus home BP monitoring; Systematic review – Home BP monitoring and cardiovascular outcomes; Public Health Wales – Winter cardiovascular risk.