NHS Hypertension Service

The check is free on the NHS. Nothing to pay, no referral, no appointment: walk in during opening hours and ask at the counter. The NHS Community Pharmacy Blood Pressure Check Service is funded for adults aged 40 and over who have not already been diagnosed with high blood pressure, and who have not had their blood pressure measured by a health professional in the previous six months.

If you are under 40 we can often still help. The service specification lets pharmacy staff use their discretion for people aged 35 to 39, and for anyone under 40 who asks because high blood pressure runs in their family. Ask rather than assuming you are too young: finding it early in people who do not yet know is the whole point of the service.

High blood pressure almost never causes symptoms. Most people who have it feel completely well, which is why the NHS advises every adult over 40 to be checked at least once every five years. Left untreated it raises the risk of heart attack, stroke, kidney disease and vascular dementia. Our chemist sits on Pinner Road between North Harrow and Harrow town centre, and we see plenty of people calling in from West Harrow or on the way back from Rayners Lane who would never have booked a GP appointment for it.

The check takes about five minutes. We take you into our private consultation room, wrap a cuff around your upper arm and take a reading while you sit still with your back supported and your arm at heart height. If the first reading is raised we take a second, and sometimes a third, because one high number on its own diagnoses nothing. Nerves alone push a reading up, and so does rushing in from the bus stop.

Prepare if you can. Avoid caffeine, exercise and smoking for at least half an hour beforehand, wear a sleeve you can push up easily, and use the toilet first, because a full bladder lifts a reading noticeably. Tell us about any heart or blood pressure medicines you take, and bring your figures if you monitor at home.

You get your number, and what it means, before you leave, along with practical advice on salt, alcohol, weight, activity and smoking. The reading goes to your GP surgery for your record. If you are about to start a blood pressure medicine for the first time, ask about our new medicine service, which gives you three free NHS consultations over your first month on it.

Ambulatory blood pressure monitoring, usually shortened to ABPM, is a different service from a one-off check in store, and it matters that you know which one you need. We fit a small monitor worn on a belt, with a cuff on your upper arm, and you wear it for 24 hours while you get on with a completely normal day. It inflates automatically at least twice an hour while you are awake, and less often overnight.

It is worth the inconvenience because it captures your blood pressure in real life rather than in a pharmacy. Some people's readings jump the moment a cuff goes on, which is known as white coat hypertension; others have normal readings in the room but high blood pressure the rest of the time. NICE treats ABPM as the standard for confirming a diagnosis and uses the average of at least 14 daytime readings rather than any single number.

NICE advises offering ABPM when a clinic reading falls between 140/90mmHg and 180/120mmHg, so it is the next step after a raised in-store check rather than something you would book first. Wearing it is straightforward: keep the cuffed arm still whenever it inflates, carry on as normal otherwise, sleep on the other side if you can, and do not shower or swim with it on. Bring the monitor back the next day and we download the results and send them to your GP. If a cuff inflating day and night is genuinely intolerable, home monitoring over several days is the recognised alternative.

Blood pressure is written as two numbers. The top one, systolic, is the pressure as your heart pushes blood out. The bottom one, diastolic, is the pressure between beats. The NHS considers blood pressure high at 140/90mmHg or above when a health professional measures it, or 135/85mmHg or above when measured at home or by ABPM, because readings taken away from a clinic tend to run slightly lower.

If your reading is raised we offer monitoring and tell your GP. If it is very high, meaning a top number of 180mmHg or more or a bottom number of 120mmHg or more, we do not wait: the service requires us to refer you urgently to be seen by your GP within 24 hours, and we contact the surgery directly rather than leaving it to you. Ring 999 instead of coming to us if a very high reading comes alongside chest pain, a sudden severe headache, blurred vision, breathlessness or weakness down one side.

The diagnosis and any treatment come from your GP, not from us. Our job is to find the people who do not yet know, and to keep an eye on the ones who do. Once you are on treatment we can dispense and review your medicines through NHS prescriptions, and you can drop in for a repeat reading whenever you want reassurance. For a set time rather than walking in, book an appointment or contact us on 020 8863 6338.