Most practices nowadays organise special clinics for groups of people with similar long-term illnesses - for example, diabetes, arthritis, epilepsy, gynaecological conditions, and family planning.

They are all very rewarding, because people attending them see big benefits from the extra attention they get at the clinic, rather than just another appointment at the regular surgery. They feel physically better when their diabetes or arthritis or epilepsy is under better control, and they appreciate their better quality of life.

High blood pressure clinics, on the other hand, are different. Most people with high blood pressure don't have symptoms. They usually discover their pressure is high at a routine medical, or when their blood pressure has been taken during a consultation for some other illness. Many people think that high blood pressure causes headaches or makes them anxious or erratic: that isn't true. If you have high blood pressure and a headache, your doctor will look for another cause for it.

Worse than that, bringing high blood pressure down may even make you feel worse than usual. For the first time you may have the odd dizzy spell, or feel woolly headed, or get extra tired when you run, or your sex drive may not be what it was. The usual response to this is to stop taking the tablets. Many people opt for the high pressure, rather than the treatment.

That may be a short-term solution, but it certainly isn't the long-term one. Because constant high blood pressure leaves you open to a higher risk of early stroke and heart attacks than people with a normal pressure. Bringing down the pressure into the normal range, and keeping it there, dramatically reduces your stroke risk. Which is why most doctors now run high blood pressure clinics. They want time to get the message across that high pressures are bad, even if you feel well. And to do so not just by prescribing drugs, but by persuading people with blood pressure problems to change their whole lives.

So at your first visit to a blood pressure clinic be prepared to answer a few pertinent questions about yourself and your family. Such as how much you smoke and drink. Smoking, even a few cigarettes a day, will raise your pressure. Drinking a little (around two small drinks a day) makes little difference, but go over that and the pressure rises. So the first step to better help and avoiding a stroke is to stop all smoking and to limit your alcohol intake. The type of alcohol doesn't seem to matter - although red wine has been promoted as good for us, it will still put up the pressure if you drink too much of it.

That's the easy part of starting to get the pressure down. The next is to persuade you to take enough exercise. A completely sedentary lifestyle raises, rather than lowers, the blood pressure. And if you take in more calories than you use up (very easy to do if all you do is sit around) the pressure will rise further as you put on weight.

So walk, run, swim, cycle, dance, play sports - whatever exercise you enjoy the most - and keep at it four or five days a week. Exercise enough to get breathless each time. Treat yourself to two days' rest a week to give your muscles time to recover. If you keep it up, you will quickly find that you are doing much more before you get short of breath, and you will probably be losing weight into the bargain. And your clinic doctor will be proud of you, as your pressure falls, often steeply. And eat healthily. Plenty of vegetables, fruit, starches (potatoes, bread, pasta, cereals) and lean meats like poultry and fish, with the occasional red meat treat if you wish.

How much salt you should eat with your meals is still a matter for debate. Some experts advise people with high blood pressure to cut it down to a minimum: others don't think it makes much difference. My own feeling is that no added salt at the table helps, and to avoid already salted ready-to-eat foods.

Which leaves us with the problem of blood pressure-lowering drugs. If your pressure remains persistently high, then you need them. Nowadays there are many types, one of which should suit you, with the minimum of side effects and the maximum of effect.

If you don't feel well on the first or even second course of drugs, then your doctor will find one on which you should feel better.

It's vital to stick at them and to keep the blood pressure as low as possible. And if that means a little inconvenience it is well worth it. The alternative is not pleasant, believe me.

Converted for the new archive on 30 June 2000. Some images and formatting may have been lost in the conversion.