Lamar Health Talk: High Blood Pressure by Crystal McCoy, MSN, Family Nurse Practitioner
Hypertension is the medical term for high blood pressure, namely a blood pressure above 140 mmHg systolic (upper value) and/or above 90 mmHg diastolic (lower value). About 1 in 3 U.S. adults—or about 75 million people—have high blood pressure. Only about half (54%) of these people have their high blood pressure under control.
High blood pressure is called the “silent killer” because it often has no warning signs or symptoms, and many people do not know they have it. Overall hypertension prevalence has not changed in the United States in recent decades although awareness, treatment, and control improved.
Untreated hypertension increases the strain on the heart and arteries, eventually causing organ damage. Hypertension increases the risk of heart failure, heart attack, kidney failure leading to dialysis, and stroke. Fortunately, treatments to lower blood pressure are usually easy to take and can help prevent health problems.
Making lifestyle changes is an important first step in the treatment of high blood pressure. In some patients, lowering sodium and alcohol intake, keeping weight in the ideal range, engaging in regular aerobic exercise, and stopping smoking can be sufficient to control high blood pressure. The DASH eating plan combines many of the interventions noted above. It is high in fruits and vegetables, low-fat dairy, and fiber. Patients who strictly follow the DASH eating plan can also have fairly significant reductions in weight, particularly when combined with a low-sodium diet. In susceptible individuals, nonsteroidal anti-inflammatory medications, otherwise known as NSAIDs (ibuprofen, naprosyn, etc), can increase blood pressure. If you are regularly consuming any of these substances, you can talk to your health care provider about potential substitutions.
Many patients also require one or more medications to lower the blood pressure. Common medications prescribed for high blood pressure include diuretics (furosemide), ACE inhibitors (lisinopril), ARBs (losartan), calcium channel blockers (amlodipine), and beta blockers (metoprolol). Although generally well tolerated, high blood pressure medications can cause side effects. The side effects depend upon the specific drug given, dose, and other factors. Some side effects result from lowering of the blood pressure, usually if the blood pressure lowering is abrupt, and therefore can be caused by any high blood pressure medication. These include dizziness, drowsiness, lightheadedness, or feeling tired. They usually subside after a few weeks when the body has adapted to the lower blood pressure.
If your health care provider knows or suspects that you have high blood pressure, he or she might want you to check it at home. There are a few reasons for this. Your provider might want to look at:
• Whether your blood pressure measures the same at home as it did in the provider’s office
• How well your blood pressure medicines are working
• Changes in your blood pressure, for example, if it goes up and down
People who check their own blood pressure at home usually do better at keeping it in an ideal range. Discuss appropriate blood pressure monitoring devices and techniques with your health care provider to ensure your readings are as accurate as possible. Record your blood pressure readings and bring the log with you to your appointment with health care providers.
Your health care provider is the best source of information for questions and concerns related to your medical problem.
Partner with a regular health care provider. By getting the right health services, screenings, and treatments, you are taking steps that help your chances for living a longer, healthier life.