High Blood Pressure – Basics For Patients

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High Blood Pressure – Basics For Patients

High blood pressure (or Hypertension) affects more than 155 to 28% of the world. It accounts for more than 6% of adult deaths worldwide and is common to all human populations.

The primary determinants of geographic variation in hypertension are obesity, sodium and fat intake. You can do much about high blood pressure. First and foremost you can prevent it.

If your blood pressure is already high you can control it. High blood pressure is a chronic disease. You may lower your blood pressure in the “short term” but the goal is “long-term control” to prevent other medical consequences.

High blood pressure can wreak havoc on your heart (heart attacks or failure) kidneys (Kidney failure) and brain (stroke).

Most of the sickness and deaths due to high blood pressure is preventable. It may be costly in terms of time and resources, the savings in freedom from illness and a longer life is worth it.

Treating high blood pressure involves making use of the knowledge of all of the known contributing factors that cause hypertension.

Treatment includes:

1. A diet low in salt and fat and involves eating more grains, fruits and vegetables. This changes your lifestyle for the better.

2. Regular exercise is absolutely essential.

3. Elimination of poisons such as tobacco, excessive alcohol, recreational drugs, and excessive caffeine

If lifestyle changes do not work the drug therapy is then necessary to prevent long-term consequences of high blood pressure which are deadly and cause excessive morbidity with personal disability and excessive financial costs to the family and country.

Drugs should not be a substitute for improvements in lifestyle changes but an “addition” to lifestyle changes. You should always be aware of and be honest with your health care provider (HCP) of the following:

1. Duration of the blood pressure (when it was diagnosed).

2. Whether it has always been high.

3. Any family history of blood pressure.

4. Your lifestyle, (smoking, alcohol use, recreational drugs.)

5. Previous treatment with drugs diet, exercise or other means (herbs, bush, teas)

6. Use of drugs that could worsen blood pressure such as steroids, birth control pills or other non-steroidal agents (for pain or arthritis)

7. If you are on medication for blood pressure discuss freely their effects on your lifestyle especially your sex life.

Here are a few simple rules to follow to get an accurate reading if you have a monitor or are in the clinic:

1. Don’t smoke or drink alcohol or coffee within 15 minutes of a blood pressure measurement

2. The length of cuff in your BP instrument should be 80% of the circumference of the upper arm. That means that heavy or muscular people need a larger cuff and children need a smaller cuff.

3. Posture is important. Sit with your back supported and your elbow about the level of your heart (home) or lying down in the clinic.

4. You should rest for several minutes before the measurement.

5. Don’t talk during the measurement

6. Your urinary bladder should be empty before the measurement.

7. Take the measurement at the same time each day.

After you have established your systolic blood pressure (SBP) and your diaslotic blood pressure (DBP) measurement, your doctor or health care provider will determine whether it is “high”.

In 2014, new guidelines were established by the Joint National Committee on Prevention, Detection, and Evaluation and treatment of High Blood Pressure (JNC 8) which we use in St. Lucia.

The new guidelines states simply that the point at which action should be taken is as follows:

1. BP 140/90 under the age of 60 years.

2. BP 150/90 over the age of 60 years if the blood pressure is elevated.

People with diabetes and kidney Disease are special and should be treated as such.

Blood pressure varies widely. You should be aware that:

1. Blood pressure tends to drop quickly sleep.

2. Blood pressure quickly increases when you awaken- in the morning.

3. Respiration and heart rate affect blood pressure-it is increased.

4. Mental and physical activity affect blood pressure.

5. The night time fall in blood pressure is less in the elderly and people with diabetes.

6. Smoking raises blood pressure with each cigarette.

7. Sleep deprivation raises blood pressure.

8. Defecation or a bladder full of urine may raise blood pressure.

9. Consuming more than two ounces of alcohol on a dialy basis raises blood pressure.

10. Your blood pressure may be higher at the clinic.

Remember to check your doctor or nearest health centre or the St. Lucia Diabetes and Hypertension Association (SLDHA) for advice on how to treat your elevated blood pressure.

Remember high blood pressure (Hypertension) is a chronic disease known as the “silent killer” a medical terrorist among us.

Uncontrolled hypertension can lead to block arteries and serious damage to many parts of the body including brain and heart.

Symptoms of Heart Disease and Kidney Disease include shortness of breath, swelling of legs and abdomen.

Stroke can result from blocked arteries to the brain. People of African descent are more likely than whites to develop kidney disease, sometimes as a result of uncontrolled hypertension.

By seeing your doctor or health care or health care provider you can spot these problems early and with the help of a good diet, exercise and medication if necessary bring them under control.

D. Martin Didier, Consultant Physician, Internal Medicine, MBBS, DM, FACP, FRCP, FACC, FESC, Patron os St. Lucia Diabetes & Hypertension Association.

Suggested Readings:

1. High blood pressure for dummies-Alan Rubin MD

2. Hypertension Primer-American Heart Association

3. High Blood Pressure: The black Man and Woman’s Guide to living with Hypertension – James W. Reed MD.

4. Joint National Committee on Prevention, Detection and Evaluation and Treatment of High Blood Pressure (JNC 8 2014)