Hypertension

Blood pressure measures the force blood exerts on the walls of your blood vessels as it travels through your body. If you have high blood pressure, your heart needs to pump extra hard. Over time, this puts you at risk for heart disease and stroke. High blood pressure is also linked to kidney disease, aneurysms, eye damage, sexual dysfunction, and other conditions. Because high blood pressure does not cause symptoms, it is known as a “silent killer,” second only to smoking as a cause of preventable heart disease and stroke deaths.

High blood pressure is the most common risk factor for stroke and heart disease. In addition, more than 50% of hypertensive patients have additional cardiovascular risk factors:

• Diabetes – 15%–20%
• Elevated LDL-cholesterol and triglycerides – 30%
• Excess weight/obesity – 40%
• Too much uric acid in the blood (Hyperuricemia) – 25%
• Metabolic syndrome – 40%)
• Unhealthy lifestyle choices such as smoking, high alcohol consumption, lack of exercise – 28-30%

The New Blood Pressure Guidelines

Blood pressure is measured with two numbers. The first number, systolic pressure, is the maximum pressure your heart exerts when it beats. The second number is diastolic pressure, which measures the maximum pressure in your arteries between heartbeats. The new guidelines are as follows:

• Normal is 120/80 or less
• Elevated blood pressure is 120 to 129 over 80 or less
• Stage 1 hypertension is 130 to 139 over 80 to 89
• Stage 2 hypertension is 140 and higher/90 and higher

By lowering the threshold for high blood pressure, the guidelines stress the need for early intervention to keep blood pressure under control. This has led to diagnostic and prescriptive changes:

• Before the new guidelines were established, 32% of the US adult population was considered to have high blood pressure — the new guidelines push this number up to 46% — nearly half the population
• 14% more people are now diagnosed with high blood pressure and counseled about lifestyle changes
• By lowering the definition of high blood pressure, the new guidelines call for earlier intervention to keep hypertension from progressing
• Medication is not recommended for Stage I hypertension unless a patient has already had a cardiovascular event or is at high risk of heart attack or stroke based on age and other health factors
• Socioeconomic status and psychosocial stress are risk factors for high blood pressure that should factor into a patient’s care plan

Hypertension is not a normal part of aging. If your blood pressure is above normal range, talk to your doctor. The first step in treating high blood pressure is making healthy lifestyle changes. This includes weight loss for overweight or obese patients; a heart healthy diet with sodium restriction and potassium supplementation within the diet; and increased physical activity. Men should be limited to no more than two and women no more than one standard alcohol drink(s) per day.

Depending on your numbers, you may need medication, or you may be able to manage your blood pressure with diet and lifestyle changes. However, when medication and lifestyle modifications are not enough to control it, MarinHealth is proud to offer the Symplicity™ Renal Denervation Procedure as a treatment option.

How To Dependably Monitor Your Own Blood Pressure

The new guidelines stress the importance of monitoring your blood pressure at home. Blood pressure fluctuates and levels should be based on an average of two-three readings on different occasions. Combining regular home readings with readings at a healthcare provider’s office can help identify the following:

• White coat hypertension, in which the blood pressure is elevated in a medical setting but not in everyday life. People with white coat hypertension feel stressed during a doctor visit, which temporarily raises their blood pressure. They do not have as elevated a heart disease risk as those with sustained high blood pressure.
• Masked hypertension, in which blood pressure is normal at the doctor’s office but elevated at home. People with masked hypertension may have stressors at home or at work that they don’t experience in the doctor’s office. Their heart disease risk may be like that of people with sustained high blood pressure.

Blood Pressure Monitoring Tips

Select a monitor that the American Medical Association recognizes as validated for clinical (you can find a list of these here).

• Don’t smoke, drink caffeinated beverages, or exercise within 30 minutes of taking your blood pressure.
• Empty your bladder and relax quietly for at least five minutes before you take your blood pressure
• Sit with your back straight and supported on a hard-backed chair as opposed to a sofa or soft armchair. Keep your feet flat on the floor and don’t cross your legs. Place your bare arm on a table next to you with your upper arm at heart level–don’t take measurements over clothing. Place the bottom of the cuff directly above the bend in your elbow. Check your monitor’s instructions for an illustration or have your healthcare provider show you how.
• Take multiple daily readings at the same time each day, such as morning and evening, and record the results. Each time you measure, take two or three readings one minute apart and record the results using a printable (PDF) tracker. If your monitor has built-in memory to store your readings, bring it to your medical appointments.