High Blood Pressure: How to Treat, Monitor and Medicate This Common Condition

Home Health Care - High Blood Pressure

An Introduction to High Blood Pressure

Everyone has heard of the term “high blood pressure” and everyone over the age of 45 fears the day when they might have it. But what really is high blood pressure? Where does it stem from? And are there better or worse ways to monitor and treat it?

When blood cells and plasma are pumping through your veins and arteries, they are exerting pressure onto the walls, and the walls are therefore exerting a pressure back. The amount of pressure can fluctuate, with the vessel walls expanding or contracting depending on which pressure is stronger. Your blood pressure is the measure of the force of your blood pushing against these vessel walls. When high blood pressure comes into play, there is too much pressure coming from the inside of the vessel walls and it starts to damage the body. If left untreated, it will cause permanent damage to the heart and veins/arteries of the body.

Your blood pressure is measured in two different numbers: your systolic blood pressure and diastolic blood pressure. The systolic number is a measure of the force pushing against the vessel walls when the heart is contracting while the diastolic number is a measure of the pressure in the vessels when the heart is resting between beats. The systolic number is usually written on top with a line over the diastolic number; like 120/80. A normal blood pressure reading would be less than 120 mmHg for systolic and 80 mmHg for diastolic. An “at risk” reading, or a sign of pre-hypertension, would be between 120-139 mmHg for systolic and 80-89 mmHg for diastolic. A high reading would be 140 mmHg or higher for systolic and 90 mmHg or higher for diastolic, and this would technically be considered high blood pressure.

Untreated high blood pressure can increase your risk for many other diseases - including heart attack, stroke, chronic heart failure, and kidney disease. About 8 out of 10 people having their first stroke have high blood pressure, about 7 out of 10 people with heart failure have high blood pressure and about 7 out of 10 people having their first heart attack have high blood pressure.

So what can you do to lower your blood pressure in the first place? Thankfully there are some small lifestyle changes that can easily lower your blood pressure, and also make you a healthier individual overall. These include keeping your weight in a healthy range, eating a healthy diet high in nutrients and low in sugar, salt and fats, decreasing your alcohol intake, decreasing your salt intake, not smoking tobacco, exercising regularly and trying not to stress out! Hormones released when your body is stressed can make your blood vessels tighten and your blood pressure higher. This is one of the more silent causes of high blood pressure that people don’t often consider and is super relevant in the day and age that we are living in currently.

How to Monitor at Home

According to the American Heart Association, 70% of adults who have high blood pressure could get it under control by just monitoring it at home themselves. People whose blood pressures start to creep up over the normal level range, so higher than 120/80, should start to monitor their blood pressure at home. To make sure you’re getting the best results you should buy a good blood pressure cuff, make sure its accurate, prep beforehand, be consistent and take multiple readings in a row.

Purchase an automatic upper-arm style cuff and make sure the cuff fits. If it’s too large or too small for your arm then you will get inaccurate readings. Take the cuff you bought to your doctor and have them do a reading with it to make sure it is getting accurate results. Also have your doctor watch you taking your blood pressure to make sure you are doing it correctly. Don’t smoke tobacco, drink caffeine, or exercise 30 minutes before taking your blood pressure. Also make sure to use the bathroom before taking a reading, a full bladder can add 10-15 points to your reading. Another thing to consider is how you sit - slouching or sitting with your back or feet unsupported can raise your reading by 5-10 points, and crossed legs can increase your reading by anywhere from 2-8 points. Make sure to sit up straight in a chair with your back against something and your feet on the ground. Rest your arm on a surface, like a table, with a slight bend in the elbow. While taking the reading, remain still and silent. Also, always take the reading with the cuff directly on your bare skin.

Make sure to be consistent with when you are taking your blood pressure. Try to take it at the same time everyday so you are in a similar state of mind and place to give more accurate results. There is no need to take it more than once per day. The best time is probably first thing in the morning, before you’ve eaten or drank coffee. There’s no need to take multiple readings per day but make sure to take a few right after each other in a row, to confirm that there is not a random false reading. Take two or three in a row, about 1 minute apart. If you get an obscure reading, talk with your doctor about it at your next visit. If your blood pressure readings suddenly exceed 180/120 mm Hg, wait five minutes and test again. If the next reading is still unusually high, contact your doctor immediately.

How to Properly Treat Your High Blood Pressure

The most common treatments to treat high blood pressure are ACE inhibitors, beta blockers and thiazide diuretics. ACE inhibitors work by relaxing constricted blood vessels, beta blockers reduce heart rate and output of blood, and thiazide diuretics eliminate extra water and sodium in the blood. A study published in the Lancet showed that thiazide diuretics were the most effective of these treatments. It was found in the study that patients taking thiazide diuretics were 15% less likely to have heart attacks, strokes and hospitalizations from high blood pressure than patients who were on ACE inhibitors. Another interesting conclusion from this study was that ACE inhibitors caused more unwanted side effects - including rash, cough, diarrhea and kidney failure. A common side effect of thiazide diuretics is low potassium and low sodium. Fortunately, these are both easily combated with a daily supplement.

ACE inhibitors always have been, and still are, the go-to prescription by doctors for high blood pressure. The results from this study show that maybe there will be a change in how doctors treat high blood pressure in the future. This could also potentially have long term ramifications on the amount of high blood pressure turning into something more serious, like a heart attack or stroke. However, make sure you talk to your doctor before self-justifying that thiazide diuretics are better for you than any current medication. Different people of different ethnic backgrounds and ages might respond differently to certain medications. If the medication your own now is working for you, then it’s still probably a good choice.

Besides what type of medication you are on, the time you take your medication can also have a large impact on the amount that your blood pressure is lowered. Taking blood pressure medication at night, instead of in the morning, could significantly lower your risk for heart-related disease and death. Another recent study has found that people who take their medication at night, instead of in the morning, cut their risk of heart attack or stroke by nearly half. How could that possibly be? Well blood pressure has a daily pattern, just like humans do. It normally is the lowest at night and increase a large amount in the morning when you wake up. By the afternoon it starts to go down again, with it being its lowest point again by night. "It better targets the morning rise in blood pressure,” says Osborne, a researcher from the study. “If you take your blood pressure medicine in the morning, it may already be after the peak, and then the peak concentration of the drug is hitting a few hours later, well after the peak of blood pressure.” Overall, people in the study who took their medication at night lowered their risk of heart attack by 34%, their risk of stroke by 49%, their risk of heart failure by 42%, and their risk of death by heart related problems by 50%.

High blood pressure is a serious condition that affects a huge portion of the population. Specifically people over the age of 45. Thankfully there are ways to mitigate your risk for high blood pressure, including changes in your lifestyle, monitoring your own blood pressure at home, what medication you take and when you take your medication.

If you or someone you know is suffering from high blood pressure, heart disease or other age specific diseases, American In-Home Care and its subsidiaries, Whitsyms In-Home Care, Advocate In-Home Care and Douglas In-Home Care can help. Visit our website to learn more about the in home health services we offer for you and your loved ones.

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