Blood pressure meter medical equipment isolated on white
High blood pressure is also known as hypertension (HTN). When blood leaves your heart (left ventricle), its systolic pressure is approximately 120. When blood returns to your heart (left auricle), its diastolic pressure is approximately 80. Blood flows through the body and delivers oxygen and nutrients to various organs, while also helping remove waste products.
Blood pressure is regulated by the kidneys in combination with adrenals and liver (RAAS) via hormones and chemicals. Baroreceptors (pressure sensitive receptors) in blood vessels also play an important role. Blood pressure can vary according to circumstances such as exercising, stress, fear, etc. Blood pressure should be stable at rest.
Hypertension is diagnosed as having elevated blood pressure over one to two weeks (four to six readings). Uncontrolled hypertension can cause significant damage to kidneys, small blood vessels (capillaries, micro-vessels), the brain, heart and eyes. For example, vessel damage can cause an aneurysm. Other side effects of hypertension include sexual dysfunction, stroke, dementia and even premature death.
Elevated blood pressure that initially has no symptoms is known as asymptomatic hypertension. Symptoms usually arise after one to three years. Initial symptoms might go unnoticed and include weakness, tiredness, fatigue, vision changes, shortness of breath, lack of concentration and dizziness. Organ-related symptoms could be due to specific damage to multiple organs (e.g., blurred vision, shortness of breath, trouble urinating, weakness).
Hypertension is divided into stages.
- Stage I. Blood pressure – Systolic 130-139 / Diastolic 80-90.
- Stage II. Blood pressure – Systolic 140 / Diastolic 90 or higher.
Common causes of hypertension are:
- Excessive sodium intake
- Being overweight
- Having a sedentary lifestyle
- Excessive stress
- Lack of sleep
- Existing illnesses
Usually, it is a combination of multiple factors. Hypertension complications are more progressive if you have other illnesses and risk factors (e.g., diabetes, overweight, smoking, etc.)
It is important to diagnose and manage hypertension to avoid organ damage and complications.
Monitor your blood pressure, pulse and weight at home, once every two weeks. If blood pressure or pulse are abnormal, start monitoring three to four times a week, for two weeks. If it remains abnormal, call your doctor for further advice. If your blood pressure is registering at Stage II or higher, call your doctor immediately and seek further advice.
Stage I Hypertension. Initially, this can be treated by lifestyle and dietary changes. Reduce salt (sodium) intake to less than 1,500 mg per day. Start walking 1-2 miles daily, get adequate sleep 7-8 hours per day, decrease the intake of ultra-processed foods (e.g., potato chips, donuts, pizza, commercial pre-made sandwiches, etc.). Eat more non-processed foods like fruits and vegetables. Alternatively, you can follow the DASH diet or a Mediterranean diet. Monitor your blood pressure regularly for four weeks. If your blood pressure is still elevated, call your doctor for further advice. If you develop any symptoms, call your doctor or seek medical help immediately.
The most used antihypertensive medications are thiazide diuretics, ACE inhibitors, ARB, calcium channel blockers or a combination of these. What you are prescribed is ultimately based on your blood pressure and your body’s response to lifestyle changes and medications.
It is important that you take your blood pressure correctly. No exercise, caffeine or verbal excitement at least 30 minutes prior to a blood pressure reading. We recommend using a battery-operated self-inflating blood pressure unit (Omron, Welch Allyn, ADC or similar units). These devices usually cost between $40 to $80. A good unit is accurate and will last a long time.
Blood pressure is taken on the right upper arm while sitting and the arm is resting on a table at mid chest level. An arm should be taken out of a shirtsleeve before measuring blood pressure. Use an adult cuff size (covers approximately 1/2 – 2/3 size of upper arm) and wrap the sleeve around the arm comfortably. A blood pressure cuff usually has a small circle or a dot-like marking on its lower edge. This marking should be on the lower edge and near the middle of the elbow (or over the pulse of the elbow) while taking the blood pressure reading. Start the blood pressure unit by pressing the start button. It will inflate and then slowly deflate. At times it may inflate again, while halfway deflating. At the end, it will deflate completely. This is your blood pressure and pulse reading.
Write down the blood pressure reading, pulse rate, date and time. If the blood pressure readings are unusually high, pulse is high (>100) or slow (<60), repeat the measuring process after 10 to 15 minutes. If the readings do not improve, call your doctor.
The goal here is to monitor blood pressure and avoid organ damage during the “no symptom” stages. Also, if you have hypertension, it is important to make lifestyle and dietary changes to improve blood pressure control and decrease the use of medications. Hypertension affects all organs of the body. Some organs are more sensitive than others. Getting sick is expensive.
Next month we will discuss adult-onset diabetes.
Mian Majeed, MD has been practicing medicine for over 40 years and is licensed in NY. He also speaks Urdu / Hindi & Punjabi. You can email him at info@click2md.healthcare.
