High Blood Pressure – the silent killer

Columbus BlackBlog Series Vol. 1, Dr. Christopher Brown

Exactly what is high blood pressure?
Male Doctor ImageHypertension or high blood pressure is a disorder that is defined as abnormally high pressure exerted by the blood against the walls of your arteries (the tubes that carry blood from your heart to your body).    It is commonly called the silent killer as it can be present for years causing damage to eyes, the heart, the brain and kidneys leading to blindness, heart failure, strokes and kidney failure.   Approximately 1in 3 Americans has hypertension and of the people that have hypertension only about half are controlled to the appropriate level.
High blood pressure is common and uncontrolled hypertension potentially deadly, but the good thing is that it is easily diagnosed and treated and most of the diseases caused by hypertension can be prevented.
How do you find out if you have high blood pressure?
Of course your first question is how to find out if you have this ‘silent killer’.    I’m sure most of you are familiar with the common ‘tool’ used to measure your blood pressure, the sphygmomanometer, also known as the “blood pressure machine/monitor”.   This is a cuff that goes around your arm.   It is inflated with air and slowly deinflated.   The result will be two numbers one on top of the other.   The top number is your systolic blood pressure – the pressure your blood exerts on the wall of the vessels when the heart pumps.  The bottom number is the diastolic blood pressure – the pressure your blood exerts on the wall of the vessels when the heart is at rest.   Once you have the blood pressure then you will fall in one of three categories, normal blood pressure, prehypertension or hypertension.
Where can you have your blood pressure checked?
Your blood pressure can be checked in a number of different places.  You can have it checked when you get a physical or go to a clinician for unrelated reason.  You can also have it checked at a health fair.   In addition there are a number of other places where you can have it checked for free.   A lot of pharmacies or grocery stores will have a place where you can have you’re blood pressure checked.   Also some fire departments will check your blood pressure.
So you found out you have hypertension now what?
If you find you have a high blood pressure reading at a place where a clinician is not available don’t panic!   The most important thing for you to do is to contact your doctor, nurse practitioner, or physician assistant to see if you need to be seen urgently.  Most people who have a high blood pressure reading, but no symptoms will be ok with following up in a clinic, but if you find you have an abnormally high reading it’s best to contact a clinician that knows you. If you don’t have an existing relationship with a clinician then contact one at an urgent care or emergency room.  They can let you know if you have a level of blood pressure that requires being managed in the hospital or if you can establish with a clinician in a clinic setting.
Once you get a primary care clinician they will perform an  exam and confirm if you have hypertension.   If you have prehypertension and no other medical problems then likely you will be prescribed lifestyle modification to prevent your blood pressure from getting higher and possibly bring it to the normal range.     If you have hypertension then your goal blood pressure will depend on the presence of certain co-existing medical problems.    If you have medical problems such as kidney disease or diabetes then your clinician will recommend a lower blood pressure than if you only have hypertension.
Treat hypertension and live longer and better…..
High blood pressure treatment falls in two broad categories that work best when they are used together.   Lifestyle modification and medication.
Lifestyle modification
Lifestyle modification refers to changes in the way you live.   The two most important components are diet and exercise, but it also refers to weight loss and decreasing stress.    Dietary changes include decreasing sodium and increasing potassium in the diet.  Decreasing sodium in the diet can be achieved by using salt substitutes, reading labels and avoiding high sodium foods, using salt at the table, but not while cooking.   Keep a journal of the food you eat and consider seeing a dietician to help decrease the sodium in your diet.
Exercise helps to either prevent or treat a number of medical problems and hypertension is another malady that seems to respond to regular exercise.   Exercise also assists with weight loss which is very important in controlling hypertension.
There are a lot of medications that can be used to treat hypertension.  They vary in the way they work, the number of times a day you take them as well as cost.    It is extremely important that you work closely with your clinician when taking medication to manage you high blood pressure.   You should monitor your own blood pressure at home and keep a log so that your clinician can make sure your blood pressure is at a safe range.   Also you need to let your clinician know if you have any side effects.   This part is key!   If you have side effects from a medication let your clinician know so they can use a different medication.   Don’t just stop taking medication without letting your clinician know.    They can find another medication that will work for you.  If you don’t like taking pills multiple times a day see if your clinician can prescribe a once a day medication.   If you feel that your medication cost too much let your clinician know so they can see if a less costly medication can be used to treat your high blood pressure.   Medication to treat high blood pressure can be obtained for as little as $4 per month from certain pharmacies.
Hypertension is a common disease that if uncontrolled can lead to serious problems and disability.  The good thing is that it is easily diagnosed and managed, but requires you to establish with a clinician and work with them to get and keep your elevated blood pressure under control.
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To learn more about Dr. Brown, check out his bio.

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