Written by Bryan Bart, PharmD Candidate 2015

 

Blood Pressure is one of the most important measurements health care professionals use to monitor heart health. Patients with high blood pressure often have no symptoms, but are at higher risk of heart disease – the number one leading cause of death in America. If you have high blood pressure, your doctor may diagnose you with hypertension.

 

What is blood pressure?

Blood applies pressure against the walls of your arteries in the same way a garden hose stiffens when you turn on the water. This wall pressure is what is measured by a blood pressure cuff. If the pressure inside your arteries gets too high, over time it will cause many negative effects on your health.

Blood pressure is recorded as two numbers (e.g. 120/80 mm Hg), called the systolic pressure and the diastolic pressure. The first number — systolic pressure — is the pressure applied to your arteries when your heart is compressed and is a higher number. The second number — diastolic pressure — is the pressure applied to your arteries when your heart is at rest and filling with blood, therefore the pressure is lower.

 

How can I tell if I have high blood pressure?

Hypertension is known as the “silent killer” because more often than not, patients have no symptoms of high blood pressure. Some patients may experience headaches or have vomiting, but this is rare. The only way to know for certain if you have high blood pressure is to have it measured and diagnosed by a doctor.

 

What are the consequences of chronic high blood pressure?

With high blood pressure, the heart has to work harder in order to push against the abnormally elevated pressure in your arteries. Over time, this leads to an increased risk of stroke, heart attack, and other heart disease. Heart disease is the leading cause of death in the United States. For more information about heart disease, click here.

 

What should I do if I have high blood pressure?

If you have been diagnosed with high blood pressure, it is important to frequently monitor your blood pressure to make sure it stays below your blood pressure goal. There are electronic blood pressure monitors which can be purchased for home use. Record your blood pressure in a log and bring your log to any visits you have with your doctor or pharmacist. Ask your doctor or pharmacist for a blood pressure log if you do not have one.

The most recent guidelines suggest these blood pressure goals:

Patient                                                              Blood Pressure Goal

Age over 60 years old                                          < 150/90 mm Hg

Age under 60 years old                                       < 140/90 mm Hg

Age over 18 with either chronic                          < 140/90 mm Hg                                                                 kidney disease of diabetes

 

Your goal may be different. Make sure to ask your doctor for your goal and write it down on your blood pressure log.

 

What else can help me manage high blood pressure?

Lowering your blood pressure is typically achieved by combining lifestyle changes with medications. It is important to take any medication prescribed by your doctor, even though you may feel no symptoms, to keep your blood pressure below goal. If you have questions about your medications, your pharmacist or doctor can help answer them. If you have side effects or issues with your medications, let your health care providers know so that they can work with you to alleviate your concerns.

The following lifestyle changes can also help reduce your blood pressure:

  • Quit Smoking: tobacco use increases your blood pressure. If you are considering quitting smoking and would like assistance, ask your doctor or pharmacist.
  • Decrease Alcohol: More than one drink per day for women or two drinks per day for men can also increase blood pressure.
  • Exercise and Lose weight: this can help reduce blood pressure and reduce the chance of developing heart disease.
  • Limit Salt: the DASH diet has been found to reduce blood pressure significantly.

 

 

What is the DASH diet?

The DASH (Dietary Approaches to Stop Hypertension) diet suggests:

  • eating more vegetables, fruits and fat-free or low-fat dairy products
  • including some whole grains, lean meats, vegetable oils, seeds and nuts
  • limiting red meats, sweets/sweet beverages like soda, limiting sodium (salt)

Of all the recommendations in DASH, limiting sodium (usually from salt or salty foods) is most important.

The recommendation for most Americans is to eat less than 2,300 mg of sodium daily. The DASH diet recommends a lower limit of 1,500 mg of sodium daily for these groups:

  • People who already have high blood pressure
  • People who have diabetes or chronic kidney disease
  • African Americans
  • People age 51 or older

The DASH diet was found to decrease systolic blood pressure by as much as 10 points! The DASH diet, especially when combined with weight loss and exercise, can reduce your risk for heart disease significantly.

 

Controlling high blood pressure is a team effort. You, your doctor and your pharmacist can all work together to find the best lifestyle and medication regimen for your individual circumstances.

 

References:

  1. CDC: Leading Causes of Death [Internet]. Atlanta: Center for Disease Control and Prevention; 2015 Jan 20 [updated 2015 Feb 6; cited 2015 Feb 10]. Available from: http://www.cdc.gov/nchs/fastats/leading-causes-of-death.htm.
  2. CDC: About High Blood Pressure [Internet]. Atlanta: Center for Disease Control and Prevention; 2014 Jul 7 [updated 2014 Jul 7; cited 2015 Jan 29]. Available from: http://www.cdc.gov/bloodpressure/family_history.htm.
  3. CDC: Behaviors That Increase Risk for High Blood Pressure [Internet]. Atlanta: Center for Disease Control and Prevention; 2014 Jul 7 [updated 2014 Jul 7; cited 2015 Jan 29]. Available from: http://www.cdc.gov/bloodpressure/behavior.htm.
  4. CDC: Family History and Other Characteristics That Increase Risk for High Blood Pressure [Internet]. Atlanta: Center for Disease Control and Prevention; 2014 Jul 7 [updated 2014 Jul 7; cited 2015 Jan 29]. Available from: http://www.cdc.gov/bloodpressure/about.htm.
  5. CDC: Heart Disease Fact Sheet [Internet]. Atlanta: Center for Disease Control and Prevention; 2014 Aug 20 [updated 2014 Aug 20; cited 2015 Jan 29]. Available from: http://www.cdc.gov/dhdsp/data_statistics/fact_sheets/fs_heart_disease.htm.
  6. NHLBI: What Is the DASH Eating Plan? [Internet]. Bethesda: National Heart, Lung and Blood Institute; 2014 Jun 6 [updated 2014 Jun 6; cited 2015 Jan 29]. Available from: http://www.nhlbi.nih.gov/health/health-topics/topics/dash/.
  7. Smith P, et al. Effects of the dietary approaches to stop hypertension diet, exercise and caloric restriction on neurocognition in overweight adults with high blood pressure. Hypertension. 2010 Mar 19;55(6):1331-1338.