High Blood Pressure Serious And Treatable
The number of people with high blood pressure (hypertension) has increased in the past two decades. High blood pressure is a serious and treatable condition and our ability to recognize and control it has had a dramatic improvement on people dying from heart attack over the last forty years. Much of the increase in cases of hypertension is related to the obesity epidemic, according to Dr. Paul D. Sorlie, from the National Heart, Lung and Blood Institute in Bethesda, Maryland. The average age at which blood pressure starts to increase is 60 for men and 40 for women.
Certainly lifestyle changes are recommended as the first treatment for lowering blood pressure and maintaining a healthy weight, exercise and diet are critical. But in many cases mediations are a necessary component of treatment. There are scores of different medications that can be used to safely lower blood pressure.
Patients are still confused about what the goal is for blood pressure. And we've learned that measuring blood pressure in the doctor’s office is not the best way to see if the goal is reached. Patient anxiety, lack of skill by the doctor or nurse and just poor hearing through the stethoscope can affect the results.
New guidelines have evolved and here they are:
Goal blood pressure for most patients younger than 80 years is lower than 140/90. The goal should be under 130/85 if the patient has diabetes, kidney disease or cardiovascular disease. The first number is the systolic and the 2nd number is the diastolic. Both are equally important to keep below the goal and numbers above 140/90 need treatment. Even a little over is too high and places the patient at risk for stroke or heart attack.
The patient should have their own automated blood pressure monitor that they use at home and if the majority of readings are not below 140/90, medication should be adjusted or added to reach the goal. Some patients require three different drugs to achieve normal blood pressure. The most important factor in preserving kidney function or reducing heart attacks is bringing blood pressure down to goal.
There are over 80 different drugs and combination drugs available to treat hypertension. (That tells you it is a common and chronic condition.) They fall into following classes of drugs:
* Angiotensin-converting enzyme (ACE) inhibitors
* Angiotensin receptor blockers (ARB)
* Beta blockers
* Calcium channel blockers
I always tell my patients, with that many choices, we will be able to find one that works and causes no side effects. It may take a little adjustment, but the end result is worth it. High blood pressure is serious and patients need to monitor it themselves and not just wait for the occasional trip to the doctor.