From an interview with:
Tom Rives, MD – Primary Care Physician
McLeod Primary Care Little River

High blood pressure is when your blood pressure is higher than it should be. Dr. Tom Rives discusses the diagnosis and various treatment options for this common condition.

Blood pressure is determined by both what the heart pumps out and the resistance that the blood vessels provide. That combination tells us what the pressure is. We can measure what that actual number is using a blood pressure cuff in our office. 

Historically, if the top number is below 140 and the bottom number is below 90, we consider that normal. However, we like to see people at 130 over 80 and below as a better standard of keeping good control of their blood pressure. If your number is higher than that, it doesn’t automatically mean your doctor will put you on blood pressure medicine; there are multiple factors that would lead to that decision.

There are certain conditions that can cause high blood pressure, but for the majority of people, we call it primary or essential hypertension. However, there are secondary, much less common conditions that can cause high blood pressure, such as obstructive sleep apnea. 

Sometimes a physician will have a patient with high blood pressure, and they have trouble trying to treat the condition, even with the use of two or three medications. Many times, if the patient is a bit overweight, the physician can look in their throat and see their anterior-posterior diameter is a little bit reduced. They’re having trouble sleeping, they get sleepy throughout the day, they wake up with a dry mouth in the morning, and they have morning headaches. They may snore loudly at night. These are all signs that sleep apnea could be causing the patient’s high blood pressure.

The are a number of risk factors that contribute to high blood pressure:

Age and hardening of the arteries
Being overweight 
High salt content in the diet 
High consumption of alcohol 
Sedentary lifestyle

If a patient is diagnosed with high blood pressure, we typically begin treatment with therapeutic lifestyle changes. That would mean decreasing the salt in your diet, adding exercise, and losing some weight. We’ll let you monitor that for three months, even up to six months. If a patient can control their blood pressure on their own without needing medication, that’s certainly the preferred option. 

However, if they’ve tried for three to six months and haven’t had success, then we can begin treatment with medication. There are different classes of medicines, so there are different things we evaluate to determine which medicine is more appropriate for one person over the other.”

To learn more about high blood pressure, speak with a primary care physician.