Medically Reviewed by Brian P. Wall, MD

“About 30% of Americans with high blood pressure don’t even know they have it,” says McLeod Cardiologist Brain Wall, MD. “Just like diabetes, sometimes you don’t know you have it until you actually get checked for it. Some symptoms you could possibly experience include headaches, nosebleeds, lightheadedness, dizziness, flushing sensation or palpitations. All those health issues can be potential signs of high blood pressure.

“However, those symptoms could also be signs of a whole host of other problems as well. They’re very nonspecific terms that could be caused by high blood pressure and definitely that’s worth checking out.”

WHAT DOES MY BLOOD PRESSURE MEAN?

“Blood pressure, in general, is the force of blood on the vessels in the body when a heart contracts and squeezes blood out,” says Dr. Wall. “Your blood pressure has a top and bottom number. The top number represents the pressure when the heart is contracting. The bottom number is the pressure when the heart is relaxed.”

“Several years ago, the Joint National Committee came out with new recommendations,” says Dr. Wall. “They said if you’re 60 years or younger a blood pressure under 140/90 was acceptable. No treatment was needed at that point in time. If a patient is younger than 60 years goal than the blood pressure goal is less than 140/90. If the patient is 60 years old or older their goal should be less than 150/90.  However, if a person has diabetes or kidney disease their goal should be less than 140/90 no matter how old they are.”

MONITOR YOUR BLOOD PRESSURE

With numerous home devices available for taking your own blood pressure, Dr. Wall has these suggestions:

“You don’t need to take your blood pressure 6 or 8 times a day,” says Dr. Wall. “If you have a blood pressure machine at home, start by sitting down and resting comfortably for three minutes. Don’t talk or look around. Try not to be stressed by anything. Then take your blood pressure. The home machines may not be absolutely accurate, but they can give you a general idea of whether your blood pressure is reaching the problem range.”

CONTROL YOUR BLOOD PRESSURE

Lifestyle modifications can have a significant impact on your blood pressure. Here are three recommendations from Dr. Wall:

Watch your salt or sodium intake. This is a big problem here in the region. Everyone I question says they don’t add salt to anything. So we ask, ‘What do you eat?’ And it’s everything high in salt – potato chips, soups, TV dinners, frozen dinners and things like that. So watch your sodium intake.
Watch your weight. If you are overweight, for every pound you lose your top blood pressure number will go down one point.
Quit Smoking. All other elements aside, smoking by itself will make your blood pressure go up.

TREATING HIGH BLOOD PRESSURE

“If you are severely elevated, let’s say 180/90, lifestyle changes alone will not get your blood pressure down where you need it to be,” says Dr. Wall. “Most people will start with what we call a diuretic that removes excess water and salt from your body by making you go to the bathroom frequently. Initial drugs used for the treatment of hypertension include ACE inhibitors, angiotensin receptor blockers, hydrochlorothiazide or a calcium channel blocker.  A combination of two medicines is recommended if one’s blood pressure is greater than 20/10 over goal. A person’s race can also affect what we use to treat them. For African-Americans, we may turn to calcium channel blockers.

“So, treatment is not a one size fits all,” explains Dr. Wall. “Your ethnic background or other health issues you may have, such as diabetes or kidney problems, will affect which treatments are best for you.”

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