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100 55 blood pressure: Blood Pressure Guidelines: The Numbers That Really Matter

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Blood Pressure Guidelines: The Numbers That Really Matter

Roughly a week before Thanksgiving in 2017, the American College of Cardiology (ACC) and the American Heart Association (AHA) released new guidelines for what constitutes high blood pressure, or hypertension, effectively putting 46 percent of Americans above the threshold for what is considered safe.

Under the old guidelines, only 1 in 3 American adults, or 33 percent of the population, were considered to have high blood pressure, which was defined as a blood pressure reading of 140/90 mmHg (millimeters of mercury). The new guidelines define high blood pressure as 130/80 mmHg.

These new guidelines, which appeared in an article published in November 2017 in the Journal of the American College of Cardiology, were developed with nine other health professional organizations to hopefully more accurately identify those at risk for serious health issues.

“One good thing about the new guidelines is that they remind people that high blood pressure is a major risk factor for premature heart disease, stroke, heart attacks, heart failure, and even dementia,” says William Frishman, MD, chair of medicine at New York Medical College and director of medicine at Westchester Medical Center in Valhalla, New York. “By following the new guidelines, we’ll see fewer negative health outcomes from high blood pressure.”

What Is Blood Pressure and What Do The Numbers Mean?

Blood pressure is the force of your blood pushing against the walls of your arteries each time your heart beats. The first number in a blood pressure reading represents the force exerted when your heart contracts. This is called systolic pressure. The second number, diastolic pressure, measures the force exerted between beats. Elevated systolic blood pressure has been shown to be a better predictor of cardiovascular disease risk than diastolic blood pressure, according to research published in March 2014 in The American Journal of Medicine.

Under the new guidelines, blood pressure categories are now defined as follows:

  • Normal: Less than 120/80 mmHg
  • Elevated: Systolic between 120 and 129 and diastolic less than 80
  • Stage 1 hypertension: Systolic between 130 and 139 or diastolic between 80 and 89
  • Stage 2 hypertension: Systolic at least 140 or diastolic at least 90 mmHg
  • Hypertensive crisis: Systolic over 180 or diastolic over 120, which requires prompt changes in medication if there are no other indications of problems, or immediate hospitalization if there are signs of organ damage

Will the New Guidelines Put More People on Medication?

Not necessarily. But before any discussions about medication occur, it’s important to confirm that you actually have high blood pressure. Your blood pressure fluctuates throughout the day, especially when you’re active or nervous. For example, it’s common for patients to have elevated blood pressure readings in their doctor’s office. This is referred to as white coat hypertension.

“Patients should have their blood pressures measured in different ways than in the past,” says Mary Ann Forciea, MD, chair of the clinical guidelines committee for the American College of Physicians. “The standard should be measurement by an electronic machine after five quiet minutes in the examination room, not on arrival at the practice. Alternatively, some patients may have their blood pressures measured over a period of 24 hours with a specialized home monitor, or keep logs of home measured blood pressure.”

If you have systolic blood pressure between 120 and 129, Dr. Frishman recommends to change some of your health behaviors, like weight management and eating better. If your systolic blood pressure is between 130 and 139 and you already have heart disease or are at increased risk for heart disease, your doctor may consider treating your high blood pressure with medication. For people with relatively uncomplicated high blood pressure, your doctor may wait until it reaches 140 or above to treat. In many cases, the goal will be to treat the blood pressure to 120 or below with lifestyle changes and medication when appropriate.

It’s important to remember that under the new guidelines, only a small increase in the number of adults requiring antihypertensive drugs is expected. If you do need medication, the good news is that all the drugs for blood pressure are generic and relatively inexpensive. They’re also well tolerated by most patients.

Role of Lifestyle Change in Managing Blood Pressure

The new guidelines also highlight nonpharmacological approaches for lowering blood pressure, including:

  • Weight loss for those who are overweight and obese
  • A healthy diet
  • Sodium reduction
  • Increased physical activity
  • Limited alcohol consumption. For example, it’s recommended that men have no more than two drinks daily, and that women have no more than one drink daily, since alcohol can raise your blood pressure.

Weight management in particular is very important, notes Frishman, but changes don’t have to be extreme. For example, if a person is 30 or 40 pounds (lbs) overweight, even losing 5 to 10 lbs can be enough to help bring their blood pressure down. Modest changes in weight can also reduce your risk of developing diabetes.

What Do the Guidelines Mean for Older Adults?

One criticism of the new guidelines is how to best treat older adults with high blood pressure. For example, if an older person’s systolic blood pressure is over 170, trying to get it down to 120 can be very challenging. In this scenario, lowering the blood pressure to 150 or even 145 can still have benefits, notes Frishman.

In January 2017, the American College of Physicians and the American Academy of Family Medicine announced a guideline on blood pressure targets for people 60 and older that appeared in an article published in March 2017 in the journal Annals of Internal Medicine. They recommended that physicians initiate treatment when persistent systolic blood pressure is at or above 150 mmHg, to achieve a target systolic blood pressure of less than 150 mmHg, because high-quality evidence shows that it reduces the risk of mortality, stroke, and cardiac events.

“All experts agree that reducing blood pressure to levels of 150/90 in all patients is beneficial. Almost all agree that in some patients reducing further has benefit. If you can’t achieve that goal through weight loss, diet, and exercise you will benefit from a conversation with your physician about what medications are best for you, and what target blood pressure best meets your needs,” says Dr. Forciea.

But even with the new guidelines, treatment must be individualized.

“Physicians will be trying to give the best advice possible for each patient. What blood pressure target is best for an individual will depend on many factors: their history of diabetes, heart disease, or stroke, coexisting illnesses, and their own personal goals about lifestyle management and medication use,” says Forciea. “What’s best for a patient in one exam room may not be best for the patient in the next room.”

It’s important to have open communication with your doctor and to practice shared decision making. That’s when you work together with your doctor to make health decisions and to create a plan of action that’s right for you.

Dealing with low blood pressure during pregnancy

Symptoms of low blood pressure can be feeling weak and dizzy, confused, or feeling sleepy with nausea, blurred vision and feeling faint. At this stage of your pregnancy, low blood pressure is usually a transitional phenomenon caused by a remarkable increase in blood volume that temporarily dilutes your blood and may cause a shortlived anaemia. This is nothing to worry about – just make sure that you’re taking an iron supplement and drinking enough fluids during the day.

More worrying is persistent low blood pressure that causes fainting, because this could indicate an underlying problem such as anaemia or diabetes. Some women who have low blood pressure in the first and second trimester may have high blood pressure in the later stages of her pregnancy – a condition that’s more problematic. Acute or sudden low blood pressure accompanied with severe pelvic pain could be a life-threatening emergency such as a burst ectopic pregnancy that needs urgent medical attention.

The increased circulating blood volume at this stage of your pregnancy is to help your womb cope with the extra demands of your growing baby and is also a preparation in anticipation of a normal blood loss (about 500mls or two cups) when you give birth. Thanks to the pregnancy hormone oestrogen that helps the heart and blood vessels to cope with this extra volume, your blood pressure quickly settles down to what it should be– 120/80 mm Hg (mercury).

When there is an underlying health problem, the heart slows down, resulting in low blood pressure, and the blood is not pumped efficiently around the body, denying vital organs of nutrition and oxygen. Hypotension or low blood pressure is diagnosed when readings are persistently below 100/65 mm Hg.

Causes of low blood pressure:

  • Standing up too quickly- after sitting or lying down.
  • Lying on your back in a very hot bath for too long. 
  • Insufficient fluid intake, or nausea with vomiting, or problematic morning sickness. 
  • Anxiety, especially combined with hyperventilation (breathing too quickly). 
  • Low blood sugar levels as with diabetes and gestational diabetes. 
  • Underlying problems with heart, kidneys or blood vessels. 

Natural ways of dealing with low blood pressure:

  • Take your time getting up in the morning- ideally have somebody bring you tea in bed!
  • Make sure you get enough liquid to drink during the day. 
  • Deal with nausea and vomiting- see a doctor. 
  • Ask your doctor to check for anaemia. 
  • Sit down periodically during the day especially if your job involves a lot of standing , eg. hairdressers and school teachers. 
  • If the dizziness and fainting continues, see a doctor. 

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High Blood Pressure and Stroke

The main groups of blood pressure medication are: 

  • ACE (angiotensin-converting enzyme) inhibitors.
  • Angiotensin-2 receptor blockers.
  • Calcium channel blockers.
  • Thiazide-like diuretics.

These are the most commonly used ones, but other types are also available, including beta-blockers.

ACE inhibitors

These drugs are usually the first choice of treatment for people aged under 55 who are not of African-Caribbean origin. Angiotensin II is a hormone which regulates blood pressure. ACE inhibitors stop the production of this hormone and relax your arteries, so your blood pressure falls. 

ACE inhibitors seem to work better at lowering your blood pressure if you also reduce the amount of salt you eat. 

Examples of ACE inhibitors include enalapril, lisinopril, perindopril and ramipril.

Possible side effects include dizziness, tiredness, weakness, rash, headaches and changes to your sense of taste. The most common side effect is a persistent dry cough. If this is troublesome, you may be advised to try an angiotensin-2 receptor blocker medication instead (see below) which works in a similar way. 

You will have blood tests after starting or increasing your dose of ACE inhibitor to check your kidney function and the level of potassium in your blood.

ACE inhibitors can cause unpredictable effects if they are taken with other types of medication including non-steroidal anti-inflammatory drugs like ibuprofen, as well as other drugs such as antacids and lithium. You should not take ACE inhibitors at the same time as Angiotensin-2 receptor blockers (ARBs). Check with your GP or pharmacist before taking any other types of medication if you take an ACE inhibitor. 

Angiotensin-2 receptor blockers (ARB)

Like ACE inhibitors, these work on the hormone angiotensin-2 by blocking its effects. They are usually used instead of an ACE inhibitor if you are not able to tolerate one. The two types of medication should not be used together.

These drugs are usually recommended for people aged under 55 who are not of African-Caribbean origin. They can be useful if you have diabetes or kidney disease as well as high blood pressure. This is because these types of drug can protect your kidneys. 

Examples include candesartan, irbesartan, losartan, valsartan and olmesartan. 

Possible side effects are usually mild and include dizziness, headache or cold or flu-like symptoms.

Calcium channel blockers

These drugs are particularly effective in controlling high blood pressure in people aged over 55 and in African-Caribbean people of any age. They stop calcium from entering the muscle cells in your heart and blood vessels. This widens your arteries and lowers your blood pressure. 

Examples of calcium channel blockers include amlodipine, felodipine and nifedipine. Diltiazem and verapamil may also be prescribed. 

Possible side effects include swollen ankles, ankle or foot pain, constipation, skin rashes, a flushed face, headaches, dizziness and tiredness. 

You should avoid drinking grapefruit juice while taking some types of calcium channel blockers as it can increase the amount of medication in your bloodstream. This can make your blood pressure drop suddenly and increase your risk of side effects. Ask your doctor or pharmacist for advice.

Thiazide-like diuretics

Thiazide-like diuretics are the diuretics most commonly used to treat high blood pressure. Diuretics are also known as water pills because they work by flushing out excess water and salt from the body through urine. This class of drug is often very successful in lowering blood pressure, especially in people over 55 and those of African-Caribbean origin. 

You may need to have regular blood tests after you start treatment to check that the potassium levels in your blood have not dropped, and that your blood sugar level is maintained.

Examples of thiazide-like diuretics include indapamide and chlortalidone.

Possible side effects include an increased need to go to the toilet, feeling thirsty, dizziness, weakness, feeling lethargic or sick, muscle cramps, skin rash, an increase in uric acid (a chemical in the body that can cause kidney problems and gout), raised blood sugar levels and for men, problems with getting an erection. Taking diuretics with beta-blockers can increase your long-term risk of diabetes. Check with your doctor whether this medicine combination is right for you. 

Other types of medication

Beta-blockers

Beta-blockers work by making your heart beat more slowly and with less force, which reduces your blood pressure. They are usually only recommended if other treatments haven’t worked, because they are less effective than other treatments.

It is important that you do not suddenly stop taking this type of medication without seeking medical advice first. These drugs would need to be tailed off gradually. Stopping suddenly can lead to serious side effects such as a rise in blood pressure or an angina attack. 

Examples of beta blockers include labetalol, atenolol, and bisoprolol. 

Possible side effects include slowing of the heart rate, cold fingers and toes, nausea, diarrhoea, tiredness and disturbed sleep.

If you are taking beta-blockers and experience difficulty breathing, or develop asthma, you should contact your doctor immediately. 

Other drug groups 

Other drugs that may be used to control blood pressure include doxazosin and terazosin (which belong to a group called alpha-blockers), and clonidine and methyldopa (which belong to a group called centrally acting drugs). Another type of diurectic called spironolactone can also be used at low doses. These drugs are only usually recommended if other treatments haven’t worked. 

In a small number of cases, medicines to lower blood pressure can react negatively with other health conditions or types of medication you may be taking, including some over-the-counter ones. Always ensure your GP knows your full medical history, and check with your GP or pharmacist before taking any other types of medication.

Many people experience no side effects when taking their medication. However, if you are reacting badly to your blood pressure medication or start to feel unwell, make an appointment with your doctor or nurse as soon as you can.  

Digital Blood Pressure Measurement

Blood pressure is the force of the blood against the wall of any blood vessel. The blood pressure measurement is written in numbers. The systolic (sis TAU lick) blood pressure is the top number. The diastolic (dy a STAU lick) blood pressure is the bottom number (for example, 110/60).

  • The systolic blood pressure is the pressure of the blood against the artery walls when the heart contracts (beats).
  • The diastolic blood pressure is the pressure of the blood against the artery walls between heartbeats, when the heart relaxes.

Doctor’s Orders 

Take the blood pressure on the child’s

  • Right arm 
  • Left arm
  • Right leg
  • Left leg 

Take your child’s blood pressure every day at the same times: 

_____________, _____________, _____________, _____________, _____________, and _____________.

When to Call the Doctor

Call your child’s doctor:

  • If the top number is: above ______ or below ______ for ______ blood pressure readings or for ______ hours.
  • If the bottom number is: above ______ or below ______ for ______ blood pressure readings or for _______ hours.

Other instructions:

____________________________________________________________________________________________________

____________________________________________________________________________________________________.

Assemble the Blood Pressure Unit

It is important to read the manual that comes with the blood pressure unit.

Follow these 5 steps to get your blood pressure unit ready to use.

  1. After you open the device, insert the batteries. The battery compartment is on the back of the device (Picture 1).
  2. Remove cover from the bottom plate, as shown.
  3. Insert 4 batteries (size AA). Always use AA long life batteries or alkaline 1.5 volt batteries. Do not use rechargeable batteries.
  4. If a battery warning appears in the display, replace the batteries. Connect the tube.
  5. Insert the cuff tube into the opening on the side of the device, (Picture 2).

How to Take a Blood Pressure Reading

  1. Place the cuff snugly about 1 inch above your child’s elbow, usually on the left arm (Picture 3).
  2. Press the On/Off/Memory button to turn on the many symbols will appear in the display window for 2 seconds. A blinking 0 appears in the display.
  3. Grasp the bulb with the hand opposite of the arm the cuff is on. Pump the bulb to fill the cuff with inflate the cuff to a number at least 30 mmHg higher than the expected top pressure. See Average Blood Pressure by Age chart below.
  4. AgeBlood Pressure
    Premature 55-75/35-45
    0-3 Months65-85/45-55
    3-6 Months70-90/50-65
    6-12 Months80-100/55-65
    1-3 Years80-105/55-70
    6-12 Years100-120/60-75
  5. When the cuff is inflated, lay down the bulb. Have your child relax and sit quietly. The measurement now proceeds on its own. As the device measures the blood pressure, the numbers always show in the window. If no measurement takes place, a flashing arrow pointing up will show in the display. Pump the bulb again to a higher number.
  6. When the device senses a pulse, a heart symbol in the display starts to flash. You will hear a beep for each heartbeat.
  7. When the measurement is complete, the systolic and diastolic blood pressure and the pulse show in the display. Quickly release the cuff pressure.

Keeping a Record 

It is It is important to keep a record of your child’s blood pressure. Use the Daily Blood Pressure Record on the next page, a regular calendar, or Helping Hand HH-3, Daily Record.

  1. Write your child’s blood pressure in the box for that day. For example, if your child’s blood pressure is 120/60 and 122/62 on the first day, you would record it as shown in the example below.
  2. Take the record with you whenever your child sees the doctor.

Digital Blood Pressure Measurement (PDF)

HH-II-213 4/16 Copyright 2016, Nationwide Children’s Hospital

High Blood Pressure and Heart Disease in Women

Is high blood pressure considered heart disease?

High blood pressure is a condition that makes the heart work harder than normal. And left untreated, it scars and damages your arteries and can lead to heart disease such as heart attack, stroke, kidney failure, eye damage, heart failure and fatty buildups in the arteries, called atherosclerosis.

What are the symptoms of high blood pressure in women?

High blood pressure, also known as HBP or hypertension, is widely misunderstood and is called the ‘silent killer’ because there can often be no symptoms. We often assume it affects those who are type-A personalities, tense and aggressive. But the truth is, it has nothing to do with personality traits. In fact, you can be the most relaxed, calm person and still suffer from HBP.

What is healthy or normal blood pressure in women?

There is no difference in what is considered normal blood pressure in women and men. The different levels are the same for all adults.

Blood pressure is typically recorded as two numbers and a written as a ratio.

  • Systolic: The top number in the ratio, which is also the higher of the two, measures the pressure in the arteries when the heart beats.
  • Diastolic: The bottom number in the ratio, which is also the lower of the two, measures the pressure in the arteries between heartbeats.

Your blood pressure rises with each heartbeat and falls when your heart relaxes between beats. While it can change from minute to minute with changes in posture, exercise, stress or sleep, it should normally be less than 120/80 mm Hg for women or men aged 20 or over.

The different blood pressure levels are:

  • Normal: Less than 120 systolic and less than 80 diastolic
  • Elevated: 120-129 systolic and less than 80 diastolic
  • High Blood Pressure (Hypertension) Stage 1:
    • 130-139 systolic or 80-89 diastolic
  • High Blood Pressure (Hypertension) Stage 2:
    • 140 or higher systolic or 90 or higher diastolic
  • Hypertensive Crisis: higher than 180 and/or higher than 120 diastolic

View the AHA blood pressure levels chart.

Because blood pressure can fluctuate, consider investing in a home blood pressure monitor to record your numbers regularly. Doing so can help your healthcare team determine whether you really have high blood pressure and, if you do, whether your treatment plan is working.

Learn how to measure your blood pressure properly.

Are women at higher risk of having high blood pressure?

Women are about as likely as men to develop high blood pressure at some point during their lives.  While high blood pressure isn’t directly related to gender, pregnancy, birth control or changes to a woman’s body surrounding menopause can impact her high blood pressure.

You have an increased risk of developing high blood pressure if you are 20 pounds or more overweight, have a family history of high blood pressure, or have reached menopause.

While there is no cure, HBP can be managed and sometimes prevented by:

These simple changes can go a long way and are key factors in lowering your numbers.

Will taking birth control pills increase my chances of getting high blood pressure?

Doctors and researchers have found a link between birth control pills and an increase in blood pressure among some women. They say that it is more likely to occur in women who are overweight, have kidney disease or have a family history of high blood pressure.

Talk to your health care team to determine what forms of birth control may be best for you. Women with known medical problems or other special conditions might need additional examinations or tests to determine the appropriate method of contraception.

Will high blood pressure effect my chances of getting pregnant?

Women who improve their heart health before pregnancy can reduce their medical risks later. This proactive approach can lower the likelihood of pregnancy complications. If you’re considering becoming pregnant, talk to your health care team about healthy changes you can make to help both you and your baby be healthier.

Doctors and researchers have found a link between birth control pills and an increase in blood pressure among some women. They say that it is more likely to occur in women who are overweight, have kidney disease or have a family history of high blood pressure.

Learn more about pregnancy and maternal health, including information on being healthy before, during and after a pregnancy.

Diabetes and High Blood Pressure |

If you have diabetes you should aim to keep your blood pressure well controlled. Having high blood pressure (hypertension) is one of several risk factors that can increase your chance of developing heart disease, a stroke and some other complications. Treatment includes a change in lifestyle risk factors where these can be improved. Many people with diabetes need to take medication to lower their blood pressure.

How common is high blood pressure in people with diabetes?

In the UK, about 1 in 4 of people have high blood pressure (hypertension). It is less common in younger adults. High blood pressure is more common in people with diabetes. Around 3 in 10 people with type 1 diabetes and around 8 in 10 people with type 2 diabetes develop high blood pressure at some stage.

People with diabetes are more at risk of developing high blood pressure if they:

  • Are of African-Caribbean origin.
  • Are from the Indian sub-continent.
  • Have a family history of high blood pressure.
  • Have certain lifestyle factors – for example, those who:
    • Are overweight.
    • Eat a lot of salt.
    • Do not eat much fruit and vegetables.
    • Do not take much exercise.
    • Drink a lot of alcohol.

What is high blood pressure?

This is not as simple to answer as it may seem. In general, the higher the blood pressure, the greater the risk to health. Depending on various factors, the level at which blood pressure is said to be high (hypertension) can vary from person to person.

The cut-off point for blood pressure that is said to be high is 140/80 mm Hg or above for people with diabetes and 130/80 mm Hg for those with diabetes and complications (for example, kidney disease). These are lower than the cut-off point for people who do not have diabetes.

Note: high blood pressure actually means that your blood pressure remains above the cut-off point each time it is taken. That is, your blood pressure is sustained at a level higher than it should be and is not just a one-off high reading when you happen to be stressed.

High blood pressure can be:

  • Just a high systolic pressure – for example, 170/70 mm Hg.
  • Just a high diastolic pressure – for example, 120/104 mm Hg.
  • Both – for example, 170/110 mm Hg.

See the separate leaflet called High Blood Pressure (Hypertension).

What causes high blood pressure?

The cause is not known in most cases. This is called essential hypertension. The pressure in the blood vessels depends on how hard the heart pumps, and how much resistance there is in the blood vessels (arteries). It is thought that slight narrowing of the arteries increases the resistance to blood flow, which increases the blood pressure. The cause of the slight narrowing of the arteries is not clear.

Various factors probably contribute. (It is a bit like water in a hosepipe. The water pressure is increased if you open the tap more but also if you make the hosepipe narrower by partially blocking the outflow with your thumb.)

Diabetic kidney disease

Diabetic kidney disease (diabetic nephropathy) is a complication which develops in some people with diabetes. In this condition the kidneys are damaged, which can cause high blood pressure. This is more common in people with type 1 diabetes.

Rarely, high blood pressure is caused by other conditions. It is then called secondary hypertension. For example, certain kidney or hormonal problems can cause high blood pressure. 

Do I need any tests?

If you are diagnosed as having high blood pressure (hypertension) you are likely to be examined by your doctor and have some routine tests which include:

  • A urine test to check whether you have protein or blood in your urine.
  • A blood test to check your kidney function and to check your cholesterol level.
  • A heart tracing (electrocardiogram, or ECG).

The purpose of the examination and tests is to:

  • Rule out (or diagnose) a secondary cause of high blood pressure.
  • Check to see if the high blood pressure has affected the heart.
  • Check whether you have other risk factors such as a high cholesterol level.

Several of these tests are ones that are routinely done anyway if you have diabetes, even if you do not have high blood pressure.

Why is high blood pressure a problem?

High blood pressure (hypertension) is a risk factor for developing a cardiovascular disease (such as a heart attack or stroke) and kidney damage, sometime in the future.

If you have high blood pressure, over the years it may have a damaging effect on blood vessels (arteries) and put a strain on your heart.

In general, the higher your blood pressure, the greater your health risk. However, high blood pressure is just one of several possible risk factors for developing a cardiovascular disease.

Other risk factors that also increase the risk of developing a cardiovascular disease are:

  • Lifestyle risk factors that can be prevented or changed:
    • Smoking.
    • Lack of physical activity (a sedentary lifestyle).
    • Obesity.
    • An unhealthy diet.
    • Excess alcohol.
    • High cholesterol blood level.
    • High fat (triglyceride) blood level.
  • Diabetes.
  • Kidney diseases that affect kidney function.
  • A strong family history. This means if you have a father or brother who developed heart disease or a stroke before they were aged 55, or in a mother or sister before they were aged 65.
  • Being male.
  • An early menopause in women.
  • Age. The older you become, the more likely you are to develop furring or ‘hardening’ of the arteries (atheroma).
  • Ethnic group. For example, people who live in the UK, with ancestry from India, Pakistan, Bangladesh or Sri Lanka, have an increased risk.

Diabetes plus high blood pressure is a particularly strong combination of risk factors.
In addition, some other complications of diabetes are more common if you have high blood pressure. For example, damage to the back of the eye (diabetic retinopathy) and kidney damage related to diabetes (diabetic nephropathy).

What are the benefits of lowering blood pressure?

There is now plenty of good evidence from studies that controlling blood pressure in people with diabetes reduces the risk of future complications.

A large research study called the UK Prospective Diabetes Study confirmed this. In this study, many people with diabetes were monitored over several years. The study found that those with well-controlled blood pressure had nearly a third less risk of dying from complications related to diabetes (heart attack, stroke, etc) compared with those with poorly controlled blood pressure.

In fact, this study found that good control of blood pressure was even more beneficial than good control of the blood sugar (glucose) level to reduce the risk of developing complications from diabetes.

Since this study, other studies have been undertaken which confirm these results. 

How can blood pressure be lowered?

There are two ways in which blood pressure can be lowered:

  • Modifications to lifestyle (weight, exercise, diet, salt, and alcohol) if any of these can be improved upon (details below).
  • Medication (details below).

Lifestyle treatments to lower high blood pressure

  • Lose weight if you are overweight:
    • Losing some excess weight can make a big difference.
    • Blood pressure can fall by up to 2.5/1.5 mm Hg for each excess kilogram which is lost.
    • Losing excess weight has other health benefits too.
  • Regular physical activity:
    • If possible, aim to do some physical activity on five or more days of the week, for at least 30 minutes. For example, brisk walking, swimming, cycling, dancing, etc.
    • Regular physical activity can lower blood pressure in addition to giving other health benefits.
    • If you previously did little physical activity and change to doing regular physical activity five times a week, this can reduce your blood pressure.
  • Have a low salt intake:
    • The amount of salt that we eat can have an effect on our blood pressure. Government guidelines recommend that we should have no more than 6 grams of salt per day. (Most people currently have more than this.)
    • Tips on how to reduce salt include:
      • Use herbs and spices rather than salt to flavour food.
      • Limit the amount of salt used in cooking and do not add salt to food at the table.
      • Choose foods labelled ‘no added salt’ and avoid processed foods as much as possible.
  • Eat a healthy diet
    • If you have diabetes you will normally be given plenty of advice about a healthy diet.
    • A healthy diet provides health benefits in different ways. For example, it can lower cholesterol and help control your weight. It also has plenty of vitamins, fibre and other nutrients which help to prevent certain diseases. See the separate leaflet called Type 2 Diabetes Diet.
  • Drink alcohol in moderation:
    • Too much alcohol can be harmful and can lead to an increase in blood pressure.
    • You should not drink more than the recommended amount. That is for both men and women no more than 14 units of alcohol per week, spreading the units out through the week and having at least two alcohol-free days a week.
    • Pregnant women and women trying to become pregnant should not drink alcohol at all.
    • One unit is in about half a pint of normal-strength beer, or two thirds of a small glass of wine, or one small pub measure of spirits.
    • Cutting back on heavy drinking improves health in various ways, including lowering your blood pressure.

Treatment with medication

  • If you have diabetes, treatment with medicines is usually advised if your blood pressure remains at 140/80 mm Hg or above despite lifestyle treatments.
  • The target blood pressure is below 130/80 mm Hg if you have had kidney or eye problems, or have had a stroke.

There are several different medicines that can lower your blood pressure. The one chosen depends on such things as:

  • Whether you have other medical problems.
  • Whether you take other medication.
  • Possible side-effects of the medicine.
  • Your age.
  • Your ethnic origin.

The first medicine most often used is a medicine called an angiotensin-converting enzyme (ACE) inhibitor. ACE inhibitors protect against kidney damage as well as helping to control blood pressure. See the separate leaflet called Diabetic Kidney Disease.

One medicine reduces high blood pressure to the target level in less than half of cases. This therefore means that it is common to need two or more different medicines to reduce your blood pressure to a target level (140/80 mm Hg or below).

In about a third of cases, three medicines or more are needed to get blood pressure to the target level. See the separate leaflet called Medicine for High Blood Pressure.

How long is medication needed for?

In most cases, medication is needed for life. However, in some people whose blood pressure has been well controlled for a period of time, medication may be able to be stopped. In particular, in people who have made significant changes to their lifestyle (such as lost a lot of weight, stopped heavy drinking, etc). Your doctor will be able to advise you if you can reduce any of your medication.

Smoking and high blood pressure

Smoking does not directly affect the level of your blood pressure. However, smoking greatly adds to your health risk if you already have high blood pressure (hypertension) and diabetes. If you smoke, you should make every effort to stop.

What is the danger of low pressure

You should check your blood pressure regularly
Photo: pixabay.com

Due to hypotension, the body is deficient in oxygen.

Many people are aware of the dangers of hypertension – high blood pressure.However, low blood pressure – hypotension – is no less dangerous. The portal “Medical Information Network” tells about it.

Hypotension occurs at a pressure of 90 to 60 and below. It can be determined using symptoms such as dizziness, blurred vision, feeling of nausea, loss of energy, decreased concentration, or even fainting. This is due to the fact that the blood slows down and the cells of the body begin to lack oxygen. In the most severe cases, this can lead to life-threatening consequences.Symptoms of a severe drop in blood pressure appear as follows:

  • confused consciousness;
  • Cold, pale and clammy skin
  • weak pulse, but palpitations;
  • Ragged breathing.

If you have these symptoms, you should immediately consult a doctor.

If you encounter hypotension often, then you should pay attention to your lifestyle. Experts recommend moving more during the day.However, it is worth doing this evenly, without overloading yourself. Try to drink more, sometimes the pressure drops due to lack of moisture. It is also worth reconsidering your eating habits. First, it is worth giving up alcoholic beverages, as they dilate blood vessels. Second, add more folic acid and vitamin B12 foods to your diet.

90,000 Arterial hypertension: risks and factors for the development of the disease

What is arterial hypertension?
Arterial hypertension (or hypertension) is high blood pressure (BP).It is considered to be elevated when the value is 140/90 mm Hg or more. According to most studies, hypertension (HD) is detected in 25-30% of the population. With age, the incidence of HD increases, and among people over 60 years of age, it is detected already in 40%. By itself, an increase in blood pressure may not cause any unpleasant sensations, so many people with hypertension do not even assume that they are seriously ill. They do not go to a doctor, they do not have their blood pressure measured, they do not receive any treatment, which, of course, is unacceptable.

What is dangerous

Why are high blood pressure dangerous?
It is dangerous because it has an adverse effect on internal organs and systems – the so-called “target organs”: heart, blood vessels, kidneys, myocardium, peripheral arteries, retina, etc. This increases the mass of the myocardium, thickens the wall of blood vessels, accelerates development of atherosclerosis of the vessels of the heart (coronary arteries), aorta, carotid and other arteries. The vessels of the retina are affected. Sclerotic processes develop in the renal tissue with subsequent impairment of its functions (renal failure).

Against this background, life-threatening complications often appear – acute myocardial infarction and cerebral stroke. These complications can arise suddenly for the patient and those around him, when, it would seem, nothing foreshadows them.

GB is called the “silent killer” for a reason. Not all patients know or feel that they have high blood pressure, and not everyone knows what this can lead to. According to statistics, in 68 out of 100 cases of myocardial infarction, and in 75 out of 100 cases of stroke, patients had high blood pressure.For a long time before the attack, it was not treated, or the treatment was not adequate (that is, the pressure did not reach the norm or target values). It has been proven that a decrease in blood pressure by only 3 mm Hg. Art. can significantly reduce deaths from stroke and coronary heart disease.

Development risk

Does the risk of complications depend on the level of increased blood pressure?
Yes, it does. The higher the blood pressure, the higher the risk of developing all complications: myocardial infarction, cerebrovascular accident, heart failure, kidney damage, etc.
The likelihood of complications depends on both systolic (first, “top” number) and diastolic (second, “bottom” number) blood pressure.

Factors

What factors, besides the level of blood pressure, influence the incidence of cardiovascular diseases?
The level of blood pressure is the most important, but far from the only factor that determines the severity of arterial hypertension, prognosis and treatment tactics. Of great importance is the assessment of the overall cardiovascular risk, the degree of which depends on the presence or absence of risk factors, damage to “target organs” and existing diseases.

The list of reasons that should be considered when determining the overall cardiovascular risk of developing cardiovascular diseases includes:

  • increase in total cholesterol level (more than 5.0 mmol / l), (150 mg / dl)
  • increase in the level of low-density lipoproteins (more than 3.0 mmol / l), (115 mg / dl)
  • decrease in the level of high-density lipoproteins (less than 1.0 mmol / l – for men and 1.2 mmol / l – for women),
  • the presence of early cardiovascular diseases in relatives (for women under 65 and men under 55),
  • abdominal obesity (waist circumference: husband. – more than 102 cm, women – more than 88 cm)
  • impaired glucose tolerance (diabetes mellitus),
  • low physical activity,
  • increased fibrinogen levels.

What is important to know about coronary heart disease?

IHD is the common abbreviation for Ischemic Heart Disease.

At the heart of ischemic heart disease is the discrepancy between the heart’s need for oxygen and the delivery of oxygen to the heart muscle (myocardium). Most often, the reason for this discrepancy is the narrowing of the lumen of the vessels of the heart by atherosclerotic plaques, which is why during physical activity (walking, running, climbing stairs), with excitement, angina attacks may occur.

Typical manifestations of an attack of angina pectoris: pain, burning, compression behind the sternum, sometimes a feeling of shortness of breath. After the termination of the load, the pain quickly disappears. The most formidable manifestation of ischemic heart disease is myocardial infarction, when blood circulation in any part of the heart muscle stops completely and myocardial cells die.

Why should young people think about CHD prevention?

It has been proven that the first signs of atherosclerosis can be found in blood vessels already from childhood, from 11-12 years.While the plaques are small, the lumen of the vessels is not significantly changed, and the person does not feel the signs of the disease. Sometimes he simply does not pay attention to changes in well-being, a decrease in exercise tolerance and, often, for the first time, he learns that he suffers from ischemic heart disease when myocardial infarction occurs, which is especially typical for young and middle-aged men.

IHD risk factors

The likelihood of developing coronary heart disease can be predicted for each individual. The role of heredity is great, especially if heart attacks, strokes occurred in close relatives under the age of 55. Other most significant factors are:

– smoking

– high blood pressure

– elevated blood glucose

– increased blood cholesterol levels and violations of its composition

– overweight and obesity

– insufficient physical activity (physical inactivity)

Alcohol abuse, stress, depression are also of great importance.

The connection of smoking with the development of ischemic heart disease has been proven for a long time. Nicotine accelerates the development of atherosclerosis, increases blood clotting, which leads to the formation of blood clots that clog the blood vessels. During physical exertion, the vessels normally expand, allowing more blood to pass through, while in a smoker, on the contrary, the vessels narrow, which can be very dangerous.

High blood pressure overloads the heart muscle, accelerates the development of atherosclerosis. It is known that about 40% of the population has high blood pressure, but most of them do not know about it, although it is enough to measure blood pressure several times to make a diagnosis.Among those who know about their high blood pressure, or hypertension, many are not treated, or are treated irregularly. Many international studies involving tens of thousands of people have proven that blood pressure control is the most important factor in the prevention of many dangerous conditions, including coronary heart disease.

Elevated blood glucose levels significantly increase the risk of coronary heart disease. Careful monitoring of blood glucose levels is required.A normal blood glucose level is not higher than 5.5 mmol / l. For people with diabetes mellitus and impaired glucose tolerance, it is important to maintain blood pressure no higher than 120/75 mm Hg. Art. and the blood cholesterol level is not higher than 4.0-4.5 mmol / l.

Overweight threatens a person with the development of many diseases, incl. coronary heart disease, arterial hypertension. The most common calculation of the body mass index (BMI) today. To calculate it, you need to divide the body weight (in kg) by the height, expressed in meters, and squared:

Index = MT / growth 2

BMI = 18.5 – 24.9 Ideal body weight

BMI = 25 – 29.9 Overweight

BMI = 30 – 34.9 Obesity

BMI> = 35 Severe obesity

For example: Your weight is 80 kg with a height of 1.65 m.

BMI = 80 / 1.65 2 = 29.38

You are overweight. The risk of comorbidities is increased.

Elevated cholesterol level threatens the development of coronary artery disease, strokes, peripheral vascular disease. It is important to determine not only total cholesterol, but also the correct ratio of its constituent parts – fractions. There is no need to understand this, the doctor will do it, it is important to adhere to the principles of rational nutrition. Compliance with a special diet (limiting animal fats, fried foods, eating foods with a low fat content, daily consumption of at least 400 g of vegetables and fruits) will reduce cholesterol levels by 10-15%.If this is not enough, your doctor will prescribe medication for you.

Lack of physical activity (physical inactivity) – this factor is so easy to cope with! The effect will be visible immediately: training will improve heart function, strengthen blood vessels, and improve glucose uptake. This will lower your risk of developing diabetes, help you lose weight, and improve your mood. And you can always find the opportunity to move. The main thing is regularity and duration: at least 30-40 minutes and at least 5 times a week.

What should we do to avoid coronary heart disease?

Of course, we cannot change our inheritance. But we can eliminate many of the risk factors. It is better to act in a comprehensive manner, in all directions at once, then the chances of staying healthy will be much greater.

Stop smoking. Choose the method that suits you: it is easier for someone to stop smoking once and for all, for someone it is easier to gradually reduce the number of cigarettes smoked, someone needs the help of a specialist.The result is important, and the efforts will pay off.

Limit alcohol consumption to 20 grams per day in terms of “pure” ethanol, which is approximately 50 ml of spirits or 150-200 ml of wine for men. For women, the amount of alcohol should be reduced by 2 times. Please note that the recommended limits mean: “no more than this amount per day.” If you have not consumed alcoholic beverages for two days, this does not mean that then you can drink a triple “norm” at once.

Think over the diet, meals – at least three times a day.The basis of food is cereals (“gray” cereals – oatmeal, buckwheat, pearl barley, etc., bread made from wholemeal flour, with the addition of bran), vegetables, fruits, dairy products with a low fat content. Lean meat, but better – fish and “white” chicken meat, or turkey meat, without skin. Salt should also be limited to 4-6 g (1 teaspoon) per day, taking into account the salt used for cooking.

Try to move as much as possible. Even in the most hectic schedule, you can choose the opportunity to train the heart and blood vessels.Do not get a couple of stops to the house, but walk them. If you have to use the elevator – go up the stairs at least to a floor or two, go down the stairs too. Dynamic exercises are required: walking, running, swimming, skiing, cycling. Physical activity should last 30-40 minutes at least 5 times a week. Pay attention to this! There will be no health benefits if you overload your body with three-hour workouts once a week, and lead a sedentary lifestyle on other days.

Interact with your doctor. For the prevention of ischemic heart disease, it is necessary to control three main indicators: blood pressure, cholesterol and blood glucose. If your indicators are normal, blood pressure should be measured at least once a year, cholesterol and blood glucose – once every three years, starting from the age of 21, and after 40 years – annually.

Be an optimist! Learn to find the positive side in all the phenomena of life. If you are unable to cope on your own, do not hesitate to seek psychological help.It’s as natural as going to the dentist to have your teeth treated. Many people who have received professional help for the first time are surprised how easy it turns out to be able to solve the problems that have tormented them for years.

If you have already been diagnosed with coronary artery disease

Your task is to slow down the progression of the disease, as long as possible to preserve the ability to lead an active, fulfilling life. All the recommendations above apply to you. You just need to regularly consult a doctor who will give proper recommendations on a balanced diet, the choice of physical activity, and prescribe the necessary medications.

90,000 Dezdrav dispelled the most popular myths about hypertension

World Hypertension Day is celebrated on 13 May. There are many myths regarding this disease. The most popular of them were dispelled by Nikolai Serebryakov, a cardiologist at Polyclinic No. 180 of the Moscow Healthcare Department.

Myth # 1: Living “under pressure” is not dangerous

Arterial hypertension for a long time may not affect health and not disturb a person.But at this time, irreversible consequences may occur in target organs: kidneys, brain, heart, blood vessels. In turn, they can lead to serious complications in the form of strokes and heart attacks. You can’t live under pressure. You need the strictest control of your pressure level; it should not exceed 140/90 mm Hg. High blood pressure can be accompanied by mild symptoms in the form of headaches. Many do not attach any importance to this, and take pain relievers, not realizing that this is a manifestation of hypertension.

Myth # 2: Only the elderly suffer from hypertension

This is far from the case. Typically, men over 55 and women over 65 are at risk for developing hypertension. But the disease is common at a young age. They are characterized by vegetative-vascular dystonia, which can subsequently cause severe manifestations of hypertension. Often, young people are faced with secondary hypertension – diseases that cause hypertension.

Myth # 3: Normal pressure – everyone has their own

There is no concept of “individual pressure”.In fact, each person needs to reach values ​​of no more than 140/90 mm Hg. During treatment, the pressure is reduced to normal optimal values. Sometimes I have to hear from patients, along with complaints about their well-being, the phrase: “I don’t need to reduce anything, because this is my pressure and I feel good with it”. Indeed, at the initial stage of lowering pressure, such side effects may occur, but in order to normalize it, you need to get used to this condition. The exception is the elderly and people with concomitant pathologies.For them, we recommend reducing the pressure only to values ​​that they tolerate well.

Myth # 4: Hypertension is a male disease

A very common misconception. The female sex is affected in the same way as the male. This is due to the fact that during the menopause, women are protected from most problems of the cardiovascular system due to the action of estrogens. They reduce the level of cholesterol activity, have a beneficial effect on blood vessels. However, women are most susceptible to arterial hypertension at the time of the formation of menopause.Hypertension itself can develop as a result of prolonged stress, emotional stress and hard work. Unfortunately, no one is immune from these factors.

Myth # 5: Garlic will cure hypertension

Eating garlic is impossible to get rid of hypertension. At one time, garlic was very actively recommended to patients after suffering a heart attack. It is believed to improve arteriological performance. There is some benefit in this, but it should not be used as an anticoagulant drug.For hypertension, it is good to eat foods high in potassium and magnesium. For example, cranberries, lingonberries, large grain products, cereals. You also need to give up salt. This mineral retains fluid in the body. There are cases when patients, refusing to use salt, and their blood pressure drops to normal values. In the treatment of arterial hypertension, one should start with the correction of risk factors: smoking cessation, weight loss, normalization of carbohydrate metabolism, and sports.Correction of nutrition gives quite good results, it helps already in the initial stage of the development of arterial hypertension. If a person observes all these rules, but does not reach normal pressure levels, this is a serious signal to see a doctor.

Myth # 6: Arterial hypertension is inherited

This is true. One of the risk factors for hypertension is heredity. The cardiologist always asks the patient if he has any relatives of the hereditary nature of hypertension.

Myth # 7: If the pressure is increased, you need to lower it faster

There is no need to knock down anything. You must learn to control. Of course, if the pressure exceeds the permissible value, you must immediately call an ambulance. A patient who relieves the condition on his own must remember that improperly selected drug therapy can cause a violation of blood microcirculation. This can provoke irreversible consequences.

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