The Facts About High Blood Pressure

What is high blood pressure?

High blood pressure (also referred to as HBP, or hypertension) is when your blood pressure, the force of blood flowing through your blood vessels, is consistently too high. Learn more about high blood pressure.

If you have high blood pressure, you are not alone

• Nearly half of American adults have high blood pressure. (Many don’t even know they have it.)
• The best way to know if you have high blood pressure it is to have your blood pressure checked.

Know your numbers

Learn about your blood pressure numbers and what they mean.

High blood pressure is a “silent killer”

Preventing and managing HBP

• This is one time that the old adage, “An ounce of prevention is worth a pound of cure,” is particularly apt. It’s best to avoid high blood pressure altogether. Healthy lifestyle choices are a great place to start.
• With proper treatment and management, you can control your blood pressure to help you live a long and healthy life.

130 Is Too High For Blood Pressure

Diastolic blood pressure: How low is too low? – News

Low diastolic blood pressure is a risk factor for new-onset heart failure in older adults. UAB cardiologist Jason Guichard explains why that might be, the causes of low diastolic pressure and how to deal with it.

Written by: Matt Windsor
Media contact: Adam Pope

Blood pressure consists of two numbers. Systolic pressure, the force exerted on blood vessels when the heart beats, is the upper number. Diastolic pressure, the force exerted when the heart is at rest, is on the bottom — in more ways than one. Systolic pressure attracts the lion’s share of attention from physicians and patients, says UAB cardiologist Jason Guichard, M. D., Ph.D.

“Physicians are busy people, and like it or not they often focus on a single number,” Guichard said. “Systolic blood pressure is the focus, and diastolic pressure is almost completely ignored.” That is a mistake, he argues. “The majority of your arteries feed your organs during systole. But your coronary arteries are different; they are surrounding the aortic valve, so they get blood only when the aortic valve closes — and that happens in diastole.”

Diastolic pressure has been getting more attention lately, however, thanks in part to an influential paper in Hypertension, written in 2011 by Guichard and Ali Ahmed, M.D., then a professor of medicine in UAB’s Division of Gerontology, Geriatrics and Palliative Care and now the associate chief of staff for Health and Aging at the Veterans Affairs Medical Center in Washington, D.C. (Ahmed remains an adjunct faculty member at UAB.)

INFOGRAPHIC: See our quick guide to causes, and treatments, for low diastolic blood pressure.

That paper coined a new term, “isolated diastolic hypotension,” which refers to a low diastolic blood pressure (less than 60 mm Hg) and a normal systolic pressure (above 100 mm Hg). Older adults who fit those conditions are at increased risk for developing new-onset heart failure, the researchers found.

“High blood pressure is a problem, but low blood pressure is also a problem,” Guichard said. That realization helped drive a 2014 decision by the panel members appointed to the Eighth Joint National Committee (JNC 8) to relax target blood pressure guidelines for those over 60 years old. [Read Guichard’s take on “ideal blood pressure” and the new guidelines in this blog post.]

“Years ago and until recently, doctors were treating blood pressure so aggressively that many patients couldn’t even stand up without getting dizzy,” Guichard said. “We want to empower patients to know that you don’t have to drop those numbers all the way down to nothing, to the point where you can’t play with your grandkids or play golf or take a simple walk around the block because your blood pressure is so low. I think it’s important to raise awareness in this area, especially for older people.”

Jason GuichardAhmed and Guichard are continuing to explore the mechanisms behind low diastolic pressure in more detail. Several new papers are pending, Guichard says. In the meantime, he sat down with The Mix to explain the dangers associated with low blood pressure.

Most people are trying to lower their blood pressure. What would you define as “too low,” and why is that a problem?

A diastolic blood pressure of somewhere between 90 and 60 is good in older folks. Once you start getting below 60, that makes people feel uncomfortable. A lot of older folks with low diastolic pressures get tired or dizzy and have frequent falls. Obviously, none of that is good news for people who are older, who potentially have brittle bones and other issues.

Your coronary arteries are fed during the diastolic phase. If you have a low diastolic pressure, it means you have a low coronary artery pressure, and that means your heart is going to lack blood and oxygen. That is what we call ischemia, and that kind of chronic, low-level ischemia may weaken the heart over time and potentially lead to heart failure.

What could cause a person to have low diastolic blood pressure?

Medications are a big one. There are some medicines that are culprits for lowering your diastolic blood pressure more than your systolic — specifically, a class of medications called alpha blockers, or central acting anti-hypertensive agents.

Another reason is age. As you get older, your vessels become a little more stiff, and that tends to raise your systolic pressure and lower your diastolic pressure.

It’s hard to reverse the aging process; but one potential therapy is to find ways to allow your vessels to retain their elasticity — or, if they’ve lost it, maybe ways to gain that back.

The best current treatment is to lower dietary salt intake, which has been shown to be very closely linked with the elasticity of your vessels. The more salt you eat, the less elastic your vessels will be. Most peoples’ salt intake is too high. Salt intake is a highly debated topic in medicine, but most believe that dietary salt intake of greater than 4 grams per day is too high, and less than 1.5 grams per day is too low. This depends on a person’s age and underlying medical problems, but this range is a good rule of thumb. There is some data that the ideal salt intake for healthy people is around 3.6 grams per day, but again this is highly debated. 

UAB’s hypertension group, led by Dr. Suzanne Oparil and Dr. David Calhoun, has detailed much of the basic science showing the effect of salt at a molecular level in the blood vessels. On the inside, your blood vessels are lined with a thin monolayer of endothelial cells. In an experimental setting, adding salt to these cells causes changes almost immediately. They become less reactive — that means they stiffen up — and lose their elasticity, which is what you actually see clinically.

Additionally, the stiffening of the vessels happens very soon after you take on a salt load during eating, which is very interesting.

Beyond changes in medications, what can people do to raise their diastolic pressure if it’s too low?

Lifestyle changes like diet and exercise can have immediate effects. Your inside changes much quicker than the mirror shows you. On the inside, you’re getting much more healthy by eating better, getting exercise, controlling your weight and not smoking.

Everyone thinks, “I’m going to have to do this for six months or a year before I see any changes.” That’s not true. The body is very dynamic. Within a few weeks, you can see the benefits of lifestyle change. In fact, with dietary changes in salt intake, you can see a difference in a day or two.

If someone does have low diastolic pressure, what should they — and their doctors — look for?

If they aren’t on medications that we could adjust, the important thing is close monitoring; maybe seeing a patient more frequently in clinic and monitoring them closely for cardiovascular disease or heart failure symptoms.

Your original study in Hypertension got a lot of attention. What are you working on now?

We’re finalizing some papers that address two big criticisms of that study. The first criticism was that we were looking strictly, as the name suggests, at isolated diastolic hypotension. We didn’t really care at the time what the systolic pressure was doing; but a high systolic pressure is a risk for heart failure, among other things. When we looked at the patients in our study, their systolic blood pressures were all relatively normal, and we adjusted for patients with a history of hypertension.

So we actually went back and redid the analysis, completely excluding people with hypertension. And the results still remained true. In fact, the association was even stronger.

The other criticism involved something called pulse pressure. That’s the difference between your systolic and diastolic blood pressure. And multiple studies have shown that a widened pulse pressure is also a risk factor for cardiovascular disease. Some fellow researchers said, “Really, all you’re looking at is just a wider pulse pressure. This isn’t necessarily novel — that’s been shown before.”

So we’ve actually looked at pulse pressure differences in all these patients and broken them down by differences in pulse pressure. And even when we adjusted for pulse pressure, the conclusion about the low diastolic pressure still rang true.

We actually looked at three different groups of pulse pressure — normal, wide and really wide. And it was true throughout. Low diastolic blood pressure increased one’s risk for heart failure.

You also have an interest in diastolic heart failure. What is that?

There are two different types of heart failure: one where the pumping function of the heart is abnormal — that is known as systolic heart failure — and one where the relaxation function is abnormal — that is known as diastolic heart failure. We have lots of medicines for, and experience treating, systolic heart failure, which is also called “heart failure with reduced ejection fraction” — everything from beta blockers, ACE inhibitors and ARBs to mineralocorticoid receptor antagonists and statins.

Diastolic heart failure, or “heart failure with preserved ejection fraction,” has no approved pharmacologic therapies to date. It was widely overlooked, to be honest, until about 10-15 years ago, when physicians realized that these poor patients were having terrible heart-failure symptoms but none of the classic objective measures of heart failure. In most cases, you can’t even tell the difference between a person with systolic and diastolic heart failure based on their symptoms. On the inside, however, their heart is pumping just fine; the problem is their heart is stiff — it doesn’t relax as well as it should. That stiffness leads fluid to back up into the lungs and extremities and causes a lot of the symptoms that you have with systolic heart failure, but the pumping function of the heart is normal.

Now that there is an awareness of diastolic heart failure, we’re realizing that it is a very common problem. It looks like there are as many people with diastolic heart failure as with systolic heart failure. As a matter of fact, there may even be more people with diastolic heart failure.

It has become a heavily studied form of heart failure right now. Everyone is clamoring to get a medicine to help these patients, because it turns out to be very prevalent, and a lot of times they have the same morbidity and mortality as people with systolic heart failure.

Make an appointment with a UAB doctor

High Blood Pressure in Pregnancy

What is high blood pressure?

If you have high blood pressure (hypertension), the pressure of the blood in your blood vessels (arteries) is too high. Blood pressure is recorded as two figures. For example, 140/85 mm Hg. This is said as “140 over 85”. Blood pressure is measured in millimetres of mercury (mm Hg). The first (or top) number is your systolic blood pressure. This is the pressure in your arteries when your heart contracts. The second (or bottom) number is your diastolic blood pressure. This is the pressure in your arteries when your heart rests between each heartbeat.

Normal blood pressure is below 140/90 mm Hg. During pregnancy:

• Mildly high blood pressure is blood pressure between 140/90 and 149/99 mm Hg (ie the systolic or upper number is between 140 and 149, and/or the lower or diastolic number is between 90 and 99).
• Moderately high blood pressure is blood pressure between 150/100 and 159/109 mm Hg. (The systolic is between 150 and 159 and/or the diastolic is between 100 and 109.)
• Severely high blood pressure is blood pressure of 160/110 mm Hg or higher. (The systolic is 160 or more, and/or the diastolic is 110 or more.)

Our blood pressure goes up when we are anxious or stressed, such as when we have to rush. Some people find it stressful seeing a doctor or midwife. It is important to give yourself enough time for your antenatal appointments so that you can relax and your blood pressure is not higher than it normally would be. Your employer is obliged to give you adequate time off work to attend antenatal appointments. If your blood pressure is high when you attend the clinic but normal when, for example, your midwife takes your blood pressure at home, this is called “white coat” hypertension. See the separate leaflet called Home and Ambulatory Blood Pressure Recording.

What are the different types of high blood pressure in pregnancy?

Pre-existing high blood pressure

Some women already have high blood pressure (hypertension) before they become pregnant and they may be on treatment for this. Your medication may need to be changed, so it is important to see a healthcare professional before, or as soon as, you know you are pregnant.

Some women are found to have high blood pressure before they are 20 weeks pregnant. (If high blood pressure is first discovered before you are 20 weeks pregnant, this usually means that you had previously undetected high blood pressure before you were pregnant.)

So, high blood pressure before 20 weeks of pregnancy is not caused by pregnancy but is pre-existing, or chronic, high blood pressure. There are various causes. See the separate leaflet called High Blood Pressure (Hypertension).

If you have pre-existing high blood pressure, you have an increased risk of developing pre-eclampsia during your pregnancy (see below).

Note: if you are taking medicines to treat high blood pressure then, ideally, you should have this reviewed before you become pregnant. Some medicines that are used to treat high blood pressure should not be taken during pregnancy – for example, medicines called:

This is because these medicines may harm a developing baby. If you are taking one of these medicines then it is very likely that your medicine will be changed to another medicine that is not known to harm a developing baby. 

Gestational high blood pressure

Some women can develop new high blood pressure during their pregnancy. This is called gestational high blood pressure (or hypertension) or pregnancy-induced high blood pressure (or hypertension).

Gestational high blood pressure is high blood pressure that develops for the first time after the 20th week of pregnancy. Doctors can confirm this type of high blood pressure if you do not go on to develop pre-eclampsia during your pregnancy (see below) and if your blood pressure has returned to normal within six weeks of giving birth. If you have gestational high blood pressure, you do not have protein in your urine when it is tested by your midwife or doctor during your pregnancy.

Note: some women may be found to have new high blood pressure after 20 weeks of pregnancy. At first, they may not have any protein in their urine on testing. However, they may later develop protein in their urine and so be diagnosed with pre-eclampsia (see below). You are only said to have gestational hypertension if you do not go on to develop pre-eclampsia during your pregnancy.

Pre-eclampsia and eclampsia

Pre-eclampsia is a condition that can affect some women who develop new high blood pressure after the 20th week of their pregnancy. Pre-eclampsia can also sometimes develop in women who have high blood pressure before they are pregnant (pre-existing high blood pressure) or in women who have protein in their urine before they are pregnant (for example, due to kidney problems).

Pre-eclampsia not only causes high blood pressure; it also affects other parts of your body such as your kidneys, liver, brain and blood clotting system. Pre-eclampsia causes protein to leak from your kidneys into your urine. If you have pre-eclampsia, you will have high blood pressure and protein will be found in your urine when it is tested. Pre-eclampsia gets better within six weeks of you giving birth.

Eclampsia can be a complication of pre-eclampsia. In eclampsia, a woman with pre-eclampsia has one or more fits (seizures or convulsions). This is a serious condition. The aim is to detect and treat pre-eclampsia successfully to try to prevent eclampsia from developing.

See the separate leaflet called Pre-eclampsia, which deals with eclampsia and a condition called HELLP syndrome.

How common is high blood pressure during pregnancy?

High blood pressure (hypertension) during pregnancy is quite a common problem.

• About 1 in 10 pregnant women have problems with high blood pressure.
• Up to 3 in 100 pregnant women have pre-existing high blood pressure.
• About 4 to 8 in 100 pregnant women have gestational high blood pressure and do not go on to develop pre-eclampsia.
• Between 2 and 8 in 100 pregnant women develop pre-eclampsia.
• For every 100 women who have already developed pre-eclampsia in one pregnancy, 16 will develop it again in a future pregnancy. Up to half of these women will develop gestational hypertension in a future pregnancy.

Problems with new high blood pressure are more common during your first pregnancy.

What are the possible problems with high blood pressure during pregnancy?

As a rule, the higher your blood pressure, the greater the risk for you and your baby.

Mild-to-moderate high blood pressure

If your blood pressure remains mildly to moderately raised and you do not develop pre-eclampsia then the risk is low. Most women with high blood pressure (hypertension) during pregnancy just have mildly or moderately raised blood pressure.

However, it is important that your blood pressure and urine should be checked regularly throughout your pregnancy and that you look out for any signs of possible pre-eclampsia (see below).

Severe high blood pressure or pre-eclampsia

Severe high blood pressure, especially with pre-eclampsia, is serious.

• The risks to you as the mother include:
• An increased chance of having a stroke.
• Damage to your kidneys and liver.
• An increased risk of blood clotting problems.
• An increased risk of severe bleeding from your placenta.
• Having fits (seizures) if you go on to develop eclampsia.
• The risks to your baby include:
• An increased chance of poor growth.
• An increased chance of premature birth.
• An increased chance of stillbirth.

How do I know if I have high blood pressure whilst I am pregnant?

Many women with high blood pressure (hypertension) during their pregnancy do not have any symptoms. This is why your blood pressure is checked regularly by your doctor or midwife during your pregnancy. Your urine is also tested regularly for protein, to look for possible pre-eclampsia.

However, there are some symptoms that you should look out for that could be signs of pre-eclampsia. If you develop any of these, you should see your doctor or midwife urgently so that they can check your blood pressure and test your urine for protein. They include:

• Severe headaches that do not go away.
• Problems with your vision, such as blurred vision, flashing lights or spots in front of your eyes.
• Tummy (abdominal) pain. The pain that occurs with pre-eclampsia tends to be mainly in the upper part of the abdomen, just below your ribs, especially on your right side.
• Vomiting later in your pregnancy (not the morning sickness of early pregnancy).
• Sudden swelling or puffiness of your hands, face or feet.
• Feeling out of breath.
• Not being able to feel your baby move as much.
• Just not feeling right.

Note: swelling or puffiness of your feet, face, or hands (oedema) is common in normal pregnancy. Most women with this symptom do not have pre-eclampsia but it can become worse in pre-eclampsia. Therefore, report any sudden worsening of swelling of the hands, face or feet promptly to your doctor or midwife.

What is the treatment for high blood pressure in pregnancy?

If your doctor or midwife finds that your blood pressure is high during your pregnancy, they will usually check to see if you have any protein in your urine and ask you if you have any symptoms of pre-eclampsia. If your blood pressure remains high, or if you have any signs of pre-eclampsia, you will usually be seen by a specialist (an obstetrician). In order to advise on treatment, there are various questions that need to be considered by the specialist, such as:

• How severe is your high blood pressure (hypertension)?
• Is there pre-eclampsia and, if so, how severe is it?
• How far on is your pregnancy?
• What are the risks to you, the mother, and your baby? This will depend on the severity of your high blood pressure and whether or not pre-eclampsia is present.

If high blood pressure remains mild and pre-eclampsia does not develop

There is usually little risk. You will be advised to take 75-150 mg aspirin daily from 12 weeks of pregnancy. Regular checks of your blood pressure and your urine for protein, as well as checks to see how your pregnancy is progressing, may be all that is needed until the natural time of birth. Checks may include blood tests and an ultrasound scan to look at how your baby is growing and to check the blood flow from the afterbirth (placenta) to the baby. You may be followed up by an obstetrician. You may need medicines to control your blood pressure during your pregnancy. You may be offered a placental growth factor blood test to help rule out pre-eclampsia between 20 weeks and up to 35 weeks of pregnancy, if you are suspected of developing pre-eclampsia.

If high blood pressure becomes severe, or if pre-eclampsia develops

There are risks to both you, as the mother, and to your baby if high blood pressure becomes more severe, especially if you develop pre-eclampsia. You will usually be seen urgently by a specialist and you may be admitted to hospital. Blood tests may be suggested to check to see how much your blood pressure or pre-eclampsia is affecting you. The well-being of your baby may also be checked using ultrasound scanning. A recording of your baby’s heart rate may be carried out.

For severe high blood pressure, especially if pre-eclampsia develops, there is often a dilemma. If the high blood pressure is caused by the pregnancy, the only cure is to deliver your baby. This may be fine if your pregnancy is near to the end. The birth can be induced, or your baby can be born by caesarean section if necessary. However, a difficult decision may have to be made if high blood pressure or pre-eclampsia becomes severe earlier in your pregnancy.

Medicine to lower the blood pressure may be prescribed for a while. The most commonly used medicine is labetalol. This may allow your pregnancy to progress further before delivering your baby. The best time to induce the birth (or deliver by caesarean section) varies depending on the factors mentioned above.

If you have severe pre-eclampsia, the medicine magnesium sulfate may be given via a drip around the time that your baby is delivered. This may reduce your chance of developing eclampsia and prevent you having fits (seizures).

What are the Symptoms of High Blood Pressure?

What are the Symptoms of High Blood Pressure?

High Blood Pressure Symptoms

These are the standard classifications for normal and high blood pressure.

• Normal blood pressure: 90/60 to under 120/80 mm Hg.
• Prehypertension, or risk for hypertension: 120-139/80-89 mm Hg.
• Stage 1 hypertension: 140-159/90-99 mm Hg.
• Stage 2 hypertension: over 160/100 mm Hg.

If your systolic and diastolic blood pressure are in two different categories, doctors consider the number that is in the higher category. For example, if your blood pressure is 135/91, your systolic blood pressure is in the prehypertensive range and your diastolic blood pressure is in the range of Stage 1 hypertension. Your measurement or 135/91 would place you in the category of Stage 1 hypertension. 

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High Blood Pressure Symptoms

The symptoms of elevated blood pressure depend on which kind you have and how severe it is. You may not have any warning signs of high blood pressure, or you could notice hypertension symptoms or side effects in your day-to-day activities. 

Symptoms of Primary Hypertension

High blood pressure is known as “the silent killer” because you can have it without knowing it. You cannot depend on specific symptoms of high blood pressure to let you know that you have high blood pressure. That means you could be at risk for long-term complications such as a stroke or kidney disease without realizing it.

The American Heart Association, or AHA, explains that the early symptoms of high blood pressure that people tend to think about are largely mythical. You are unlikely to notice “classic” signs such as anxiety, insomnia, or flushing in your face. You could have blood spots in your eyes due to subconjunctival hemorrhage, but dizziness itself is not among the essential symptoms of high blood pressure.

Symptoms of Pulmonary Hypertension

Early signs of pulmonary arterial hypertension can be related to the trouble you have getting blood to your lungs to get oxygenated. You might experience shortness of breath and a fast heart beat while doing activities that are otherwise routine, such as climbing stairs. You might also have chest pain, a reduced appetite, and pain in your chest or upper right portion of your abdomen.

Pulmonary arterial hypertension symptoms can develop into light-headedness and fainting. Your lips and skin might have a bluish tinge because of the lack of adequate oxygenation of your blood.  

Symptoms of Orthostatic Hypertension

Early signs of orthostatic hypertension can include an intense headache that throbs, and possibly blurry vision. Orthostatic hypertension symptoms can also include poor circulation and narrowing of the arterioles. 

Symptoms of Portal Hypertension

You may not have specific early signs of portal hypertension, but since the condition is usually caused by cirrhosis of the liver, you are likely to have portal hypertension if you have cirrhosis. You might have the following portal hypertension symptoms.

• Bleeding in the gastrointestinal tract with bloody stools or vomit.
• Low platelet count or reduced blood clotting ability.
• Low white blood cell count, which can lead to more infections, since white blood cells are immune cells
• Confusion or encephalopathy related to lower liver function.
• Fluid in the abdomen, or ascites.

Your doctor might perform angiography, an ultrasound, or an endoscopy to help diagnose portal hypertension.  

Symptoms of Malignant Hypertension

Because of the need for emergency care, it is important to recognize the early signs of malignant hypertension. The first giveaway is blood pressure of 180/120. You might have bleeding in the eyes due to rupture of the small blood vessels. Other malignant hypertension symptoms can include chest pain, dizziness, a headache, numbness in your extremities, and confusion. 

Symptoms of Idiopathic Intracranial Hypertension

Early signs of idiopathic intracranial hypertension can include trouble with your vision, such as periodic episodes of blindness, blind spots, trouble with your peripheral (side) vision, and double vision. Other common idiopathic intracranial hypertension symptoms include:

• Ringing in your ears, or tinnitus.
• Headaches.
• Pain in your shoulders or neck.

Hypertension Headache

Headaches strike over 90% of adults each year. You may be able to wait out some and let them pass, but others may be a sign that your body is asking you to take action. There is a chance that your headache could be a symptom of high blood pressure. If there are no other causes of your headache, you should ask your healthcare provider about getting your blood pressure checked.

2018 High Blood Pressure Clinical Guidelines

Hypertension clinical guidelines from the American Heart Association are comprehensive guidelines for healthcare professionals for the detection and treatment of high blood pressure in a wide range of patients. Included in the 2018 hypertension clinical guidelines are proper methods for measuring blood pressure, risk factors for hypertension, and hypertension treatment for different populations.

These guidelines help guide healthcare practice
s, and can be related to patient reimbursement and healthcare coverage. The tenth revision of the International Statistical Classification of Diseases and Related Health Problems, or ICD-10, is the set of codes used to designate specific health conditions and allow for reimbursement through health insurance programs.

There are a few hypertension ICD-10 codes. The code for essential primary hypertension without comorbidities is I10. A patient with hypertension and heart disease would qualify for I11.9 or I11.0, depending on if she had heart failure as well. Other ICD-10 codes consider hypertension with or without chronic kidney disease and kidney failure.

Best High Blood Pressure App

You are putting in the work, so you deserve to maximize the benefits. A weight loss health coach app can help you do just that. A health coach app serves all the functions of a regular coach: informing, motivating, guiding, cheering, and organizing. The best weight loss health coach app:

• Informs you about healthy ways to lose weight and incorporate healthy behaviors into your lifestyle.
• Motivates you to keep setting and chasing new goals.
• Guides you through your weight loss journey in your own way.
• Cheers your successes, your efforts, and, should you fall short of your goals for a time, your renewed dedication.
• Organizes by encouraging you to log your food, activity and weight, and storing that information.

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Lark Health Coach serves all of those roles, and then some. Lark is available 24/7 to be your coach and friend. Your health coach automatically customizes your program for you.

Lark even learns your patterns and coaches around them. Do you prefer a gluten-free or dairy-free lifestyle? You’ll get tips on healthy ways to get your nutrients without eating gluten or dairy products. Do you normally take an afternoon walk? Then do not be surprised if Lark gives you a gentle nudge if you forget to take it one day.

The Greenville News

New blood pressure numbers for seniors over 60

New blood pressure numbers for seniors over 60

Patrick Collard/Staff

New guidelines that relax blood pressure levels for people over 60 came as welcome news to Tanis Bryan.

The retired college professor watched her blood pressure inch up after losing her husband and, though she discussed it with her doctor, she wasn’t interested in taking more medication.

“The new guidelines give a little more leeway and a little less stress about this particular indicator,” the Greenville woman said.

“The data have accumulated to indicate that hitting 140 didn’t mean ‘Crisis Ahead — Beware,’ ” she said. “That was something else I had to worry about that increased stress levels.”

Until recently, the control goal for people 60 and older was 140/90. Now, it’s 150/90.

According to Duke University researchers, that could mean that 5.8 million people considered uncontrolled under the old guidelines wouldn’t need blood pressure medication under the new guidelines.

While the new guidelines should result in fewer medication side effects, some say it could increase the risk for heart disease, stroke and kidney disease.

About one in three adults in the U. S. has high blood pressure, or hypertension, according to the U.S. Centers for Disease Control and Prevention. But only about half are under control.

African Americans are disproportionately affected by high blood pressure, and at an earlier age, according to CDC. And hypertension costs the nation $47.5 billion a year.

While everyone agrees that hypertension can lead to strokes, heart disease and kidney disease, just how low blood pressure levels should be to reduce the risk is controversial.

Out with the old

One in four adults in the over-60 group is on hypertension drugs to meet the old guidelines, according to the researchers from Duke Clinical Research Institute, who collaborated with McGill University researchers.

According to the study, 13.5 million adults — most over 60 — would no longer be classified as having poorly controlled blood pressure, including 5.8 million who would no longer need blood pressure pills under the new guidelines, lead author Ann Marie Navar-Boggan, a cardiology fellow at Duke University School of Medicine, told The Greenville News.

“These adults would be eligible for less intensive blood pressure medication under the new guidelines, particularly if they were experiencing side effects,” she said. “But many experts fear that increasing blood pressure levels in these adults could be harmful.”

The American Heart Association advocates that health care providers continue to follow the 140/90 guideline, saying there’s not enough evidence to justify such “a major change.”

But Dr. Andrea Bryan of Carolina Cardiology Consultants with Greenville Health System said the new guideline for the top, or cystolic number, is good news.

“For quite a while, the goal, especially for older patients, has been much too low,” she said.

“They get calcified arteries, so it’s harder to get blood pressure control overall. Adding more and more medications, and driving their cystolic pressure down makes the diastolic (bottom) number way too low for them. It can cause a lot weakness and dizziness.”

That can affect quality of life, she said, and cause falls, which can mean dangerous hip fractures among other injuries.

“I don’t know if we’ve ever seen long-term benefits from very low blood pressure in patients over 60,” she said. “I think this will help a lot. They will have higher pressures to be able to move more blood, and that’s a good thing.”

And internist Dr. Adam Scher of Cypress Internal Medicine in Greer said the guidelines were changed because there were no proven benefits from the stricter limits and more adverse effects when patients were more aggressively treated.

“From the older population I see, we try so hard with so many medications to get it perfectly controlled,” he said. “But it makes patients feel better when it’s higher and they can take fewer pills and medications. And all these medications have side effects.”

Dizziness and falls

Those side effects include headaches, dizziness, fatigue, leg swelling and falls, he said.

And in addition to side effects from the antihypertension drugs, doctors need to keep an eye on drug-drug interactions, Bryan said, because elderly patients are often on a number of medicines.

“A lot of these patients, especially women over 60, get dizziness from changing position from having too low blood pressure,” she said. “Improving those symptoms will help them feel better. And their wallet will feel better, too.”

Scher said he will adopt the new guidelines, but will still treat each patient as an individual.

“If I have a 65-year-old patient with diabetes or heart disease who is walking around with a blood pressure of 130/80 and no side effects, I won’t withdraw his blood pressure medications,” he said.

“But if … the blood pressure is 148/84 and we can’t get it to 140, and some medications are affecting his head or his energy, that 148 is great. Too low is not good, either.”

Dr. Bryan said she’s been able to reduce medications in her own practice and that patients have been “thrilled.”

“We will see down the road what long-term impact this has, but for now it’s very beneficial,” she said. “When you’re talking about stroke from high blood pressure . .. it has to be pretty high for that to happen. This is only 10 points, so it’s not going to rise out of control.”

And while a higher blood pressure does put more strain on the heart, these numbers aren’t high enough to do that, she said.

Dr. Edward Stewart, a cardiologist with Upstate Cardiology of Bon Secours Medical Group, said the new guidelines are a good change for patients over 60 who don’t have a lot of other health issues, but should be individualized.

A good thing for some

“It depends on how many medicines they’re on, the patient’s functional status, family history of heart disease or stroke,” he said. “But I would say as a general rule, if I have an elderly patient who has a cystolic blood pressure around 145-155, I’m not going to be as aggressive with that patient as I would with somebody of a younger age.”

“I think it allows for more relaxed blood pressure control in the elderly,” he said, “which is a good thing for some people.”

And Dr. Andrew Freeman, of National Jewish Health in Denver and chair of the American College of Cardiology’s Early Career Professional Section, said the guidelines are a step in the right direction and likely to result in better compliance and improved outcomes overall.

“I think it’s a great idea. As the population ages, one of the major issues is polypharmacy, or way too many pills,” he said.

“And that may not improve outcomes, it could worsen them,” he added. “A big fall in an older person versus blood pressure control – avoiding the fall is better because trauma and falls in the elderly can be life-ending.”

Dr. Bryan said the goals for patients with diabetes or heart disease won’t change, and that more research is needed to see whether the rate can be increased in people younger than 60.

The change came after a review of the research found no difference in adults treated at the higher level versus the lower level, Navar-Boggan said, though the vote on the guidelines by the Eighth Joint National Committee wasn’t unanimous.

“A lot of experts fear it could cause harm,” she said. “It’s important that older adults talk to their doctors before making changes.”

Instead of taking medication to lower her blood pressure, which had only hit 140, Tanis Bryan chose to exercise to control it.

“I was clearly in a period of great stress and was not anxious to take another medication,” said the 77-year-old mother of two and grandmother of seven. “Because of the new guidelines, I don’t have to.”

LEARN MORE

Want to know more about high blood pressure? Go to www.cdc.gov/bloodpressure/about.htm.

Symptoms of Low Blood Pressure and When to See a Doctor

While blood pressure that is too high can pose a serious risk to health, low blood pressure is generally of little concern. As long as you’re not experiencing any symptoms of low blood pressure, doctors don’t worry about the effect of blood pressure because consensus in the research community has shown there is no such thing as blood pressure that is “too low. ” 

Katrina Wittkamp/DigitalVision / Getty Images

Blood pressure considered optimal is systolic pressure that is lower than 120 and diastolic pressure that is lower than 80, otherwise expressed as lower than 120/80 mm Hg. Generally speaking, the lower your blood pressure is, the better. In fact, studies have shown that the risk of heart attack, stroke, and other cardiovascular diseases continues to fall even as blood pressure falls below 120/80.

Symptoms of Low Blood Pressure

However, some people experience troubling symptoms of low blood pressure, also called hypotension, that may cause them to seek the advice of a doctor, and how low blood pressure can fall before symptoms develop is different for everyone. As long as you feel OK, “low numbers” are nothing to worry about. Note that this is exactly the opposite as high blood pressure -– even blood pressure that is high enough to be an immediate health risk usually doesn’t cause any symptoms. You may feel fine even though your pressure is dangerously high.

When blood pressure drops so low that blood flow to organs is compromised, symptoms will develop. Common symptoms of low blood pressure that may prompt a visit to your doctor include:

• Dizziness
• Confusion
• Dehydration and excessive thirst
• Decreased urine output
• Fatigue when exercising
• Fainting
• Lack of concentration
• Blurred vision
• Nausea
• Cold, clammy, pale skin
• Rapid, shallow breathing
• Depression

Low Blood Pressure Causes

If your blood pressure drops stays lower than what is normal for you for a prolonged period of time, or you experience persistent symptoms of low blood pressure, your physician may want to look for an underlying cause. The treatment for low blood pressure will depend on its cause. 

Various conditions can cause chronically low blood pressure, including: 

• Bed rest for an extended period of time
• Pregnancy
• Decrease in blood volume as a result of blood loss
• Certain medications
• Certain heart problems 
• Endocrine conditions
• Severe infection 
• Anaphylaxis (severe allergic reaction) 
• Certain nutritional deficiencies such as a lack of vitamin B-12 or folic acid

If you’re concerned that your blood pressure may be too low, or if you’re having symptoms of low blood pressure, contact your doctor at once, but do not stop taking your medications unless told to do so. Several high blood pressure medications require a period of weaning in order to stop taking them, and suddenly stopping them can cause potentially serious side effects. Most common is “rebound hypertension,” a drug-induced condition that causes a sudden, dramatic increase in blood pressure, sometimes to dangerously high levels.

Read more:

Blood Pressure Changes – Managing Side Effects

Blood Pressure Changes Include:

High blood pressure
(hypertension), and managing low
blood pressure (hypotension)

Common Examinations for Blood Pressure Changes:

• Blood pressure monitoring – Your healthcare provider may take your
  blood pressure when you visit the office to check for changes in blood pressure.
  Your blood pressure is the force of blood flow against the walls of your artery.
  Arteries carry blood from your heart to your body. This is a part of your vital
  signs. Your vital signs include your blood pressure, your heart
  rate or pulse, your respiratory rate (how fast or slow you are breathing in a minute),
  and your temperature. These alert your healthcare provider to certain diseases or
  conditions that may be present.
• To measure your blood pressure, your healthcare provider will place your arm (it
  is also possible to measure blood pressure using the wrist, finger or any extremity)
  into an inflatable cuff. If an electric monitor is being used, the cuff will inflate
  and automatically record your blood pressure readings.
• If your healthcare provider is measuring your blood pressure by hand (manually),
  the cuff usually will be positioned on your arm, and the stethoscope placed in the
  bend of your elbow. The cuff will be slowly inflated and deflated, and your healthcare
  provider will be able to determine your blood pressure readings in the form of a
  top number your systolic blood pressure reading and a bottom number, your diastolic
  blood pressure reading.

Causes of Blood Pressure Changes:

• Recent intake of caffeine, alcohol or cigarette smoking. This potentially causes
  an increase in your blood pressure.
• When you have your blood pressure taken, rest in a comfortable and relaxed position
  for at least 5 minutes, if possible.
• If the blood pressure cuff is too large, it is possible that your blood pressure
  changes to a falsely lower reading. Also, if the blood pressure cuff is too small,
  it is possible that your blood pressure changes to a falsely elevated reading. Your
  healthcare provider should measure the diameter of your arm, and use the appropriate
  sized blood pressure cuff.
• If you are using your arm for a blood pressure reading, your healthcare provider
  should ensure that the lower edge of the cuff is at least 1 inch above the bend
  of your elbow.
• If you take your blood pressure at home, and you purchase a monitor, make sure that
  your blood pressure cuff gives a similar reading to the cuff in your doctor’s office.
  Electronic blood pressure cuffs need to be checked periodically, to ensure that
  they are giving an accurate reading.

What is a normal blood pressure?


When your blood pressure is taken, there are two readings given. These are the
systolic and the diastolic blood pressure readings.
Your systolic blood pressure is the top number that you get. This
refers to the pressure of the blood, on the walls of your arteries, when the heart
muscle contracts. This is when the blood pressure is the greatest. The bottom number,
or your diastolic reading, refers to the pressure in your arteries
at all times, when the heart is resting in between heartbeats.

The normal blood pressure is 120/80, although most people do not have blood pressure
of exactly 120/80.Low blood pressure is much less common than high blood
pressure.

• People with high blood pressure, or hypertension, are at risk for organ damage (kidney,
  and heart especially), in the long term. Most people with high blood pressure do
  not have any symptoms. High blood pressure over a long period of time potentially
  causes extra stress on your heart muscle. If you have a blood pressure of 140/90,
  on 2 or more checks, you may be diagnosed with high blood pressure.
• Even if you have a normal blood pressure of 120/80, your healthcare provider may
  want the bottom (diastolic) number to be lower, if you have certain diseases. This
  includes diabetes, especially if you have protein in your urine. Protein in your
  urine from diabetes means that you have kidney damage, and you are at risk for worsening
  function of the kidneys in the future. Lower blood pressure can reduce stress
  on the kidneys, and reduce the chance of kidney damage.
• There are many causes of low blood pressure as well. If you have low blood
  pressure, you are at risk for fainting, or “passing out.” If lower blood
  pressure is due to a more serious condition, such as acute blood loss or infection,
  your doctor will focus on treating the underlying condition.

Common Blood Pressure Problems:

Hypertension (High Blood Pressure)

What is hypertension?

• Hypertension is when the blood pressure changes to an elevated rate in your arteries.
  Most of the consequences of hypertension occur over a long period of time. When
  your blood pressure changes to an elevated rate for many months, or years, damage
  to your internal organs may occur as a result.

There are 2 main types of hypertension: Primary and secondary

• Primary hypertension occurs as a result of problems in your body,
  or electrolyte imbalances. This is also called essential hypertension. It also can
  occur if you are overweight, take in too much sodium, alcohol, or due to cigarette
  smoking.
• Primary hypertension is the most common type of high blood pressure, however
  in 95% of cases, no causes can be found.
• Secondary hypertension may occur as a result of many diseases and
  conditions, including medications, heart problems from birth, kidney disease, estrogen
  use, or other diseases of the endocrine system.
• “White coat” hypertension is a category of hypertension, when the
  blood pressure changes to an elevated rate in the doctor’s office, and the individual
  has normal blood pressure readings at home. High blood pressure readings in the
  office were once considered unimportant, as the blood pressures returned to normal
  at home. Now, many researchers conclude that people with white coat hypertension
  should be treated the same as those with regular hypertension. High blood pressure
  is high blood pressure, no matter what causes it when the reading was
  taken.
• Fifty million Americans have elevated blood pressure, but only a little more than
  half of them are aware of their diagnosis.
• The percentage of individuals who have elevated blood pressure levels increases
  with age, and is greater in individuals who are of African American heritage.

Risk factors: Causes of hypertension are many. The risk factors
for high blood pressure that you can change, also called modifiable, include:

• Obesity
• Lack of physical activity.
• Sodium intake
• Alcohol and drug use, caffeine intake.

Factors for high blood pressure that you cannot change, include:

• Genetics
• Age
• Race
• Other diseases and conditions.

What are some high blood pressure symptoms to look for?

• Most people do not notice any symptoms of high blood pressure. This is why high
  blood pressure is known as “the silent killer,” because most people do not notice
  symptoms immediately.
• Some individuals may experience headaches when blood pressure changes
  to an elevated rate.
• If you are having an “acute” or suddenly serious event, you may experience nausea,
  dizziness, and loss of vision, severe headaches, or confusion. If these symptoms
  occur, seek emergency assistance.

Things you can do to manage high blood pressure:

The American Heart Association recommendations for elevated blood pressure:

With any elevated blood pressure readings, your doctor or healthcare provider
may suggest that you:

• Quit smoking
• Exercise most days of the week, for at least 20 to 30 minutes at a time.
• Try to reduce the amount of stress in your life by following relaxation techniques.
• Eat a diet that is low in saturated fat and cholesterol, low in sodium, with lots
  of fresh fruits and vegetables.
• Lose weight if you are overweight.
• Avoid alcohol use. Limit caffeine intake.
• Again, with low blood pressure, safety and treating the underlying cause is the
  greatest concern.
• Try to reduce the amount of stress in your life. Use relaxation techniques to decrease
  the amount of anxiety you have. If you feel anxious, place yourself in a quiet environment,
  and close your eyes. Take slow, steady, deep breaths, and try to concentrate on
  things that have relaxed you in the past.
• If you have hypertension, you may be told to reduce the amount of salt you are eating
  in a day. Many times, it may be restricted to about 2 grams of sodium per day. A
  diet lower in salt potentially causes a decrease in the amount of work that is placed
  on your heart. You should discuss this with your healthcare provider how you can
  specifically use your diet to stimulate changes in high blood pressure. Also, eat
  a diet that is low in saturated fat, cholesterol, sodium, and with lots of fresh
  fruits and vegetables.

Other things you can do to stimulate changes in high blood pressure:

• Make sure you tell your doctor, as well as all healthcare providers, about any other
  medications you are taking (including over-the-counter, vitamins, or herbal remedies).
• Remind your doctor or healthcare provider if you have a history of diabetes, liver,
  kidney, or heart disease.
• Keep a diary of your any abnormal symptoms, to report to your healthcare
  provider. These may include excessive fatigue, shortness of breath or chest pain.
• Questions to ask yourself, may include:
  • Did my symptoms of blood pressure changes occur gradually, or did this episode come
    on all of a sudden?
  • Was I feeling anxious?
  • Did I perform any kind of activity, or was I resting?
• If you are ordered a medication to treat your high blood pressure, do not stop taking
  it unless your healthcare provider tells you to. Take the medication exactly as
  directed. Do not share your pills with anyone.
• If you miss a dose of your medication, discuss with your healthcare provider what
  you should do.
• If you experience symptoms or side effects, especially if severe, be sure to discuss
  them with your health care team. They can prescribe medications and/or offer
  other suggestions that are effective in managing problems that high blood pressure
  causes.
• Keep all your appointments for your treatments.

Drugs and recommendations that may be prescribed by your health care provider:

Your doctor or healthcare provider may prescribe certain drugs to treat your hypertension. Diuretics
and beta-blockers are the most common types of medications used to treat high blood
pressure initially, upon diagnosis.

Some other drugs that are commonly used to treat high blood pressure may
include:

• ACE inhibitors – These drugs work by opening, or dilating,
  your arteries. They will lower your blood pressure, which causes improved blood
  flow to your kidneys, and throughout your body. Your healthcare provider may also
  prescribe these medications if you have diabetes or protein in your urine, to protect
  your kidneys. Some examples of this medication may include: Enalapril maleate (Vasotec^®), Lisinopril (Zestril^®),
  and fosinopril sodium (Monopril^®)
• Beta-blockers – can be used to slow down your heart rate,
  which causes improved blood flow through your body. You may take this drug if you
  have been diagnosed with irregular heartbeats, palpitations, heart failure, or high
  blood pressure. Some examples of this medication may include: Metoprolol (Lopressor^®), propanolol (Inderal^®),
  and atenolol (Tenormin^®).
• Calcium Channel Blockers – These medications may be given
  to treat chest pain, high blood pressure, or irregular heartbeats. A few common
  drugs include Verapamil HCL (Calan^®), and Diltiazem
  (Dilacor^®XR).
• Diuretics – may be known as “water pills” as they work
  to prevent or treat high blood pressure by making you urinate out extra
  fluid. Some examples of this medication may include furosemide (Lasix^®),
  and Hydrochlorthiazide. You may receive this medication alone or in combination
  with other medications.
• Digoxin – Also called digitalis, this medication causes
  the heart rate to slow down, making it beat more effectively. This will pump blood
  throughout the body better. It is also called Lanoxin^®.
• Vasodilators – are drugs that work by opening up or “dilating”
  the vessels. These may include isosorbide dinitrate (Isordil^®).
• Do not stop any of these medications abruptly, especially if you
  are prescribed any anti-arrhythmia drugs or beta blockers, as serious side effects
  may occur.

When to call your doctor or health care provider about symptoms of blood pressure
changes:

• Shortness of breath, chest pain or discomfort; swelling of your lips or throat should
  be evaluated immediately- especially if you are taking new medications, or have
  a history of elevated blood pressure.
• If you are having an “acute” or suddenly serious event, you may experience nausea,
  dizziness, and loss of vision, severe headaches, or confusion. If these symptoms
  of blood pressure changes occur, seek emergency assistance.
• Feeling your heart beat rapidly (palpitations).
• Bleeding that does not stop after a few minutes, blood in your urine or stool.
• Any new rashes on your skin, especially if you are taking new medications.
• Any unusual swelling in your feet and legs, weight gain of greater than 3 to 5 pounds
  in 1 week.

Note: We strongly encourage you to talk with your health care professional about
your specific medical condition, including blood pressure changes, causes and treatments.
The information contained in this website about blood pressure changes and other
medical conditions is meant to be helpful and educational, but is not a substitute
for medical advice.

Hypotension (Low Blood Pressure)

What is hypotension?

• 
  Hypotension may be defined as a lower than normal blood pressure readings. There
  are many causes for hypotension. Some of the main causes may include:

  • Some chemotherapy or biological drugs may cause low blood pressure, such as bleomycin
    or interleukin. Adverse effects of other drugs, such as rituxamab (Rituxan^®) or paclitaxel (Taxol^®),
    may cause blood pressure changes in either direction, higher or lower.
  • You may have low blood counts (anemic), from causes such as recent chemotherapy
    treatments, or your disease.
  • Certain physical conditions – such as orthostatic hypotension. Orthostatic hypotension
    is often a result of a disease state, or dehydration.
  • As you get older, or as a result of certain conditions, the central nervous system
    has a more difficult time regulating blood pressure levels. When you change from
    a lying to a standing position rapidly, you may feel “faint” or lightheaded, as
    your blood pressure changes to a level below normal.
  • Orthostatic hypotension may also occur if you are anemic, or dehydrated, as the
    fluid volume levels in your body are low.
  • Medications – If you are taking certain medications to control
    your high blood pressure or heart rate, for example, these may cause changes in blood
    pressure to a lower level.
  • Irregular heart rhythm changes – if your heart is beating irregularly,
    it potentially causes your blood pressure to be low as a result. The blood is not
    pumping through your body very effectively, and your body is unable to compensate.
  • Shock – “Shock” may occur from many causes that are related to
    your heart, lungs, trauma, infection or other diseases. This happens when the circulation
    of blood is not able to meet your body’s needs of oxygen, fluid and nutrients. For
    example, if you have a severe blood infection, you may develop low blood pressure as
    a result. Treatment of shock consists of identifying the causes, and trying to correct
    it.
  • Bleeding – if you are bleeding from your gastrointestinal track,
    or from some other location, you may be at risk for low blood pressure. This is
    because you are losing fluids, and fluid levels work to maintain normal blood pressure
    readings. Severe bleeding may lead to a form of “shock.”

  
  What are some symptoms of blood pressure changes to look for?

  • You may be overly tired, or very weak (fatigued). It may be hard for you to do any
    kind of your normal activities.
  • You may feel dizzy or “faint” when you stand up, or change positions slowly. You
    may feel like you are going “pass out.”
  • You may feel sweaty or nauseous, if you think you may faint or lose consciousness.
  • If your low blood pressure changes to a lower rate due to a heart problem,
    you may feel your heartbeat, or palpitations.
  • You may have a fever, chills or feel ill, if an infection causes your low pressure.
  • You may notice that you are pale in color, or have blood in your stool. This may
    be due to bleeding from your gastrointestinal tract, or anemia from your disease
    or chemotherapy treatments.

  
  Things you can do to manage hypotension:

  • If you have low blood pressure, changes in position must be performed slowly.
    Rest for a few minutes in between lying, sitting and standing.
  • Avoid hot environments, such as a shower or a bath, which may cause your blood pressure
    to be reduced.
  • Avoid alcohol and certain drugs that may cause low blood pressure. Discuss these
    causes of low blood pressure with your healthcare provider.
  • Drink lots of fluid. Drink 2 to 3 liters of fluid every 24 hours, unless you were
    told to restrict your fluid intake. This will decrease your chances of being dehydrated,
    and developing low blood pressure.
  • Monitor for signs of bleeding. If you have tarry black stools, or maroon stools,
    notify your healthcare provider immediately.
  • Make sure you tell your doctor, as well as all healthcare providers, about any other
    medications you are taking (including over-the-counter, vitamins, or herbal remedies).
  • Remind your doctor or healthcare provider if you have a history of diabetes, liver,
    kidney, or heart disease.

  
  Drugs that may be prescribed by your doctor:

  
  Treatment of low blood pressure is based on correcting the underlying causes.

  • If anti-cancer medication causes your low blood pressure, you will be monitored
    closely and corrective actions will be taken based on that medication.
  • If you are prescribed a medication for your high blood pressure, and your blood
    pressure changes too dramatically your dose may be decreased.
  • If you are bleeding, or are dehydrated, your fluid and blood volumes may be low.
    This potentially causes low blood pressure. Your doctor or healthcare provider will
    treat this by giving you fluids, plasma, or blood.
  • If you have an infection that causes your low blood pressure, your healthcare providers
    will correct this with identifying and treating the source of infection in your
    body. Depending on the source of the infection, the type of antibiotics you will
    receive may vary.
  • Aspirin – depending on your overall health status, your
    healthcare provider may prescribe aspirin as a “blood thinner.” Aspirin works by
    preventing platelets in your blood from forming blood clots (anti-platelet). This
    may be prescribed if you have had a blood clot, irregular heart rhythm, or
    a heart attack.
  • Beta-blockers – If your low blood pressure changes to
    a lower rate due to your heart beating irregularly, your doctor will prescribe medications
    to control your heart rate. Beta-blockers can be used to slow down your heart
    rate, and improve blood flow through your body. You may take this drug if you have
    been diagnosed with irregular heartbeats, palpitations, heart failure, or high blood
    pressure. Some examples of this medication may include: Metoprolol (Lopressor^®), propanolol (Inderal^®),
    and atenolol (Tenormin^®).
    • A side effect of beta-blockers is low blood pressure. If you are given this
      medication to control your heart rate, your blood pressure should return to normal.
      However, you must be careful, and take the medication exactly as directed by your
      healthcare provider.

  • Digoxin – Also called digitalis, this medication works
    by slowing down the heart rate, and making it beat more effectively. This will pump
    blood throughout the body better.
    • Your doctor or healthcare provider should be testing your blood for the levels of
      digoxin in your blood stream.

  • Midodrine Hydrochloride – This medication may be given
    to you by your cardiologist or specialist, if you have low blood pressure when you
    stand up. You will likely receive this medication if your blood pressure changes
    to a low level when you change positions, and this causes you to feel dizzy, faint,
    or even “pass out.”
    • If you are taking this medication for your low blood pressure, make sure to take
      it exactly as directed. If your blood pressure changes to a level too high when
      you lay down as a result of this medication, your healthcare provider may suggest
      that you sleep on one or two pillows, with the head of the bed elevated.

  
  When to call your doctor or health care provider about symptoms of blood pressure
  changes:

  • Notify your doctor or health care provider immediately and seek emergency help if
    you have chest pain, chest tightness, or sudden shortness of breath.
  • Notify your doctor or health care provider immediately and seek emergency help if
    you have a sudden severe headache, slurring speech or weakness on one side of your
    body and not the other.
  • Shortness of breath, chest pain or discomfort; swelling of your lips or throat should
    be evaluated immediately- especially if you are taking new medications.

  
  Notify your doctor or health care provider within 24 hours if you experience:

  • Fever of 100.5° F (38° C), chills, sore throat (possible signs of infection, especially
    if you are undergoing chemotherapy).
  • If you “pass out” or lose consciousness as a result of your low blood pressure.
  • Feeling your heart beat rapidly (palpitations).
  • Monitor for signs of bleeding. If you have tarry black stools, or maroon stools,
    notify your healthcare provider immediately.
  • Any new rashes on your skin, especially if you are taking new medications.

  
  Note: We strongly encourage you to talk with your health care professional
  about your specific medical condition including blood pressure changes, causes and
  treatments. The information contained in this website about blood pressure changes
  and other medical conditions is meant to be helpful and educational, but is not
  a substitute for medical advice.

90,000 The expert named the most common consequence of COVID-19

Increased blood pressure is the most common consequence of coronavirus infection, said doctor Vladimir Bolibok. The reason for this is changes in the blood vessels. It is not yet clear whether such consequences of the previous illness are long-term.

People who have recovered from COVID-19 most often have high blood pressure. As the immunologist-allergist Vladimir Bolibok said in a conversation with “Lenta.ru”, this is the most widespread phenomenon.

“This is a tendency towards an increase in blood pressure due to a decrease in the elasticity of the vascular walls throughout the body,” the expert noted.

According to the doctor, it is still unclear which human organ can get the coronavirus. And it is unclear whether the consequences for the body will be short-term or long-term.

“The whole organism can be affected. Probably no one knows what to do with this, ”he stressed.

Coronavirus infection can have a wide variety of consequences for the body – even after recovery.Men who have undergone COIVD-19 may face consequences such as erectile dysfunction, American virologist Dena Grayson told NBC Chicago.

It is also related to vascular problems caused by COVID-19. The American physician warned that other delayed consequences of the infection, including neurological complications, may appear over time.

According to Anchi Baranova, professor at the School of Systems Biology at George Mason University, premature aging of the body is one of the likely consequences of the coronavirus.

“Even in people who were very mildly ill, 70 percent had pathologies of some internal organs. Only the main pathology was not cardiac, but mainly fatty hepatosis (the liver suffers) and fatty degenerations of the pancreatic tissue. Usually, such diagnoses are made at 60 years old, and in the post-covid group – already at 40, ”Baranova said, relying on the results of the work of a group of doctors, during which patients who had suffered from COVID-19 in a moderate and mild form were examined.

According to her, the coronavirus infection “takes resources and brings old age closer.”At the same time, Baranova emphasized that the consequences of the disease require more detailed study.

A group of British researchers reported the danger of coronavirus for the brain – according to their data, 62% of patients with COVID-19 who received neurological and psychiatric complications had a damaged blood supply to the brain. At the same time, 31% had confusion and prolonged unconsciousness.

The most common neurological consequences of infection are stroke and encephalitis – inflammation of the brain tissue.Moreover, such symptoms could appear in different groups of the population, including young people.

On November 28, doctor of medical sciences, immunologist, specialist in especially dangerous infections Vladislav Zhemchugov advised those who had a new coronavirus infection to do yoga breathing exercises in order to get rid of the consequences of COVID-19.

The specialist said that after recovery in patients who have had an infection, breathing may be impaired or there may be various damage to the central nervous system, including surges in pressure, temperature and pulse.

According to him, yoga breathing and breathing exercises of Dr. Anastasia Strelnikova are a universal way to get rid of the consequences of COVID-19.

90,000 Conferences / ROSOMED-2020, Conference and IX Congress of Society / Assessment of the survival rate of knowledge of blood pressure measurement techniques in 6th year students of the RUDN Medical Institute in preparation for primary accreditation.

Assessment of the survival rate of knowledge of the blood pressure measurement technique in 6th year students of the RUDN University Medical Institute in preparation for primary accreditation.

Author (s): Badretdinova A.I., Klimenko A.S., Tania R.V., Tigay Zh.G.

City: Moscow

Institution: Accreditation and Simulation Center of Peoples’ Friendship University of Russia

Relevance

Arterial hypertension is a leading risk factor for the development of cardiovascular (myocardial infarction, stroke, coronary heart disease (IHD), chronic heart failure), cerebrovascular (ischemic or hemorrhagic stroke, transient ischemic attack) and renal (chronic kidney disease) diseases.Timely and correct diagnosis of arterial hypertension is extremely important for the earliest possible selection of the necessary treatment and improvement of the patient’s prognosis, quality and duration of life. In addition, measuring blood pressure is the most common medical procedure.

Target

The purpose of our study was to assess the residual knowledge of students in relation to the skills of non-invasive methods of measuring blood pressure.

Materials and Methods

Our study involved 148 graduate students of the RUDN Medical Institute, who were trained at the Accreditation and Simulation Center in the 2017-2018 academic year in preparation for primary accreditation. In the first semester, students got acquainted with the procedure for passing accreditation and the peculiarities of performing skills according to checklists developed on the basis of ROSOMED and passed the test.The skill of measuring blood pressure is presented in detail and step by step in the passport of the “Dispensary” station. Then, in the second semester, as part of the preparation cycle for accreditation, the residual knowledge of the students was assessed. Students were not warned in advance that control would be carried out, however, during the class they were asked to voluntarily take part in the research; no grades were given for performing skills.

The checklist of the examination station “Dispensary examination” was taken as the basis for the sequence of actions, however, this station includes the assessment of several volumetric skills (hygienic treatment of the hands of medical personnel, general examination, palpation, percussion and auscultation of the lungs and heart, etc.).etc.). Therefore, specifically for our study, we have selected from the station checklist only the procedure for measuring blood pressure. The students were given an introduction that they see the patient for the first time, so it was necessary to perform a greeting and self-presentation, as well as the final actions (cleaning the equipment, final communication with the patient).

A completed skill was scored at 1 point, not completed – 0 points, so each student had the opportunity to score a maximum of 50 points.
A Korean BT-CEAB2 wireless blood pressure monitor (South Korea) was used to prepare students and assess their skills.

Results

None of the students completed the full spectrum of skills. The number of completed skills ranged from 15 (30%) to 49 (98%). On average, 33 points of the checklist were fulfilled (66%). However, 74% of the students (n = 109) completed more than 50% of the required skills, which is relatively good considering that the study was conducted without additional training.According to our data, almost the only item completed by all students (99%, n = 146) is a greeting, with which only self-presentation is comparable – 92% (n = 136) and finding out the patient’s personal data (last name, first name and patronymic) – a little more 80% (n = 118). The performance of the remaining items on the checklist ranged from 39% (n = 57) – this is “repeated measurement of blood pressure on the other arm” to 87% (n = 129) – “to find the place of radial artery pulsation”. Thus, the average value of fulfillment was 67% (n = 99).

Discussion

The most common errors in blood pressure measurement include incorrect selection of the tonometer cuff size, or the absence of any selection at all, auscultation errors, talking during manipulation [DDD].Measurement of the patient’s shoulder diameter and selection of the cuff was carried out only by 61% of the subjects (n = 91), which cannot be considered satisfactory. Incorrect positioning of the phonendoscope membrane, too sharp decrease in pressure in the tonometer cuff can lead to auscultation errors; according to our data, only 49% of students (n = 73) did not place the stethophonendoscope head under the cuff; only 60% of the subjects reduced the pressure in the cuff at the recommended rate (n = 89).

Conclusions

Thus, the survival rate of knowledge regarding the method of measuring blood pressure within six months after a detailed analysis and passing a test lesson remains not entirely satisfactory, which indicates the need for additional trainings both on simulators and in conditions closer to real ones, perhaps involving simulated patients.

90,000 Treatment of arterial hypertension – inquire about the service, make an appointment. MEDSI network of clinics in Nizhnevartovsk

Causes of arterial hypertension 90 076

There are 2 types of disease:

• Essential. Hypertension develops as an independent pathology. In this case, blood pressure rises due to an imbalance in the regulatory system of the body
• Secondary (symptomatic).Arterial hypertension is a manifestation of such major diseases as pyelonephritis, hydronephrosis, renal artery stenosis, renal tumors, thyrotoxicosis, Itsenko-Cushing’s syndrome, aortic atherosclerosis, etc.

There are also risk factors that play a leading role in the development of pathology.

The main ones include:

• Prolonged strong excitement, nervous shocks
• Increased consumption of salty foods
• Heredity
• Obesity
• Diabetes mellitus
• Diseases of the thyroid gland, adrenal glands and kidneys
• Smoking and alcoholism

In women, arterial hypertension often develops during menopause.In this case, the pathology becomes a consequence of exacerbations of emotional reactions and disturbances in the functioning of the nervous system, provoked by hormonal imbalances. Age can also be a factor in the development of the disease. Often patients over 50-55 years old suffer from arterial hypertension.

Symptoms of the disease

In the early stages, the disease can manifest itself with mild symptoms.

These include:

• Headaches (usually in the occipital region)
• Short and infrequent dizziness
• Sleep disorders
• Fatigue
• Heaviness in the head
• Noise in the ears
• Feeling of pulsation in the head

As the disease develops, the symptoms become more pronounced.Often, patients complain of shortness of breath, palpitations, sweating, facial flushing, numbness of the limbs. Due to the delay in the body of fluid, there may be swelling of the hands, puffiness of the face, the appearance of bags under the eyes (especially in the morning).

Patients often notice unpleasant visual effects (flashing of flies, shroud, lightning). With hypertension, retinal hemorrhages may occur. In some cases, there is a general decrease in vision.

Types and stages of the disease

The classification of pathology is carried out according to a number of signs, including the reasons for the increase in blood pressure, its level, damage to target organs, etc.

Depending on the level of blood pressure, for example, there are:

• Optimum performance: 120-129 / 80-84 mm. rt. Art.
• Borderline normal state: 130-139 / 85-89 mm. rt. Art.
• Arterial hypertension of the 1st degree: 140-159 / 90-99 mm. rt. Art.
• 2 degrees: 160-179 / 100-109 mm. rt. Art.
• 3 degrees: more than 180/110 mm. rt. Art.

Benign, slowly progressive disease goes through 3 stages:

• Mild and moderate stage 1 arterial hypertension. With such a pathology, the pressure fluctuates unstably throughout the day. Even if crises occur, they are not difficult. At the same time, signs of damage to internal organs and the central nervous system do not emit
• Severe hypertension stage 2. This pathology is characterized by crises. Patients face problems such as narrowing of retinal arteries, transient cerebral ischemia, etc.
• Very severe stage 3 hypertension. Crises occur frequently and are difficult to bear.Patients are diagnosed with left ventricular heart failure, cerebral thrombosis, optic nerve edema and other dangerous conditions

Important! Treatment requires arterial hypertension of any stage, but at stages 2 and 3 it should be carried out in a complex manner, with therapy for damaged target organs. Otherwise, the pathology can be fatal!

Complications

With a long course of the disease, the following dangerous complications can develop:

• Angina
• Myocardial infarction
• Stroke (ischemic or hemorrhagic)
• Pulmonary edema
• Cardiac asthma
• Uremia
• Retinal detachment, etc.

Important! The development of acute emergency conditions against the background of arterial hypertension of stages 2 and 3 requires a rapid decrease in blood pressure indicators. Otherwise, the patient may die.

Diagnosis of the disease

Patient examination is carried out in order to solve the following problems:

• Confirmation of the facts of a stable increase in blood pressure indicators
• Identification of the presence of damage to target organs and their degree
• Assessments of the stage of pathology

When collecting anamnesis, the doctor determines the patient’s susceptibility to risk factors, finds out the complaints, the time of the first manifestation of the symptoms of the disease, their severity, the presence of crises, etc.

The main method for diagnosing pathology is the regular measurement of blood pressure levels. To obtain reliable indicators, follow:

• Conduct performance assessments in a comfortable, calm environment after rest
• One hour before the procedure, exclude stress, food intake, drinking tea, coffee and other tonic drinks, smoking, drinking alcohol, using eye and nasal vasoconstrictor drops
• Take a comfortable position (preferably sitting or lying)

If the values ​​are constantly changing, the average is taken as the true value.

Laboratory research

Patients passing:

• General blood and urine tests
• Biochemical blood test

Within the framework of research, special attention is paid to indicators of levels of glucose, potassium, total cholesterol, creatinine, triglycerides.

Instrumental and functional diagnostics

Patient can be referred to:

• ECG
• EchoCG
• Ophthalmoscopy
• Ultrasound of the abdominal cavity
• CT of kidneys and adrenal glands
• EEG, etc.

Comprehensive diagnostics makes it possible to identify not only the main pathology, but also concomitant ones, to find out the degree of damage to target organs and to correctly select the necessary therapy. Also, examinations are carried out during treatment. They allow you to increase its efficiency and control the course.

Treatment of arterial hypertension

Therapy of a pathological condition is aimed not only at lowering blood pressure indicators, but also at reducing the risk of complications.

Important! It is impossible to completely cure the disease, but experienced specialists manage to eliminate the symptoms, stop the development and prevent crises.

In the treatment of arterial hypertension stages 1, 2 and 3, it is necessary to take medications on a regular basis. Patients are prescribed special antihypertensive drugs, diuretics, antiplatelet agents, sedatives and other drugs.

Important! The selection of the necessary treatment is carried out exclusively by a doctor! At the same time, the specialist focuses on the individual characteristics of the patient, his current condition, concomitant diseases and lesions of target organs.As a result, stable, stable blood pressure is achieved. It should be borne in mind that the selection of drugs often takes several months. The first drug does not always give the desired result.

Also important:

• Stick to a diet. The patient will have to limit salt intake and increase the amount of foods with potassium and magnesium in the diet
• Stop taking alcoholic beverages and quit smoking
• Try to lose weight (if overweight)
• Increase physical activity.Hypertensive patients are recommended to go for walks, go in for swimming. Exercise therapy courses are often prescribed

Advantages of contacting MEDSI

• Experienced doctors. Our specialists have all the skills and knowledge to successfully treat stage 1, 2 and 3 arterial hypertension
• Comprehensive diagnostics. It is performed using advanced expert-class equipment, allows you to quickly make an accurate diagnosis and prescribe adequate therapy
• Treatment using modern means of safety and effectiveness. Selection of drugs and methods is carried out individually. If necessary, specialists of narrow profiles are involved in therapy: ophthalmologists, endocrinologists, urologists, etc.
• There are no queues. Receptions are held at a strictly designated time. Our patients don’t have to wait

If you are planning to undergo treatment for stage 1, 2 or 3 arterial hypertension in our clinic in Nizhnevartovsk, call +7 (3466) 29-88-00. The specialist will announce the conditions for the provision of services and make an appointment with a doctor at a convenient time.

90,000 How to deal with hypertension? – GBUZ “City Hospital No. 4 of Sochi” MH KK

Published by on 15 July 2016 .

REMINDER FOR THE POPULATION

HYPERTENSION AND PRESSURE JUMPS

Hypertension and pressure surges caused by it – in 89% of cases kill the patient with a heart attack or stroke!

How to deal with pressure and save your life?

Heart attack with strokes is the cause of almost 70% of all deaths in the world.Seven out of ten people die due to blockages in the arteries of the heart or brain. In almost all cases, the reason for such a terrible end is the same – pressure surges due to hypertension. The “silent killer”, as cardiologists dub it, takes millions of lives every year. In absolute terms, this is about 1.54 million deaths in 2015 and 1.49 million in 2014. That is, the numbers are truly colossal and frightening. Especially scary is the fact that a lot of people do not even suspect that they have hypertension. And they miss the opportunity to fix something, simply dooming themselves to death.

By these symptoms, you can determine that you have hypertension:

• Headache
• Increased heart rate
• Blackheads before the eyes (flies)
• Apathy, irritability, drowsiness
• Blurred vision
• Sweating
• Chronic fatigue
• Facial edema
• Numbness and chills of fingers
• Pressure surges

Even one of these symptoms should make you wonder.And if there are two of them, then do not doubt – you have hypertension. According to statistics from the Ministry of Health, 67% of hypertensive patients do not even suspect that they are sick.

How to fight the disease?

Hypertension, like any chronic progressive disease, is easier to prevent than to cure. Therefore, the prevention of hypertension, especially for people with a burdened heredity, is the first priority. A correct lifestyle and regular observation by a cardiologist help to delay or mitigate the manifestations of hypertension, and often even prevent its development altogether.

So, what can we do on our own for prevention?

Firstly, everyone needs to have information about cases of hypertension in the family, especially among the closest relatives. These data will help you with a high degree of probability to assume whether a person is at risk for hypertension. Children born to mothers with essential hypertension are obviously at risk, because hypertension is primarily transmitted through the maternal line.Therefore, the parents of such children especially need to make every effort to ensure that the hereditary predisposition to hypertension does not develop into a disease.

Secondly, for a person who may develop arterial hypertension, as a preventive measure, it is necessary to revise the usual way of life and make the necessary amendments to it. This concerns the increase in physical activity, which should not be excessive. Regular outdoor activities are especially good, especially those that, in addition to the nervous system, also strengthen the heart muscle: running, walking, swimming, skiing.

Let’s remind about proper nutrition.

“Eating Right” has nothing to do with all kinds of fad diets. It should be complete and varied, include both vegetables and fruits, and cereals, lean meats, fish. What else is worth saying a good word about is the now fashionable passion for Far Eastern cuisine, especially Japanese. Most often, these are low-fat, well-balanced dishes based on rice and fish, which are healthy in and of themselves. In addition, in Japanese cuisine, table salt is almost never used, which is successfully replaced by soy sauce.Of course, we do not suggest spending the day and night in sushi bars, especially since soy can cause allergies, and sushi is a food for everybody. No, we are talking specifically about the principles of nutrition, which are good not only for the Japanese, but also for you and me. Large amounts of table salt are not useful to anyone, and for people with the possibility of developing hypertension this is truly a “white death” ..

You should also not get carried away with alcoholic beverages, especially beer. The reason is the same: beer is usually drunk with salty snacks. And a large amount of excess fluid with a large amount of salt, which prevents the kidneys from removing this fluid from the body, is a path to edema, excess weight and other troubles that provoke, among other things, an exacerbation of hypertension.The same can be said for stronger drinks: neither the liver, nor the kidneys, nor the heart will thank you for overusing them! Although, of course, a small amount of grape wine will not hurt anyone.

Nicotine is especially harmful to the lungs and cardiovascular system. So, it is probably better to give up smoking, this “pleasure”, of our own free will than at the insistence of a cardiologist.

“The most important thing is the weather at home.” This is not just a phrase from a song, but an immutable truth, which is also important for the prevention of hypertension.The trigger, the cause of hypertension, is the nerves. A warm and sunny home atmosphere helps even a sick person avoid exacerbations of hypertension, let alone the fact that the best prevention of hypertension, like all heart diseases, is a loving family and a favorite job. This often becomes a decisive factor in the patient’s recovery. The tense situation at home and work through the power of even a healthy, in principle, person can make a hypertensive person in a few years.

Hence the conclusion, simple and definite: happy people rarely suffer from severe hypertension, even with poor heredity.Make your loved ones and loved ones happy, they will answer you in the same way, and there is no better prevention of hypertension in nature! So, a healthy lifestyle, a calm and welcoming atmosphere in the family and at work, regular preventive examinations by a doctor – that’s all the prevention of hypertension and cardiovascular diseases.

The first two points completely depend on you, and in the third you will be happy to help the specialists of our “Health Center”, which is located at:Sochi, Chaikovskogo street building 6.

Phone 253-01-96.

Information for the population

How to measure blood pressure correctly

Arterial hypertension is a disease that is life-threatening to the patient with complications, both due to the increase in blood pressure itself and the development of atherosclerosis of the vessels supplying blood to vital organs (heart, brain, kidneys, etc.). In particular, if the blood vessels supplying the heart are damaged, ischemic (coronary) heart disease develops, and if the cerebral vessels are damaged, stroke.

Why are different readings obtained when blood pressure is measured several times a day?

Since the heart rate changes constantly throughout the day, one blood pressure measurement shows one value at a single moment. From heartbeat to heartbeat, human pressure changes about 100 times a day. Only regular measurements at the same time of day and under the same conditions can give comparable indicators and can be used to compare different blood pressure values.

Why should BP always be measured at the same time of day?

Many functions of the human body are subject to daily biorhythms that have similar characteristics when environmental conditions are similar. So blood pressure is subject to constant daily biorhythms: it rises in the morning, shortly before getting out of bed, falls in the afternoon and rises again when evening comes. The lowest blood pressure is observed at night. In order to compare blood pressure readings one with another, measurements must be made at the same time.Measurements taken in the morning cannot be compared with evening readings.

Why does the doctor get completely different results than at home?

Blood pressure readings can be compared with one another only if both measurements were taken when you were in a relaxed state and always at the same time of day. Studies have shown that 25% of people have higher readings in the doctor’s office than at home. This phenomenon has been called the “white coat effect” or “white coat hypertension.”This is not a disease, since high blood pressure in this case is due to a stressful situation and nervousness during a visit to the doctor. However, such elevated blood pressure readings may be the first indicator of impending hypertension.

Why does the tonometer give different results all the time?

Blood pressure is not a constant value, as it depends on the mental and physical condition at a particular moment, time of day and measurement conditions.Therefore, you must measure blood pressure under the same conditions, i.e. try to measure blood pressure at the same time of the day and rest for at least 5 minutes before measuring. However, for many people, blood pressure spikes despite rest. In this case, it is recommended to measure blood pressure two or three times at intervals of 1 minute and take the average between these measurements. If you are still confused by something, contact your local RosTest office or Metrological laboratory to check your device.

What should be done so that external factors do not affect the results of measuring blood pressure?

1. Avoid alcohol and nicotine for one hour before measurement.
2. Do not drink coffee immediately before measurement.
3. The bladder must be empty before measurement. A full bladder increases the pressure by about 10 mmHg.
4. Do not measure blood pressure if you are experiencing stress, pain or fear. These factors can alter BP.
5. Ensure that the cuff is worn correctly during measurement. When measuring blood pressure at the shoulder, the border of the cuff should be 2.5 cm above the bend of the elbow. When measuring blood pressure at the wrist, place the cuff 1 cm above the wrist.
6. When measuring blood pressure on the wrist or shoulder, make sure that the measurement site is at the level of the heart – if the position is shifted by 1.5 cm, – the pressure rises by 1 mmHg.
7. Relax the arm muscles during measurement. Muscle tension increases the pressure by about 10 mmHg.
8. Do not speak during measurement. A conversation during measurement can increase the pressure by 6 – 7 mm Hg. Art.
9. The upper arm should not be pinched by clothing when measuring blood pressure on the shoulder.It is best to remove all clothing from the shoulder.
10. Before measuring on the upper arm, make sure that you are wearing the cuff correctly. If you can slip 2 fingers under the cuff from the top and bottom, you can start measuring. If the cuff is too loose or too tight, the results will be either too high or too low, respectively.
11. Rest for at least 1 minute before taking another measurement.
12. Remember that blood pressure is subject to circadian rhythms and can change depending on the time of day and the needs of the body at a particular moment.To obtain comparable results, the best solution is to measure the pressure at the same time of day.

What is high blood pressure?

The World Health Organization (WHO) has adopted a new classification of blood pressure levels:

Optimal level <120/80 Normal <130/85 Mild hypertension 140-159 / 90-99 Moderate hypertension 160-179 / 100-109 Severe hypertension> 180 and> 110

What should be done if a person has a pathological rhythm disturbance? How to measure blood pressure?

It is not possible to give general recommendations as there are a large number of different heart rhythm pathologies that must be considered individually.In case of doubt, measurements should be taken several times at 1-minute intervals and the average of several measurements should be taken. However, each case is different and the details should be discussed with your doctor.

What to look for when measuring blood pressure during pregnancy?

High blood pressure during pregnancy is noted in about 10% of expectant mothers. Such cases need to be identified and carefully treated. Self-measurement of blood pressure during pregnancy is recommended for every pregnant woman, and it should also be carried out by a doctor during the consultation.

Is it possible to change the dosage of medications based on the pressure readings?

Finding the right combination of suitable drugs for the hypertensive patient requires an individualized treatment plan. You should never independently change the dosage of the drug taken and prescribed by the doctor. Regular readings of your blood pressure provide your doctor with valuable information to optimize your individual treatment plan. Record your measurements carefully in your blood pressure diary and discuss possible drug dosage changes with your doctor.Do I need to meet with a doctor regularly if I measure my blood pressure at home?

Regular measurements of blood pressure at home will allow your doctor to assess the profile and dynamics of your blood pressure over several weeks or months and thereby allow an optimal change in the therapy plan. Measuring blood pressure at home is not a substitute for required doctor visits.

Why is it necessary to record indicators in a personal BP diary?

A single blood pressure measurement is only a one-time reading and does not provide an accurate picture of blood pressure levels over the course of a day or several days.Therefore, you should measure your blood pressure two or three times a day, always at the same time. Record your results along with the date, time, and medications you took in your blood pressure diary. BP readings recorded over a long period of time will provide your doctor with a valuable basis for tailoring individual therapy.

Which model of tonometer is better to buy for an elderly person suffering from hypertension?

Automatic model for measuring blood pressure on the shoulder (but not on the wrist).In older adults, the BP measured at the wrist may differ from the BP measured at the brachial artery due to atherosclerosis.

Even a small increase in pressure is dangerous – Science – Kommersant

Cardiovascular accidents (stroke and myocardial infarction) remain the leading cause of death in Russia and throughout the world. One of the main conditions leading to the development of cardiac and vascular complications is arterial hypertension. What is arterial hypertension (or, in other words, hypertension)? This is a stable increase in the patient’s blood pressure when measured by the doctor in the office above 140 (systolic) and 90 (diastolic) millimeters of mercury during at least two visits.

But in addition to the well-known villainous hypertension, a significant number of patients have an initial increase in blood pressure – the so-called prehypertension. Prehypertension – a borderline state between optimal blood pressure and arterial hypertension – is defined as systolic from 120 to 139 mm and (or) diastolic from 80 to 89 mm Hg.

According to the recommendations of the Russian Cardiological Society of 2008, prehypertension includes the concepts of normal blood pressure (systolic 120-129 mm Hg and (or) diastolic 80-84 mm) and high normal blood pressure (systolic 130-139 mm and (or) diastolic 85-89 mm Hg).

Table 1 summarizes the rate and degree of increase in blood pressure.

Table 1

Why it is important to detect even mildly high blood pressure

According to the Framingham study (in the USA, a sample of more than 5000 participants was observed for 50 years) in 38% of cases within four years, prehypertension progresses to arterial hypertension (Vasan et al.Lancet 2001; 358 (9294): 1682-6). That is, if you warn a person, explain how to prevent a further increase in pressure, you can prevent the development of hypertension and the appointment of pills.

In another study, observing a sample of more than 1 million people aged 40-69 years, each increase in systolic pressure by 20 mm or diastolic pressure by 10 mm above 115/75 mm Hg was associated with a twofold increase in cardiovascular mortality (Lewington S. et al. Lancet 2003; 361 (9362): 1060).

How often prehypertension occurs in the Russian population

The answer to this question was received recently: The Ministry of Health of Russia initiated a study of residents of different regions of Russia to study the characteristics of risk factors for the development of cardiovascular diseases in different regions of Russia. The study was named “Multicenter observational study” Epidemiology of cardiovascular diseases in the regions of the Russian Federation “” (abbreviated ESSE-RF).For observation, 13 regions of Russia were taken (with different characteristics – climatic, social, etc.), and in each of them people were randomly selected who were invited to take part in the study. That is, among the invitees there were all sorts of people: those who do not seek help from the clinic and do not know anything about their blood pressure, cholesterol level, blood sugar, and those who know about their health problems.

The most difficult thing was to involve in the survey young people who are busy at work and who have no complaints.But gradually groups that reliably reflect the population by sex and age were formed, and in total, more than 22 thousand people took part in the study throughout Russia. The collected data on risk factors – how people often eat improperly, smoke, exercise insufficiently, have obesity and high blood pressure – will allow the Ministry of Health to plan preventive measures, with particularities in each region.

According to the ESSE-RF epidemiological study, the prevalence of prehypertension in the Russian population is 34.1%, and only less than a quarter of the population has an ideal blood pressure level.

Does Russia differ from other countries

The prevalence of prehypertension among the population of different countries of the world is very variable and when using unified criteria, according to different authors, it is 14.5% in Turkey, Japan – 33%, USA – 36.3%, China – 35.7%, Nigeria – 58.7%.

It turns out that prehypertension is also associated with obesity and metabolic abnormalities (high sugar, cholesterol, diabetes mellitus). That is, people with slightly high blood pressure often have slightly increased other risk factors, which cumulatively accumulate and can lead to a cardiovascular catastrophe.It seems to ordinary people that stroke occurs only in those who have very high blood pressure, but this is not the case. If you look at the distribution of stroke frequency by pressure level, normal and high normal account for 31% of all strokes (diagram based on data from Wolf PA, 2002).

How to prevent even a small increase in blood pressure

How to return from prehypertension to normal? Here comes the time to remember the famous expression “One pound of prevention is worth a pound of treatment” (as a clarification: in a pood of 40 pounds).That is, the detection of prehypertension should lead to the start of preventive measures:

– to reduce body weight: weight loss by 1 kg lowers the level of blood pressure by 1 mm Hg and the risk of stroke by eight times;

– limit salt and liquid intake – yes, people with high blood pressure should consume no more than 6 g of salt per day and drink no more than 1800-2000 ml per day;

– quit smoking;

– increase physical activity – it can be walking, swimming, exercising in the gym;

– Reduce stress levels in any way, including psychotherapy.

Preventive measures should be carried out not only by the person himself, but also at the state level, they could reduce the content of table salt in products, create conditions for sports and a smoking-free environment. It is much more difficult than just taking a pill, but it is much more effective.

Oksana Rotar, Candidate of Medical Sciences

History of Compression

In 1881, the Austrian physician and physiologist Samuel Siegfried Karl von Bach was the first to propose a technique for measuring blood pressure without piercing a blood vessel.He used a rubber bag filled with water and a manometer, a device for measuring pressure in liquids and gases. The edges of the bag were tightly wrapped around the neck of the manometer flask, which was filled with mercury. Hollow tubes branched off from the flask so that any pressure created inside the bag of water was transferred to the measuring flask: the level of mercury in it rose and pressure readings could be recorded. Von Bash considered the simplicity of his method to be an excellent merit.

At first, experiments were carried out on animals, then von Bash tested the device on humans.He noticed that patients with arteriosclerosis had a markedly higher systolic pressure than healthy people. In addition, he showed that blood pressure was lowered in patients with fever.

Basha’s invention was modified in 1889 by the French cardiologist Pierre Poten – he replaced water with air.

An important breakthrough was made in the mid-1890s by the resourceful Italian physician Shipione Riva Rocci: it was he who in 1896 invented the technology that is still used today. It consists in the fact that a rubber bag with special “cuffs” made of non-stretching material wraps around the hand in a circle and then is filled with air by periodically pressing the rubber ball connected by means of a tube.The pressure in the cuff is recorded with an ordinary mercury manometer and increases until the pulse can no longer be felt. When the pressure is slowly released, the mercury level in the manometer drops, and the pressure reading at the moment the pulse reappears is taken as the systolic blood pressure. An important advantage of this device was that the brachial artery was compressed evenly, and not, as in von Basch, unilaterally. Riva-Rocci tested his sphygmomanometer extremely thoroughly: it was important for him to make sure that the pressure was measured completely.He experimented with animals, with the hands of corpses, and with artificial circulation mechanisms made of rubber tubes.

But this sphygmomanometer also had one serious drawback. Riva-Rocci used narrow cuffs, only 5 cm wide. Because of this, an acute angle was formed between the edges of the cuffs and the skin, which created a local increase in pressure and made the study insufficiently accurate. In 1901, the defect was corrected by the German pathologist Friedrich von Recklinghausen, who made the cuff wider – 12 cm.

The Russian surgeon Nikolai Korotkov added the last but most important touch. In 1905, he proposed using a stethoscope when measuring pressure with a tonometer in order to listen to sound tones in a constricted pulsating artery and accurately determine both systolic and diastolic pressure.

Dementia became the leading cause of death

As reported by the BBC, last year in England and Wales, dementia, including Alzheimer’s disease, became the leading cause of death – 11.6% of all deaths.Until now, English and Welsh people were more likely to die of cardiovascular disease. If we combine all cancers, then they will become the main cause of death.

The Ministry of Statistics attributes this astonishing rise in deaths from dementia to an aging population and advances in the fight against cardiovascular and cancer pathologies. Another reason is that doctors are better able to diagnose dementia.

In 2015, 41,283 women (15.2% of all female deaths) and 20,403 men died from dementia in England and Wales.There are approximately 850,000 people living with dementia in the UK.

For men, cardiovascular diseases remain the main cause of death. In the group of young people under 19 years of age, suicide remains the main cause of death. Among women between the ages of 35 and 49, breast cancer is the leading cause.

Signs of dementia

It’s time to consult a doctor if the person:

– hardly remembers recent events, but remembers the distant past well;

– has difficulty maintaining a conversation or understanding the content of a TV show;

– forgets the names of friends and the names of household items;

– cannot reproduce what was heard, seen or read;

– loses the thread of his own reasoning;

– all the time shy, upset or annoyed;

– gets lost in ordinary everyday circumstances or cannot find the usual way;

– discovers that those close to him point out to him the deterioration of his memory.

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aspirin with high blood pressure If the pressure drops below 100 to 60, doctors call this condition hypotension.At the age after 20 and up to 40 years, this condition is observed in 5-7% of people, regardless of their gender, and in pregnant women the percentage. Blood pressure (BP) for each person individually, depends on. For the average young man, BP 99/67 is very close to normal. Pulse and blood pressure are indicators of health. If they are constantly above normal, then this is hypertension. Low blood pressure is a hallmark of hypotension. With this disease, the vascular tone is disturbed.Human pressure standards by age. What is pulse pressure. General information. As a general rule, any initial medical examination begins with a check of the basic indicators of normal human functioning. For adolescents, the pressure is 90–99 / 60–65 mm Hg. Art. characteristic, which indicates the immaturity of the heart muscle. Pressure at the level of 85–99 / 60–66 mm Hg. Art. can be a symptom of many pathologies: internal hemorrhages. A pressure of 90 to 70 is a sign of low blood pressure or hypotension.What does 90 to 70 pressure mean, the reasons and what to do about it? A pressure of 90 to 70 is a sign of low blood pressure or. Pressure 99 to 61. 05/29/2019 Category: Pressure. Table of contents [Show]. If the pressure drops below 100 to 60, doctors call this condition hypotension. At the age of after 20 and up to 40 years, this condition. What a person feels When a person has a 90/60 pressure, he experiences painful sensations. What should be the rate of blood pressure in children and adults.Why you should often measure your blood pressure, what consequences of hypertension can lead to. The reasons for the pressure 90 to 70, what do such indicators mean and what to do. The blood pressure indicator is the main one for assessing the condition. high blood pressure signs and treatment pressure reducer 1 hypertension at work

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I tried a bunch of pressure medications, but it jumped and jumped.The last thing I drank was the Tonosil complex. And what do you think? Again, no result. Apparently, this is another divorce and will have to look further. Although hardly anything will help. My medical experience has long passed into the second dozen. I have seen many different forms of drugs that promise to help with hypertension. There were some good ones among them, but I was always embarrassed by the possible side effects from them. I praise not only the high-quality and natural composition, but also for minimizing the likelihood of a side effect.Treatment of hypertension in the sanatoriums of Russia KMV is perfect for those patients who want to relax in peace away from the bustle of the city. Sanatoriums with the treatment of hypertension and high blood pressure at the best price! Free consultations of a professional balneologist, discounts and promotions. The advantages of spa treatment. Treatment of hypertension in a sanatorium has undeniable advantages over therapy carried out in a hospital or at home: Additional diagnostic measures for detection. Rating of resorts and sanatoriums specializing in the treatment of arterial hypertension (hypertension) – The best prices for spa hotels and sanatoriums for treatment.Profiles of hypertension treatment in sanatoriums of the Saratov region: Diseases of the heart and blood vessels have become today the main cause of high mortality in various parts of the world. CVDs form a special group. Hypertension is a disease associated with elevated levels. Treatment of hypertension in the sanatorium includes: a course of drug treatment, therapeutic baths, apparatus physiotherapy, physiotherapy exercises, herbal medicine, dietary. To choose a sanatorium with treatment of the cardiovascular system in Russia in 2020.Sanatoriums with treatment of the cardiovascular system, unlike other areas, do not have a large list. Treatment of hypertension in a sanatorium. What is hypertension. In our time, hypertension has become a scourge for the entire population of the Earth. Therefore, I propose my short list of sanatoriums where there is a sufficiently developed infrastructure for the treatment of hypertension II, as well as the initial I and III stages of hypertension. 1) Sanatorium Gurzufsky (village Gurzuf). Treatment of hypertension in a sanatorium on a flat or forest area is suitable for an uncomplicated course of the disease.It is worth noting that it is necessary to choose a non-hot period of the year, when the sun’s rays are less aggressive.

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More than 4000 people were selected for the experiments, who voluntarily took pressure drops for 30 days. During this period, the developers of Tonosil checked the condition of the subjects, an improvement of 1 kgf cm2. Conversion of units of measurement. Pressure. Convert pressure 1 Kilogram of force per square centimeter (kgf cm2, kgf / cm2). Having remembered how many kgf / cm2 or kPa in 1 MPa, the translation of values ​​can be easily carried out in the mind without outside help.Pressure units, pressure conversion tables. Conversion of values. Pressure is a physical quantity that is numerically equal to the force acting per unit of surface area perpendicular to this surface. With this calculator, you can convert atm to kgf / cm2 and vice versa in one click. The units of measurement for pressure or stress are quantities used in mechanics. Not so long ago, the Russian Federation changed the basic units of measurement, so our table will be relevant for both beginners and experienced specialists in order to easily convert kgf / cm2 to MPa, kgf / cm2.The technical atmosphere is equal to the pressure produced by a force of 1 kgf, evenly distributed over a flat surface perpendicular to it with an area of ​​1 cm². In reference books and old documentation, they are found the same way. 1 kgf / cm² = 1 at. Pressure unit ratio table. In order to use the instant conversion of one pressure value to another and find out how much bar will be in MPa, kgf / cm², atm or psi you need Technical atmosphere (at, at, kgf / cm²) – equal to the pressure produced by a force of 1 kgf directed perpendicularly and evenly distributed over a flat surface with an area of ​​1 cm² (98,066.5 Pa).kgf / cm2. Multiply by: Pa (N / m2) – pascal, SI unit of pressure. 0.0025. Pressure unit conversion table. Pa; MPa; bar; atm; mmHg.; mm.st .; m.st., kg / cm 2; psf; psi; inches Hg; in.st. Online converter of basic pressure units for manometers. The ratio of units of measure of pressure. Pa kPa MPa kgf / cm² bar phys. atm mm water column mm Hg psi. pressure 99 . pressure reducer 1. Reviews, instructions for use, composition and properties. High blood pressure combined with diabetes mellitus is a very dangerous condition for humans.It can cause severe complications. Of particular importance is the diet of diabetics. Nutrition for type 2 diabetes with hypertension, as in type 1 diabetes, should. Adequate nutrition for type 2 diabetes with hypertension can significantly ease the course of the disease and improve quality of life. More often than not, the very cause of diabetes lies. High blood pressure combined with diabetes mellitus is a very dangerous condition for humans. It can cause severe complications.A menu for those suffering from diabetes and hypertension. The diet for diabetes and hypertension should include. A properly compiled menu for diabetics for a week allows maintaining the disease in a compensated state for a long time, which, in turn, reduces it. The menu for type 2 diabetes allows the use of fish or non-concentrated meat broth. To lose weight with hypertension and type 2 diabetes mellitus, it is necessary to understand the pathogenesis and etiology of these diseases. In diabetes, metabolic processes fail when.The combination of hypertension and diabetes mellitus is manifested as follows. Proper nutrition for hypertension and type 2 diabetes. There is a list of products recommended for one disease and prohibited for another. Special care must be taken when including in the menu. Treatment of hypertension in diabetes mellitus involves taking several groups of drugs. The menu for hypertension and diabetes mellitus involves the prevention of edema, pressure surges and an increase in blood glucose.Nutrition for type 2 diabetes with hypertension cannot. Healthy foods. Hello. We, diabetics, in addition to diabetes, suffer from complications and concomitant diseases. High sugar affects almost all organs, but especially the heart. Hypertension in type 2 diabetes usually develops due to an acute disorder of carbohydrate metabolism. When composing the menu, the main thing is to adhere to the correct balance of fats and carbohydrates, take into account the energy value of dishes in accordance with the needs of the body in order to prevent obesity.