High blood pressure: Common, Silent, and Dangerous
Originally written by Dr Stephens for the Montrose Mirror.
MONTROSE-While you might be tempted to think the title is over-dramatic, I can assure you it is, if anything, too modest. High blood pressure is the number one cause of strokes, and a leading cause of heart attacks, and yet in America, only about 1 in 4 people diagnosed with high blood pressure have it under control(1).
Additionally, it affects about half of American adults, although 1 in 5 of these people aren’t aware they have it. It is the number 2 cause of deaths worldwide (after poor diet) and is more than twice as important as the next most important risk factor, obesity(2).
I suspect part of the reason it is under-diagnosed and under-managed is because, for the majority of people, high blood pressure doesn’t cause any symptoms. Meanwhile, it can be quietly damaging the inner walls of blood vessels all around the body. Sometimes healthcare providers can also become complacent about numbers that are merely ‘not too bad’ in a rushed environment where blood pressure isn’t the priority for that day.
The good news is that blood pressure is both easy to check and usually straightforward to treat, through both lifestyle changes (which can make an enormous difference) and medications.
If you are an adult and don’t know your blood pressure numbers, please make it a priority to get your blood pressure checked. If you don’t have a blood pressure machine at home and aren’t able to borrow one from a friend, you could schedule a nurse visit at your primary care provider’s office, or even stop by one of our local pharmacies in town as many have a machine you can use. If possible, I recommend using an upper arm cuff as these tend to be more accurate than a wrist cuff.
To check your blood pressure, first sit quietly for 1-3 minutes. Avoid checking right after smoking, drinking caffeine or alcohol, or exercising. First thing in the morning pre-coffee tends to work best for most. Sit with your feet flat on the floor, your back supported in a chair, and your arm resting at about the level of your breast bone. Check your blood pressure twice, one minute apart, and record both readings. For more accurate results, do this twice daily for 4–7 days. Then, discard the readings from the first day (these tend to be artificially raised) and work out an average from the remainder.
For most people, we aim for an average of about 120/80mmHg. We might be slightly more lenient with adults over 80y as a blood pressure that is too low can increase the risk of dizziness and falls in this group.
If your average is over 130mmHg on the top or over 80mmHg on the bottom, please book an appointment with your primary care provider and bring your readings in to decide together on a treatment plan. For many people, this might simply be a 3-month trial of making certain lifestyle changes then a review after; it doesn’t necessarily mean your provider will want to start medication immediately.
The most important thing is not to ignore high blood pressure — or not know your blood pressure numbers — just because you feel well, or your provider hasn’t raised it as an issue. Preventing strokes and heart disease starts years before symptoms appear. If you don’t have a provider, and are looking for someone local, Cimarron Family Practice is a Direct Primary Care clinic in Montrose, currently open and accepting new patients of all ages.
References
https://www.cdc.gov/high-blood-pressure/data-research/facts-stats/index.html
Forouzanfar M, Alexander L, Anderson H et al. Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks in 188 countries, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013 The Lancet, 2015; 386, 2287-2323 https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(15)00128-2/fulltext