High Blood Pressure Accuracy

If your blood pressure is higher than 120/80 repeatedly, you have high blood pressure also known as hypertension. Three consecutive visits to the doctor's office with high readings can be all it takes to be diagnosed with high blood pressure. It is called the silent killer because there are often no symptoms until a heart attack or stroke occurs. 

Even when your blood pressure is normal at home, it is the readings at your doctor's office that determine the diagnosis and treatment.  Ambulatory blood pressure monitoring (ABPM) is changing the way to accurate diagnosis.  More doctors are becoming aware of this and ordering it to check for twenty-four hours. In addition, checks by patients with blood pressure devices are being recommended.  This allows for checks in everyday life situations versus the few high anxiety visits to the doctor.

ABPM can help with treatment as well.  You can see what makes it go up and avoid these things.  Some medication can make it go too low, and the dosage adjustment or type of medication may need adjustment.  These situations usually occur at home after doctors' office hours.

When blood pressure monitoring is done by your schedule, it may be more accurate. ABPM can be a healthy way to keep it stable for you and your family. Best health!  

MY PATIENT HANDBOOK: Ambulatory Blood Pressure Monitoring

MY PATIENT HANDBOOK: high blood pressure

High Blood Pressure Education Month: Hypertension Tension

Tension in the morning can be stressful. Hypertension may be contributing to this.  It may cause symptoms often associated with starting a new day and all you have to do.  This should be less stressful than many choose to make it.  Normal blood pressure at this time of day is associated with better health and less comorbidity.  

Hypertension in the morning may start as early awakening, anxiety. headache, chest discomfort, and general fatigue.  Studies have shown heart attacks are more likely to occur this time.  High blood pressure in the morning should be recognized. Often it may be associated with normal blood pressure for most of the waking hours without symptoms.  

Treatment must be specific for each person.  It is good to begin with simple common sense things like restful sleep, healthy diet, and exercise.  Meditation, yoga, and prayer are beneficial as well as easy to do upon waking up.  Reading books and watching instructional videos is an easy, inexpensive way to learn.  As these are made routine, stress reduction is also enhanced.  

Maintaining a healthy weight and BMI are important as well.  Foods specific for cardiac health like beans, greens, and grains are very beneficial. Lack of response to these may indicate a need for medication especially if blood pressure is elevated more than four hours upon and after awakening. Specific herbs and supplements may also be added.

Home blood pressure checks remain beneficial for keeping track of daily blood pressure measurements.  A record of these should be kept along with notes on present activity and treatment.  After two weeks or sooner, you will be able to see patterns, and what is working.  Continue your hypertension diary for at least three months or longer.  It will become apparent what you can do to keep a normal blood pressure without symptoms and hypertension tension.  Best health!

Holiday Hypertension Healers

 Make less stress, tolerate even less.

Learn relaxation techniques.

Meditate daily.

Eat heart healthy food.

Exercise at least fifteen minutes or more a day in your best way.

Pursue enjoyable hobbies that you like.

Sleep soundly at least eight hours per twenty-four.

Let love keep you healthy.

Smile a lot.

Pray often.

Own a blood pressure device and /or an application on a phone.

Check your blood pressure at home. 

Give a blood pressure monitor as a gift.

Use positive kindness as daily medicine.

Best health!

MY PATIENT HANDBOOK: hypertension 

Ambulatory Blood Pressure Monitoring

Did you know that your blood pressure changes every second? This change depends on what you are doing, thinking, and feeling.  This is one reason to get your blood pressure checked more often than your routine doctor visit.  You may discover that your blood pressure is normal more often during your waking hours, and that high blood pressure occurs only certain times.  These times are often stress related.

One of the best ways to see what stressors cause your blood pressure to be high (or low) is with ambulatory blood pressure monitoring. ABPM is simple to do for patients.  Own a blood pressure monitor of your choice be it arm or wrist.  These are quite inexpensive and affordable.  Use it to check your blood pressure three times a day and at times of your choice. 

Record your daily readings for at least a month. Review your recorded readings.  This will show you patterns of your blood pressure.  Certain times of day almost every day or on some days note the times it is abnormal.  For instance, every Monday it is high, and by the weekend it is normal.  Those first days of the week especially during work hours is one of the main times it reveals itself.  Listen to it! You may also find stressful situations like pain, anxiety, and even healthy excitement can lead to high blood pressure. 

As you see the patterns, you become more mindful of what induces hypertension. Often times you may have certain symptoms that correlate.  Find ways to decrease those moments.  For example, many patients get an extra bump up in blood pressure from watching violent video content regardless of the source.  When you wait to see the doctor just getting ready may be a high blood pressure trigger.  

Share your information with your doctor.  Together you may find more normotension than hypertension.  This can be confirmed with a cardiology referral for evaluation and formal ABPM.  Check yourself and get yourself checked.  Best health!  For more information:  MY PATIENT HANDBOOK: hypertension 

Morning Hypertension Tension

Tension in the morning can be stressful. Hypertension may be contibuting to this.  It may cause symptoms often associated with starting a new day and all you have to do.  This should  be less stressful than many choose to make it.  Normal blood pressure at this time of day is associated with better health and less comorbidity.  

Hypertension in the morning may start as early awakening, anxiety. headache, chest discomfort, and general fatigue.  Studies have shown heart attacks are more likely to occur this time.  High blood pressure in the morning should be recognized.  Many times it is associated with normal blood presuure for most of the waking hours without symptoms.  

Treatment must be specific for each person.  It is good to begin with simple common sense things like restful sleep, healthy diet, and exercise.  Meditation, yoga, and prayer are beneficial as well as easy to do upon waking up.  Reading books and watching instructional videos is an easy, inexpensive way to learn.  As these are made routine, stress reduction is also enhanced.  

Maintaining a healthy weight and BMI are important as well.  Foods specific for cardiac health like beans, greens, and grains are very beneficial. Lack of response to these may indicate a need for medication especially if blood pressure is elevated more than four hours upon and after awakening. Specific herbs and supplements may also be added.

Home blood pressure checks remain beneficial for keeping track of daily blood pressure measurements.  A record of these should be kept along with notes on present activity and treatment.  After two weeks or sooner, you will be able to see patterns, and what is working.  Continue your hypertenson diary for at least three months or longer.  It will become apparent what you can do to keep a normal blood pressure without symptoms and hypertension tension.  Best health!

Preventive Guidelines: Do Lower Medical Numbers Make Chronic Disease More Likely?

Hypertension has new numbers that are lower for normal.  To be considered normotensive your blood pressure numbers should be lower than 120/80 versus the former normal blood pressure below 140/90.  This is the new recommendation from the cardiology experts.  This may be shown to cause less morbidity and mortality, but it may cause more people to be considered hypertensive.  If your reading on three doctor visits is over 120/80, you will be considered a patient with hypertension.

This is just one of the many medical measurements or blood tests where the WNL (within normal limits) has been lowered.  Cholesterol was at one time considered normal at 300.  The normal now is under 180.  New tests can have the same effect.  The BUN and creatinine were once the basic kidney function tests.  Now the GFR is added to these.  Your BUN and creatinine can be normal while your GFR suggests kidney disease based on your sex and your ethnicity. 

Do lower medical measurements and numbers really mean that more patients will have some chronic disease sooner? Or does it mean lower numbers mean better health with less morbidity and mortality?    Good health care will help keep you and your numbers healthier.  Keeping a lifestyle of healthy food, exercise, good sleep, and minimal stress are important health care routines for better health.  These can be integrated with complementary medicine and medication treatments if necessary. 
You should know the measurements and numbers of all your health tests.  This helps you attain better understanding and control of the unhealthy abnormal.  Lower numbers can mean less chronic disease if you know what you have and how to keep it from becoming chronic disease.  Best health!
  

Blood Pressure Home Checks

Do you know your average blood pressure reading? Do you know a normal blood pressure should be? High blood pressure, also called hypertension affects 1 in 3 adults worldwide.  It affects more people than any disease in the world. Untreated hypertension leads to unhealthy feelings and symptoms.  It causes heart disease, strokes, kidney failure, blindness, poor circulation, and more. 

A normal reading is 120/80 with borderline at 130/85 to 140/90.  For more accurate measures of your blood pressure and what affects it, you should do home blood pressure monitoring. Buy a blood pressure monitor for home use. Wrist and arm monitors are available in many stores on and off line. Record your blood pressure readings daily starting with morning, midday, and night. Make a note of your activity and how you are feeling. You may notice that extreme anxiety makes it go up. The correlation to your pressure will help you manage the things that make it go up. Share your results with your doctor so medication and lifestyle changes can be made if necessary.

You may find that while your blood pressure is high in the doctor's office, it may be normal in everyday activity. Remember, the doctor's result is a one time reading every one to four or more months. With normal home results, and high results at your doctor visits you may have "white coat" hypertension. There is much controversy over whether this should be treated. Check with your primary care doctor and cardiologist.

If your blood pressure is borderline at 130/85, you want o start a low salt, low fat diet. One of the best is the DASH diet. Integrating healthy food. exercise, weight control, and stress reduction in your treatment plan improves the way you feel and controls blood pressure. For higher blood pressure readings over 140/90, medication may be necessary. Be sure to take your home blood pressure results in to your doctor. This will help in deciding on the best treatment for you. Best health!

White Coat Hypertension: Is It Really High Blood Pressure?  http://bit.ly/1cGaeMj

High Blood Pressure: How Loud It Can Be

High blood pressure (HBP) is louder than you may think.  Often called the “silent killer”, hypertension has symptoms to let you know it is present.  Symptoms may include headache, dizziness, fatigue, weakness, blurred vision, seizures, unexplained anxiety, and more.  Though nonspecific these signs and symptoms do correlate with high blood pressure. If you have a family history of HBP and heart problems, it is very likely the symptoms will be present. Untreated hypertension may lead to more serious conditions like heart attacks and strokes.

When you experience symptoms suggestive of hypertension, it is important to get it checked.  This should be done by a health care professional, but can be done at home, also.  Consistent readings above 140/90 call for assessment and treatment.  A complete physical exam, complete blood tests, and EKG should be done to check for overall good health and findings that are seen with hypertension. 

On physical exam the eye exam may reveal retinopathy and artery narrowing.  This is associated with decreased vision and can proceed to blindness.  Bruits over the carotid arteries in the neck and over the abdomen area suggest vascular disease that can block the arteries off.  This can lead to strokes, chronic kidney disease, peripheral vascular disease (poor circulation in legs), sexual dysfunction and more.  Heart findings and EKG changes can show signs of heart disease that accompany hypertension.  Blood tests provide further information and can even help assess if there are secondary causes.  Your doctor correlates all the information to assess a treatment plan. 

Initial therapy includes lifestyle changes like a healthy, nutritious diet, good sleep, low stress, and exercise.  If your blood pressure reading consistently remains elevated medication may be needed.  This may be temporary or lifetime depending on your lifestyle health habits.  For example, weight loss and eating the right foods especially those known to decrease blood pressure, can totally eliminate the need for medication and its side effects that can create new chronic problems. The best part is that you will feel better, and hopefully prevent any problems from untreated high blood pressure.  Best health!

Family Health: Continuity of Your Care

Your family's health is of utmost importance.  Continuity of care is disrupted all to often due to lack of communication and follow-up.  Make sure your family members have accurate information for each person,  These suggestions will help you continue your health care communication continuous with less stress:

• call your doctor's office, testing center prior to appointment to be sure all is on time as scheduled
• reschedule appointments that are over an hour late especially if it jeopardizes your health conditions (e.g. persons with diabetes, hypertension, arthritis)
• read often on your health condition
• use email, fax, postal mail if unable to reach your doctor by phone
• get copies of your medical records and reports from all doctors you see
• contact your doctors for your test results, specialists reports if you fail to get contacted within 1 week
• tell your doctor what other doctors have told you as these reports often arrive after your visit, if at all

Best health!

Family Health: How to Keep Your Health History

Your medical history is the cornerstone of your medical record.

Use it to keep up with your health. Update your medical history often especially as new treatment plans and healthcare issues arise.  Copy and complete the following assessment to keep up with your family's health and medical history. 

MEDICAL HISTORY

 

NAME____________________________

DATE OF BIRTH_____________________________

 

INSURANCE COMPANY___________________

INSURANCE ID #________________________

PHONE______________   FAX__________________

ADDRESS__________________________

CITY_____________STATE___________

ZIP________________COUNTRY__________

EMAIL___________________________

 

PAST MEDICAL HISTORY

ALLERGIES______________________________________________________________________________________

_______________________________________________________________________________________________

DRUGREACTIONS________________________________________________________________________________

_______________________________________________________________________________________________

_______________________________________________________________________________________________

DIAGNOSES & MEDICAL CONDITIONS (include year diagnosed)

________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

SURGERY/ OPERATIONS (include year done)

________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

MEDICATIONS (list prescription, over-the-counter, foods, herbs

also write dosage and how often taken)

_______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

PAST MEDICATIONS (list anything you have taken and stopped – note why it was stopped)

______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

 

FAMILY HISTORY (list medical conditions in family members – list ages, list if deceased and reason)

MOTHER____AGE________

LIVING: YES___NO____

FATHER____AGE_________

LIVING: YES___NO____

______________________________________________________________________________________________

SISTERS_____AGES_________

LIVING: YES___NO____
_______________________________________________________________________________________________

BROTHERS __AGES_________

LIVING: YES___NO___

_______________________________________________________________________________________________

GRANDMOTHER (Mother’s mother) AGE__________LIVING: YES___NO___

_______________________________________________________________________________________________

GRANDMOTHER (Father’s mother)  AGE__________LIVING: YES__ NO___

_______________________________________________________________________________________________

GRANDFATHER (Mother’s father)    AGE__________LIVING: YES___NO___

 

GRANDFATHER (Father’s father)    AGE___________LIVING: YES___NO___
______________________________________________________________________________________________

 

OTHER RELATIVES (list any more sisters, brothers, great grandparents, etc. especially those with medical conditions)_________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

 

OTHER MEDICAL TREATMENTS (list any other treatments like prayer, massage, chiropractor, exercise, physical therapy, etc.)___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

 

SOCIAL HISTORY

Home:  lives alone___ 

             lives with family___

             lives with friend____

             lives in facility_____facility name, address____________________year moved in____________

Marital: Single___Married____Divorced___Widow/Widower_____

Use of cane___ walker___ wheelchair___prosthetic_____

Other___________________________________________

Alcohol consumption: 

   How many times per day/week/year?________________

   How much per drink?____________________________

Cigarette use: Yes___ No___

   How many per day?________

   At what age did you start?_______

Sexual:  Are you active? Yes___No___

Drug use: Yes___ No___

 

OCCUPATIONS/ JOBS/SCHOOLING

___________________________________________________________________________________________________________________________________

 

MY MEDICAL NOTES

Use extra page to list any other medical history

________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

 

White Coat Hypertension: Is it Really High Blood Pressure?

Is it really high blood pressure or is it the white coat? White coat hypertension is a term that refers to high blood pressure (HBP) when you visit your doctor or other health care provider.  It is normal during other times.  Are you really hypertensive if this is the case?  Do you really need the DASH diet and medication?

High blood pressure is defined as three consecutive blood pressure readings at or above 140/90, or one reading above 160/100.  These readings are most commonly obtained when you visit your doctor which can be from one time to several times a year.  Needless to say the preparation and anxiety that go with doctor's appointments is enough to make any one's blood pressure go up normally! Getting ready and getting there can surely create this effect, but is this enough to make a diagnosis of high blood pressure when your blood pressure checks weekly or daily are normal?

HBP monitoring by patients outside the doctor's office may prove that white coat hypertension is what it is.  Normal readings outside the health setting in your everyday environment are more accurate and real. By tracking your own blood pressure at home you may find that your blood pressure is normal most of the time.  You can also see what makes it abnormal, too, and avoid or decrease these things. If it stays consistently high without white coats, treatment with diet and medicine may be indicated.

Best health!

High Blood Pressure Home Remedies

Treating hypertension with lifestyle changes that promte good habits is key to staying 120/80, the normal blood pressure reading. Of course, maintainimg healthy weight for your height, eating the right foods, regular exercise, limited alcohol intake, avoidance of cigarettes and severe stress help. If these things fail to keep you 120/80 then you will need blood pressure medication prescribed by your primary care physician or cardiologist.

Many regimens start with a diuretic ("water pill") either alone or combined with any other medication groups like beta blockers, angiotensin converting enzyme inhibitors, calcium channel blockers, and more. Many of these have lots of side effects as well as create new medical problems (e.g. diuretics can cause loss of potasssium resulting in cramping, heart rhythm abnormalities; beta blockers can cause bradycardia, exacerbate asthma, COPD). When used in combination this can worsen. Home remedies may offer healthier and safer treatment.

Some high blood pressure home treatments include:
- honey and onion juice in equal amounts equal to 2 teaspoons daily
- garlic clove daily
- foods: fruits esp banannas, oranges, apples, watermelon. papaya; fish (less
red meat; vegetables especially carrots, spinach; whole grains; low fat
- apple cider vinegar 2 tablespoons daily
- aloe vera
- tea (black, green, hibiscus)
- coconut water ("noelani")

Many of these remedies also help other maladies, but more importantly they are natural, wholesome and inexpensive requiring no prescription. Remember to also halt the salt!

Best health!

High Blood Pressure - Home Checks

High blood pressure, also called hypertension affects 1 in 3 adults. Stay 120/80! Know your numbers.

For more accurate measures of your blood pressure and what affects it consider home blood pressure monitoring. Buy a blood pressure monitor for home use. Wrist and arm monitors are available at Amazon, Target, Walgreen's, CVS, Wal-Mart, and local medical supply stores. Shop on line by doing a search for "blood pressure monitor". One of the top finds is for those made by Omron, and of course, the store brands.

Record your blood pressure readings daily starting with morning, midday, and night. Make a note of your activity and how you are feeling. You may notice that extreme anxiety makes it go up, or that your head hurts. The correlation to your pressure will help you manage your symptoms.

If your blood pressure is borderline at 140/90, you want to start a low salt diet. The best is the DASH diet (http://bit.ly/hnbsL). Exercise, weight control, and stress reduction are other things to include in your treatment plan. For higher blood pressure readings over 140/90, medication may be necessary. Take your home blood pressure results in to your doctor. This will help in deciding on the best treatment for you.

Share your results with your doctor so medication and lifestyle changes can be made if necessary. You may find that while your blood pressure is high in the doctor's office, it may be normal in everyday activity. Remember, the doctor's result is a one time reading every few months. With normal home results, and high results at your doctor visits you may have "white coat" hypertension. There is much controversy over whether this should be treated. Check with your cardiologist.

American Heart Association http://hearthub.org/ for your cardiovascular concerns.


by J.L. Richardson, MD, author of the award winning Patient Handbook to Medical Care.

mypatienthandbook.com/
www.twitter.com/MD4U

High Blood Pressure/ Hypertension Follow-up

High blood pressure, also called hypertension affects 1 in 4 adults. Stay 120/75! Know your mumbers.

For more accurate measures of your blood pressure and what affects it consider home blood pressure monitoring. Buy a blood pressure monitor for home use. Wrist and arm monitors are available at Target, Walgreen's, CVS, Wal-Mart, and local medical supply stores. Shop on line by doing a search for "blood pressure monitor".

Record your blood pressure readings daily starting with morning, midday, and night. Make a note of your activity and how you are feeling. You may notice that extreme anxiety makes it go up, or that your head hurts. The correlation to your pressure will help you manage your symptoms.

Share your results with your doctor so medication and lifestyle changes can be made if necessary. You may find that while your blood pressure is high in the doctor's office, it may be normal in everyday activity. Remember, the doctor's result is a one time reading every few months. With normal home results, and high results at your doctor visits you may have "white coat" hypertension. There is much controversy over whether this should be treated. Check with your cardiologist.

American Heart Association http://hearthub.org for all your cardiovascular concerns.