Goal of pharmacological or non pharmacological management is to reduce the blood pressure to less than 130/80 mm Hg.
Secondary causes of High Blood Pressure
Some medical conditions can contribute to high blood pressure. when those medical conditions are managed appropriately, blood pressure can be controlled.
- Obstructive sleep apnea
- Hyperthyroidism
- Hyperaldosteronism (Conn’s Syndrome)
- Renal Artery Stenosis
- Pheochromocytoma
- Hypercortisolism
- Chronic Kidney Disease
Some medications can increase the blood pressure. In that case upon discontinuing the medication, blood pressure can be normalized.
- NSAIDS (Ibuprofen, Motrin, Allieve, Naproxen, Celebrex, Meloxicam)
- Steroids (prednisone)
- Some Antidepressants (Venlaflaxine or Effexor, Wellbutyrin or Bupropion)
- ADHD medications (Adderall, Ritalin)
- Estrogen containing Birth control pills
Why is it important to keep the Blood Pressure Under Control?
Uncontrolled Blood pressure can cause many significant and dangerous health problems and can even lead to death.
Cardiovascular (Heart) Problems : When the blood pressure is high your heart needs to work extra hard to pump blood to the rest of the body. By working extra hard for a long period of time heart goes under tremendous stress and can develop conditions such as Heart Failure and Heart Attack
Neurovascular (Brain) Problems: High Blood pressure reduces blood supply to the brain and therefore can cause Ischemic stroke (part of the brain that gives up functioning due to no blood flow) and Dementia. In addition high blood pressure can also cause hemorrhagic Stroke by causing increase pressure in the vessels leading them to rupture (Think of your blood vessels like a pipeline, if the pressure in the pipe increases it can cause the Pipe to explode and water will start leaking).
Vascular (Blood Vessel)Problem: Long standing high blood pressure can weaken the blood vessel and cause problems such as aneurysm and dissection (blood vessel ruptures causing the blood to leak internally).
Vision (EYE) Problems: Lack of blood supply to the eyes can cause retinopathy and eventually blindness.
Nephropathy (Kidney) Problem : Lack of blood supply due to increase pressure can put alot of stress for the kidneys to function and can cause kidneys to fail and eventually needing Dialysis or kidney transplantation.
Erectile Dysfunction (Sexual dysfunction): Who would have thought High blood pressure can contribute to sexual dysfunction. It is caused by the same concept, and that is high pressure reduces blood supply to the Penis causing it to not function as it should be. This can lead to difficulty maintaining or achieving an erection.
Management of hypertension
Like any other medical condition if you have 2 or more reading of elevated blood pressure that are not affected by external factors (drinking caffeine before checking the blood pressure etc.) your doctor can diagnose you with Hypertension. There is a common problem called White coat Hypertension in which people have elevated blood pressure every time they come in to the doctor’s office (since no one likes to come to the doctors office and the anxiety or stress cause the blood pressure to falsely be high). In that case your doctor would ask you to check the blood pressure outside of that environment such as home or a pharmacy or etc.
Proper management of Hypertension includes a multidisciplinary approach. Just following one without controlling the others is not going to help you achieve good blood pressure control
- Medications
- Diet & Exercise
- Weight loss
- Management of Stress
- Management of other medical problems that can contribute to High Blood Pressure
medication
No one likes to be on medications, however if you are diagnosed with Hypertension and if you failed to control your blood pressure by lifestyle changes being on medication is the best option for you. Many people are worried about the side effects of medications. Even though medications do have side effects, having high blood pressure can cause more harm than the side effects of medications. If you look at any medication It would always have a long list of possible side effects, that does not mean everyone is going to experience some or all the side effects. Your doctor would explain you the most common and most dangerous side effects and if you experience any of them you can talk to your doctor and stop or switch the medication immediately. Your doctor will also discuss with you the best blood pressure medication for you depending on your ethnicity, age and comorbidities. Just because you have to start a medication for hypertension does not mean you have to be on it forever. When you work on the other factors that affect your blood pressure and control them your blood pressure will also be under control and eventually you can get off of the medication with your doctors guidance and supervision.
Diet & Exercise
Diet plays a major role in blood pressure control. Recommended diet plan for hypertension is DASH diet. DASH diet includes
- High consumption of fruits and vegetables
- High consumption of whole grains
- Moderate consumption of low fat dairy products
- Moderate consumption of lean meat (Chicken, Turkey and Fish are preferred over Beef, Lamb and Pork)
- Moderate consumption of healthy nuts and seeds
- Low consumption of Red meat
- Low consumption of salt (less than 2400 mg (or 2.4 g )of salt per day)
- Low consumption of saturated fat
- Low consumption of Sweets
Most health benefits with exercise occurs with moderate to high intensity exercise for at least 150 minutes per week .
Weight loss
Over weight, obese or morbid obesity puts you at high risk of developing hypertension and other complications. Studies have shown that losing approximately 10 lbs will reduce the systolic blood pressure by 5 – 20 mmHg. In addition if you have a secondary cause of hypertension that is related to your body habitus, it can help reduce it even further.
Management of stress
We all go through a lot of stress on a daily basis. From waking up in the morning , then getting stuck in the traffic and finally when you get to work there is more stress. If we do not find a way to handle our stress, stress will take control of our life and health. There is no one way to manage stress, you just have to find what works for you. some of the most common stress relievers are
- Meditation or yoga
- spending time with your loved ones
- Taking a stroll in the nature
- Having a pet
- Listening to music
Mediculous 