Reblogged from Tisha Rowe, MD
Its heart health month and hypertension is one of the most prevalent medical conditions that can impact your heart. As a primary care physician I often see people with uncontrolled blood pressure. There are a few trends that I have noticed that contribute to their blood pressure being poorly controlled. Here are 5 things you should know if you have hypertension.
1. Blood pressure is usually a lifelong diagnosis.
If a doctor prescribes high blood pressure medication and then your blood pressure goes back to normal while on medication, you still have a diagnosis of high blood pressure. Even if your blood pressure is normal you should not stop the medication until you discuss with your doctor. If you stop your medication your blood pressure will most likely go back to abnormal over time since it is a chronic, long lasting, medical problem. If your doctor asks do you have a medical problem even if it has been years since you took medication it is important to disclose that you have high blood pressure. There are tests that may need to run which they can not recommend without knowing your full medical history.
2. Medication side effects are common but the alternative is worse.
I often see people who stop their blood pressure medications because of side effects. Some of the most common side effects include urinating frequently and swelling in the legs. These side effects may be frustrating but stopping your medications because of side effects can lead to a stroke. So before you stop your medication ask yourself, ‘is dealing with this side effect worse than having a stroke?’ If not, stay on your medication or discuss an alternative medication with your doctor. Trust me, there are plenty of options.
3. Know your medications.
I do pre-employment physicals at work and the majority of patients I see with hypertension do not know the medication they are on. Of course I am happy they are taking their medications and compliant but I am frustrated because I know that if they end up in the hospital unexpectedly it will be a disaster. If you go to the hospital in an emergency it is very important that the doctors know what you are on so they can avoid giving you anything that would cause a drug interaction. Furthermore, if I do not know what medications you are on, how can I give you advice on how to make adjustments? Finally, “what if your medication is recalled?” how would you know if you don’t know the name of your medication? Forget about pronouncing it correctly or memorizing the name. Simply write it down and put it in your wallet or take a picture and keep it in your phone. Knowing your meds is a must.
4. You have to exercise.
I find a lot of people with high blood pressure do not feel a need to exercise since their blood pressure is controlled by medication. Unfortunately the longer you have high blood pressure the more likely it will be that you will need additional medication. I have had patients on three blood pressure medications at the maximum dose and their blood pressure is still uncontrolled. This is called ‘resistant’ hypertension. By exercising regularly you can protect your heart from complications of heart disease and decrease the amount of medications you have to take. Also in some cases with the right amount of exercise and weight loss you may not need medications at all. Even so, you should still check your blood pressure regularly even if the medication is discontinued. If your blood pressure creeps back up off medication, checking regularly will help you to catch it before it gets out of control. Exercise has many benefits for your health beyond blood pressure control so don’t miss out more energy, more stamina, and better overall well being by skipping the gym.
5. White Coat Hypertension is real but that doesn’t mean you have it.
I have a lot of people who come in to see me and swear their blood pressure is always normal at home and only high at the doctor’s office. This is the definition of white coat hypertension. Unfortunately many of the people using this excuse do not check their blood pressure regularly and some do not even own a blood pressure monitor.
It is very important when you see your doctor that you bring in the actual blood pressure readings. Even if that means brining in your monitor. It is the best way for the doctor to help you manage your blood pressure and make the necessary adjustments. A normal blood pressure is less than 140 on the top and less than 90 on the bottom. If your numbers are consistently higher than either its time to book an appointment. Thankfully with telemedicine as an option, you no longer have to leave the house to see a doctor for a refill or medication adjustment.
Blood pressure is a silent killer. If you do not monitor your blood pressure regularly, take your medications, exercise, eat well and work with your doctor to come up with a good treatment plan then the next stroke victim could be you.
Its time we make High Blood Pressure management a family affair. Check a family members blood pressure today and don’t take for granted someone you love is taking their medications…ask them. When we start to make talking about high blood pressure as routine as talking about the real housewives we will see a difference in our communities and more importantly, save lives.
Tisha Rowe MD