If you have even a mild chronic elevation of your blood pressure, we will probably recommend that you begin taking a medication to lower it. When you see blood pressure written, for example 120/80, both numbers are important. Currently the “ideal” blood pressure goal is felt to be around 115/75.
Patients who have been taking blood pressure medicine for a while will recall that our “goal” blood pressure used to be anything under 150/90, but more recent studies show that a target of 135/85 is ideal for patients with known high blood pressure. We can push the numbers lower, but there are associated risks. We will discuss all of this with you.
An average reduction of 12-13mmHG in systolic blood pressure maintained over 4 years is associated with:
21% reduction in coronary heart disease
37% reduction in stroke
25% reduction in total cardiovascular disease deaths
What's the big deal about blood pressure?
The constant pounding of the elevated blood pressure causes a gradual deterioration of the tiny vessels in the kidneys, eventually causing them to leak and rupture. When that happens, a small area of kidney tissue is destroyed, maybe no larger than the tip of a ball-point pen, but that part of the kidney is gone for good. This elevated pressure also makes the heart muscle work harder, causing it to get larger and become more inefficient.
We understand this whole process very clearly, so we try to correct even mild blood pressure elevations as early as possible, especially in young people. We can easily lower the pressure to normal, often with only one pill a day, thereby preventing the progressive "end organ" damage. Side-effects from blood pressure medicines are rare, when properly administered.
A consistent program of proper eating behavior, weight loss, and exercise, also helps immensely.
CHECKING YOUR OWN BLOOD PRESSURE
There are many reliable blood pressure instruments available; but we recommend that all of our patients purchase and use an “Omron Automatic Blood Pressure Monitor”; so that everyone is using the same “standard”. These instruments are available from numerous stores for about $70. After you purchase yours, please bring it by the office so we can check the calibration and your technique.
During the next several weeks we will be “fine tuning” your blood pressure; so please record your readings faithfully three times a day in the exact format shown below. Blood pressure should be checked in the LEFT ARM (because of the layout of blood vessels in the chest, the right arm is always going to yield incorrect lower readings).
At your next office visit, we will look over your log to get an impression of how your blood pressure is doing at different times of the day. This will help us select a medicine for you that will have peak effect at the time of day when you need it most.
Once we have your blood pressure properly regulated, you will seldom need to check it at home, since we routinely check it, every time you come by the office.