I remember my first experience as a resident physician treating a sick patient. I was called to the emergency department to assess “John” who was complaining of shortness of breath and chest pain.
My patient was a 46-year-old overweight man, with no regular primary care provider. I learned he was a frequent visitor to the emergency department and usually expressed these same symptoms.
John had been told on four previous visits that he had elevated blood pressure and needed further evaluation and possible treatment. Unfortunately, John never took the advice and was brought into the emergency department by EMS with elevated blood pressure.
John had experienced a heart attack and was diagnosed with hypertension that was left untreated for several months. Unfortunately, John’s story is not unusual.
Facts about hypertension
Hypertension is a common and dangerous condition, often referred to as the “silent killer.” Hypertension is defined as a higher-than-normal rise in blood pressure. It breaks down like this:
- Blood pressure is calculated using a blood pressure cuff with normal values being around 120/80 mm Hg (or lower). BP is not the same every time, but changes during the day based on the level of activity.
- According to the American Academy of Cardiology, BP readings that are consistently greater than 130/80 mm Hg during all hours of the day, would most likely be considered high.
- According to the Centers for Disease Control and Prevention, about 47% of people in the United States suffer from hypertension.
- Some of the known complications of untreated hypertension include major diseases like heart attacks, strokes, certain eye disorders and kidney disease.
Risk factors for developing high blood pressure are divided into two categories: things we can change and things we can’t.
Things we can change: smoking, unhealthy diet, elevated cholesterol, diabetes, excessive body weight, low physical activity and obstructive sleep apnea.
Things we cannot change: Age, sex and family history.
Like risk factors, treatment is also divided into two categories. Non-pharmaceutical help (lifestyle changes) or pharmaceutical help (medication). Here are several ways to improve your BP and overall health:
- Eat fresh vegetables, fruits, low-fat dairy, whole grains, poultry, fish and nuts. Reduce your daily salt intake.
- People with hypertension are usually encouraged to stay away from excess sugar, heavy starches and excessive amounts of red meat. Weight loss plays a major role in reducing hypertension for overweight and obese individuals.
- Having a target weight loss goal of about 1 pound per week and performing the recommended daily amount of cardio exercise will help develop a good routine and shed excess weight.
Follow a tobacco cessation plan
Your doctor may recommend medication if your lifestyle changes aren’t helping, or if your BP is dangerously elevated and needs to be lowered quickly. There are a variety of medications available, and your doctor will work with you to determine the best treatment option. In many cases, lifestyle management along with medication is needed.
Remember, high BP typically has no symptoms until it becomes severe, so have your BP checked at least once a year to ensure it’s not elevated — more if you’re at an increased risk. Let’s learn from our patient, John.
You can check your BP quickly and for free at a supermarket or pharmacy, church or community event.
Dr. Adeyemi Gbogboade is a part of the family medicine resident program at Northeast Georgia Health System. Columns will publish occassionally from residents in the program.