Controlling Your Blood Pressure Archive

When older people start taking a new blood pressure drug or change the dose of their current drug, they may be more prone to a serious fall during the following two weeks. But this increased fall risk doesn’t seem to persist over the long term. 

A high blood pressure diagnosis can come as a shock due to a lack of symptoms, but the condition is manageable. Dr. Naomi Fisher explains what to do after you are diagnosed.

Take an active role by checking your blood pressure with a home monitor.

Most appointments with a health care provider begin with a gentle squeeze—the sensation of a blood pressure cuff inflating around your upper arm. But that single blood pressure reading offers only a glimpse of the health of your cardiovascular system.

"When you have your blood pressure checked in the doctor's office, you're in an artificial environment that is not reflective of the vast majority of the time when your blood pressure is going through its daily excursions," says cardiologist Dr. Elliott Antman, professor of medicine at Harvard Medical School. Throughout the course of a day, the average person's systolic b-lood pressure (the first number in the reading) may fluctuate considerably.

Your primary care provider should help you control risks for heart disease and refer you to a cardiologist if needed.

Any primary care provider you see—a doctor, nurse practitioner, or physician's assistant—should offer detailed advice on how to lessen your odds of cardiovascular disease, which is responsible for one in three deaths in the United States. However, some people need more specialized care for their hearts.

"I see or hear from a lot of people who have very common problems, like high cholesterol and high blood pressure, who think they need to see a cardiologist," says Dr. Patrick O'Gara, a cardiologist at Harvard-affiliated Brigham and Women's Hospital. For many people, a primary care physician can effectively manage those problems. But if you have specific concerns, talk to your doctor about whether more specialized care might be beneficial, says Dr. O'Gara.

The longstanding "More Matters" campaign urges Americans to eat more fruits and vegetables (see www.fruitsandveggiesmorematters.org). Evidence to support this healthy habit keeps piling up, with the latest from a study that pooled dietary data from three large, long-term studies that followed more than 187,000 people for an average of over 20 years.

The researchers found that people who ate more whole fruits—especially apples, pears, grapes, and raisins—were less likely to develop high blood pressure than those who rarely ate those foods. As for vegetables, broccoli and carrots appeared to be the best choices for staving off high blood pressure. Fruits and vegetables provide minerals such as potassium and substances called flavonoids, both of which are linked to lower blood pressure. The study was published online in the Dec. 7, 2015, issue of Hypertension.

The strength of your hands may hold clues to the health of your heart. A study in the December 2015 American Journal of Preventive Medicine found that people with stronger handgrips had more favorable findings on measures of their cardiovascular health than those with weaker grips.

The study included more than 4,200 adults ages 20 and older who were part of a nationwide health study. Researchers used a device called a dynamometer to measure each participant's hand strength, adjusting the readings based on body mass index. They found that higher handgrip strength was associated with lower blood pressure, lower triglycerides (a type of fat in the blood), lower blood sugar, and higher HDL (good) cholesterol.

A new study suggests greater health benefits with a lower-than-standard number.

Blood pressure has long been one of the best markers of your health. It is a number you can remember and monitor. High blood pressure (hypertension) is linked to a greater risk of heart attacks and strokes.

About one out of three adults has high blood pressure, which is usually defined as a reading of 140/90 millimeters of mercury (mm Hg) or higher.

Image: Thinkstock

Ask the doctor

Q. I know that sometimes people have high blood pressure only at the doctor's office but normal blood pressure at home. But can the opposite also happen?

A. Yes. This phenomenon—when your blood pressure reading is normal at the doctor's office but high at home—is known as masked hypertension. It's hard to know just how common it is, since doctors don't routinely tell people to measure their blood pressure at home if it's normal in the doctor's office or clinic. The only reason we know it exists is from clinical studies that required people to undergo ambulatory blood pressure monitoring. For this type of monitoring, you wear a portable blood pressure cuff and monitor for 24 hours. The machine records your blood pressure every 20 minutes while you're awake and hourly while you're asleep. In these studies, anywhere from 10% to 40% of the participants were found to have masked hypertension, depending on the exact population evaluated.

Image: Bigstock

You get the most bang for your buck from keeping blood pressure in the normal range, but don't skip the other things.

Many tasks are required to run a household. There are groceries to shop for, broken things to fix, and windows to wash. But you need to prioritize: it makes no sense to worry about the weeds in the garden if the mortgage payment is overdue.

Ask the doctor

Q. I take my blood pressure medication twice a day. Or at least I am supposed to, but I sometimes forget the second dose because my evenings tend to be really busy. What can I do?

A. One idea is to leave a sticky note on your bathroom mirror or near your bed as a reminder. Or try using an alarm (either a traditional alarm clock or one on a smartphone) that rings close to the time when you normally go to bed. You might also consider taking the second dose with dinner, assuming your doctor or pharmacist says it is okay to take your particular medicine with food.