What is Blood Pressure:
Complication of uncontrolled high blood pressure:
Brain damage / Stroke (paralysis)
Heart failure
Retinal damage (vision problems)
Renal/Kidney damage
3. 24 year old man complaining of headache, BP=140/90. This is not normal. All other tests were normal, no secondary causes identified which raises blood pressure. I started him on low salt diet and exercise. But he was symptomatic due to headache. So, I have to start him on medicine. I started him on low dose of B blocker. After 6 months, his BP was normal. Then I tapered his medicine. And now he free without hypertension, not on any medicine from past 7 years. BP should be controlled to be 120/80 in young or any symptomatic patient.
Prophylactic Aspirin in Hypertensive patients?
Low dose of aspirin is recommended in many patients to prevent stroke and heart attack who have hypertension, or mild blockage. Aspirin is a two age sword. It can protect us from stroke ( in which lack of blood supply damage brain tissue) or it can worsen the stroke( bleeding in brain from rupture of artery due to high pressure).
Do I need to take medicine if my blood pressure is normal on medicine?
Yes. If your BP is controlled after starting you on the medicine, you should keep taking it regularly. If it goes down then you can start adjusting its dose/ tapering it off under physician's guidance.
Learning points:
Walking, losing 10% of body weight and staying stress free helps control the blood pressure.
Reference:
There are two numbers in blood pressure: one is systolic and another is diastolic blood pressure.
Systolic blood pressure:
Pressure required by heart to squeeze blood from heart to various blood vessels to supply oxygen to organs. Normal systolic blood pressure is under 120 mmHg.
Diastolic Blood pressure:
Resting pressure in artery between two heart beats / when heart is resting. Normal diastolic blood pressure is under 80 mmHg.
As per previous guidelines, normal blood pressure was under 140/90 but as per new guidelines it is 120/80.
Complication of uncontrolled high blood pressure:
Brain damage / Stroke (paralysis)
Heart failure
Retinal damage (vision problems)
Renal/Kidney damage
Practical approach:
When the medicine is needed to control blood pressure?
Examples:
1. My mom is having hypertension from past 20 years and she is on 3 blood pressure control medicines. Her medicine dose was increased 3 months ago as her pressure was staying in range of 170-180 systolic. She is in India, I am in US but I am still her primary physician. Yesterday she called me that she is getting tired a lot even if she does small work from past 1 week. I know we might think may be she is getting symptoms of heart failure but I knew her and all her history so, I knew her heart has mild hypertrophy but its function is fine. There were no leg swellings/pedal edema. I ask her to measure her blood pressure. To her surprised it was 116/ 64 , at two different times. I stopped one out of 3 of her medicines. After two days her blood pressure was 130/80. She was feeling great and was back to her routine.
Tight blood pressure control is not needed but it should be below 140/90 in chronic hypertensive patients. As guideline changed from 140 to 120 as normal systolic pressure, but patients whose heart was accustomed to 140 may not tolerate lower pressure. On the other end, in young newly diagnostic hypertensive patient tight control of blood pressure with diet, exercise and medicine is recommended.
2. I know a physician whose blood pressure ranged between 140-160 on medicines. He used to say it was normal for him. After 5-7 years he got a stroke and half body weakness, at the time of stroke BP was 180 systolic. Learning point: BP should be tightly controlled to be less than 140 mmHg systolic in chronic hypertensive patients.
2. I know a physician whose blood pressure ranged between 140-160 on medicines. He used to say it was normal for him. After 5-7 years he got a stroke and half body weakness, at the time of stroke BP was 180 systolic. Learning point: BP should be tightly controlled to be less than 140 mmHg systolic in chronic hypertensive patients.
3. 24 year old man complaining of headache, BP=140/90. This is not normal. All other tests were normal, no secondary causes identified which raises blood pressure. I started him on low salt diet and exercise. But he was symptomatic due to headache. So, I have to start him on medicine. I started him on low dose of B blocker. After 6 months, his BP was normal. Then I tapered his medicine. And now he free without hypertension, not on any medicine from past 7 years. BP should be controlled to be 120/80 in young or any symptomatic patient.
Prophylactic Aspirin in Hypertensive patients?
Low dose of aspirin is recommended in many patients to prevent stroke and heart attack who have hypertension, or mild blockage. Aspirin is a two age sword. It can protect us from stroke ( in which lack of blood supply damage brain tissue) or it can worsen the stroke( bleeding in brain from rupture of artery due to high pressure).
In patient taking aspirin tight blood pressure control below 140 systolic is needed to prevent intracranial bleeding.
Do I need to take medicine if my blood pressure is normal on medicine?
Yes. If your BP is controlled after starting you on the medicine, you should keep taking it regularly. If it goes down then you can start adjusting its dose/ tapering it off under physician's guidance.
Learning points:
Walking, losing 10% of body weight and staying stress free helps control the blood pressure.
Reference:
