‘White coat syndrome’ refers to elevated blood pressure due to nervousness or anxiety when clients have their blood pressure taken by a healthcare provider. This occurs in approximately 20% of clients. Key message: have the client take their blood pressure at home with an automatic home blood pressure cuff and compare the findings. Alternatively, you can ask the client to sit quietly and leave the room while an automatic cuff takes a client’s blood pressure. The automatic cuff can be programmed to take three measurements and the blood pressure documented is an average of the three readings.
There are many popular medical myths about high blood pressure. For example, many physicians believe that high blood pressure is an “inevitable consequence of aging;” that the “only viable treatment option for high blood pressure patients is medication”; that high blood pressure patients must take their medications “for the rest of their lives”; and, worst of all, that high blood pressure medications are “safe and effective.”
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If you have ever been in a hot tub with the “jets” on, you have observed a circulating system. When the pump is “on,” the water circulates from the hot tub, through pipes, into a pump, and then back to the hot tub. In this way, the water can be put through a filter to remove impurities and be re-utilized again and again. A hot tub with its pump “on” is a simple circulatory system. When the pump is “off,” the water stops circulating and stays wherever it is in the system.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Making some stuffed peppers for dinner tonight could be the first step on a journey toward a healthier heart and lower blood pressure. Bell peppers are an excellent source of vitamin C, with more of the potent antioxidant than even citrus fruits, which has been shown to improve cardiac function and lower blood pressure. Research published in the American Journal of Clinical Nutrition reveals that loading up on vitamin C reduced blood pressure by 5 millimeters of mercury in patients with hypertension, making these versatile veggies a smart addition to any meal plan.
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Many of us have had our blood pressure measured at the doctor but don’t really understand why it’s important. Find out why (and how) your doctor measures your blood pressure, what’s normal and what’s not, and what to do if you have high blood pressure.How is blood pressure measured?Blood pressure is measured using an instrument called a sphygmomanometer. It consists of an inflatable cuff, an inflating bulb, and a gauge to show the blood pressure.The cuff is wrapped around the upper arm, and inflated to a pressure which temporarily stops the blood from flowing through the brachial artery – the main blood vessel in your arm. At this point, the doctor will not be able to feel a pulse in the arm. The cuff pressure is then raised slightly above this point, and then slowly lowered.As the pressure is lowered, your doctor will listen through a stethoscope for the sound of blood starting to pulse through the brachial artery again. The pressure reading on the sphygmomanometer when the sound of blood is first heard pulsing through the artery is known as the systolic pressure. As the doctor continues to lower the pressure in the cuff, the sounds will disappear. Usually, the point at which the sounds disappear is known as the diastolic pressure.The systolic reading (the first number of the 2) indicates the pressure of blood within your arteries during a contraction of the left ventricle of the heart. The diastolic reading (the second number) indicates the pressure within the arteries when the heart is at rest. Blood pressure is measured in millimetres of mercury (mmHg), for example 120/80 mmHg (known as 120 over 80).What is normal blood pressure?According to the Heart Foundation of Australia, as a general guide:blood pressure below 120/80 mmHg can be classified as 'optimal';blood pressure between 120/80 and 129/84 mmHg is 'normal'; andblood pressure between 130/85 and 139/89 mmHg is classified as 'high-normal'.A person is defined by the Heart Foundation as having high blood pressure (hypertension) if they:have a systolic pressure greater than or equal to 140 mmHg; and/ora diastolic pressure greater than or equal to 90 mmHg.High blood pressure is further classified as mild, moderate or severe as the pressure increases above this level.Low blood pressure, or hypotension, is not as easy to define as it is usually relative to a person’s normal blood pressure reading, and varies between different people. It generally refers to a blood pressure below an average of about 90/60 mmHg.Getting an accurate readingAccording to the Heart Foundation, the diagnosis of high blood pressure should be based on multiple blood pressure measurements taken on separate occasions.It is recommended that you do not smoke or drink caffeine-containing drinks for 2 hours before having your blood pressure monitored, as this can cause an increase in your readings.Self-monitoring of blood pressure in your own environment (home blood pressure monitoring) or ambulatory monitoring of blood pressure is also used to help diagnose high blood pressure.For ambulatory blood pressure monitoring, you wear a portable automatic blood pressure machine for 24 hours while going about your usual daily routine. The portable monitor will measure your blood pressure multiple times during the 24 hours. Your doctor will ask you to record your activities over the 24 hours, plus any symptoms you experience (and when they occur). Variations in blood pressure are normal and may occur depending on where and when the blood pressure is taken.Some people who have raised blood pressure readings taken at the doctor’s surgery actually have acceptable levels outside the surgery, when under normal stress levels. This is known as ‘white-coat’ hypertension.There are also people with ‘reverse white-coat’ hypertension (also known as masked hypertension), who have normal blood pressure when measured in the clinic but high ambulatory blood pressure readings (those recorded during normal daily activities).Keeping on targetYour target blood pressure may vary according to whether you have other conditions that can increase your risk of cardiovascular (heart and blood vessel) disease or conditions that have been caused by high blood pressure.Raised blood pressure is a major risk factor for cardiovascular disease, and the higher your blood pressure, the greater your chance of having heart disease or stroke. For this reason it is important that you have your blood pressure monitored regularly, and that you always take any high blood pressure treatments that have been recommended, including medicines that have been prescribed.Hypertension can also be controlled to a large extent by lifestyle measures such as:losing excess weight;undertaking regular physical activity;quitting smoking; andchanging your diet (reducing your alcohol and salt intake, and following a healthy eating plan).These steps can help to lower your blood pressure and reduce your risk of cardiovascular disease. Last Reviewed: 8 February 2017
Half of American adults have this life-threatening condition, yet many are unaware or simply don’t take it seriously. But it doesn’t have to be that way. Hypertension is manageable and even preventable, but you have to know your risk factors and get your blood pressure checked (regularly!) to see if you’re at risk. Let’s take a closer look at what blood pressure actually is, how hypertension works, and how you can prevent the effects of high blood pressure to stave off heart disease.
Hypertension in African-Americans tends to occur earlier in life and tends to be more severe. Plus, some medications that work to lower blood pressure in other ethnicities may have limited effect on African-Americans. Thiazide diuretics (such as HCTZ) or a calcium channel blocker are recommended first choices along with the possible add-on of a second drug from either the ACE inhibitor class or the angiotensin II receptor blocker group.
Often, hypertension can improve with lifestyle changes. In some cases, high blood pressure can go down to normal levels with only lifestyle modifications, particularly if you have stage 1 hypertension (systolic blood pressure of 130 mmHg to 159 mmHg, or diastolic blood pressure 80 mmHg to 99 mmHg), or if you have elevated blood pressure (systolic blood of 120 mmHg to 129 mmHg and diastolic less than 80 mmHg).
Pre-hypertension is when your systolic blood pressure is between 120 and 139 or your diastolic blood pressure is between 80 and 89 on multiple readings. If you have pre-hypertension, you are likely to develop high blood pressure at some point. Therefore, your doctor will recommend lifestyle changes to bring your blood pressure down to normal range.
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As you age, prevention becomes even more important. Systolic pressure tends to creep up once you’re older than 50, and it’s far more important in predicting the risk of coronary heart disease and other conditions. Certain health conditions, such as diabetes and kidney disease, may also play a role. Talk to your doctor about how you can manage your overall health to help prevent the onset of hypertension.