Effective lifestyle modification may lower blood pressure as much as an individual antihypertensive medication. Combinations of two or more lifestyle modifications can achieve even better results. There is considerable evidence that reducing dietary salt intake lowers blood pressure, but whether this translates into a reduction in mortality and cardiovascular disease remains uncertain. Estimated sodium intake ≥6g/day and <3g/day are both associated with high risk of death or major cardiovascular disease, but the association between high sodium intake and adverse outcomes is only observed in people with hypertension. Consequently, in the absence of results from randomized controlled trials, the wisdom of reducing levels of dietary salt intake below 3g/day has been questioned.
John P. Cunha, DO, is a U.S. board-certified Emergency Medicine Physician. Dr. Cunha's educational background includes a BS in Biology from Rutgers, the State University of New Jersey, and a DO from the Kansas City University of Medicine and Biosciences in Kansas City, MO. He completed residency training in Emergency Medicine at Newark Beth Israel Medical Center in Newark, New Jersey.
Some people have blood vessels that are stiff and lack elasticity, due to vascular disease. When this affects the tiny arteries (arterioles), the arteriolar stiffness causes increased resistance to the flow of blood and high blood pressure. This is most common in people who are also obese, have a lack of physical activity or exercise, have high salt intake, and are older.
Determining the normal blood pressure range in children is a little complicated, and it all depends on the size and age of the child. One rule of thumb that doctors use to determine BP troubles in children is that, a child is considered to be suffering from Prehypertension. If he/she has a blood pressure higher than that of 90% of the children of the same age and size. The child is said to have hypertension if he/she has a blood pressure higher than that of 95% of the children of the same age and size.
Creatinine is a chemical waste molecule that is generated from muscle metabolism. Creatinine is produced from creatine, a molecule of major importance for energy production in muscles. Creatinine has been found to be a fairly reliable indicator of kidney function. As the kidneys become impaired the creatinine level in the blood will rise. Normal levels of creatinine in the blood vary from gender and age of the individual.
Although it's most common in older adults, hypertension can also affect children. The normal blood pressure for a child is dependent upon the child's age, gender, and height. Your doctor can tell if your child's blood pressure is abnormal. Children are at higher risk for hypertension if they are overweight, African-American, or if they have a family history of the condition. Children with high blood pressure may benefit from the DASH diet and taking medications. Children with high blood pressure should also maintain a healthy weight and avoid tobacco smoke.
Orthostatic hypotension is caused by a sudden change in body position. This occurs most often when you shift from lying down to standing. This type of low blood pressure usually lasts only a few seconds or minutes. If this type of low blood pressure occurs after eating, it is called postprandial orthostatic hypotension. This type most often affects older adults, those with high blood pressure, and people with Parkinson disease.
As people age, they get plaque buildup inside the blood vessels, and the flexible walls of the arteries become stiff. Now, when the heart squeezes and pushes the blood out, the blood vessels can't expand like they used to do and sustain higher pressure. Over time, the heart has to push so hard against the pressure that it starts to fail, Bauman said.
You can also have symptoms of low blood pressure when someone with hypertension comes down from very high pressures. For instance, 120/80 mm Hg may be normal for everyone else, but if your patient lives at 190/100 mm Hg, they are going to feel the difference. For this reason, the objective sign of a pressure must be combined with the subjective symptoms the patient reports.
If your blood pressure is above the normal range for up to 5 readings (taken at different visits), your doctor will likely diagnose you with high blood pressure. Sometimes the doctor may diagnose you after a fewer number of readings, depending on how high above normal your blood pressure is and if you have other medical conditions. Blood pressure tends to be at its highest during exercise, physical work, or stress, and lowest during sleep. Everyone can have a temporary increase in blood pressure at one time or another, which is why it's important to take multiple readings.
There are a number of factors that likely work together to cause high blood pressure. A family history of high blood pressure can make you more likely to develop the condition, so genetics likely plays a role. High salt intake (too much salt in the diet) or salt sensitivity occurs in some people, which can lead to hypertension, particularly in the elderly, African Americans, people who are obese, or people with chronic kidney (renal) disease.
The first line of treatment for hypertension is lifestyle changes, including dietary changes, physical exercise, and weight loss. Though these have all been recommended in scientific advisories, a Cochrane systematic review found no evidence for effects of weight loss diets on death, long-term complications or adverse events in persons with hypertension. The review did find a decrease in blood pressure. Their potential effectiveness is similar to and at times exceeds a single medication. If hypertension is high enough to justify immediate use of medications, lifestyle changes are still recommended in conjunction with medication.
Postural hypotension can be treated with changes in diet such as increasing water and salt intake,* increasing intake of caffeinated beverages (because caffeine constricts blood vessels), using compression stockings to compress the leg veins and reduce the pooling of blood in the leg veins, and in some patients, the use of a medication called midodrine (ProAmatine). The problem with midodrine is that while it increases blood pressure in the upright position, the supine blood pressure may become too high, thus increasing the risk of strokes. Mayo Clinic researchers found that a medication used to treat muscle weakness in myasthenia gravis called pyridostigmine (Mestinon) increases upright blood pressure but not supine blood pressure. Pyridostigmine, an anticholinesterase medication, works on the autonomic nervous system, especially when a person is standing up. Side effects include minor abdominal cramping or increased frequency of bowel movements.
It wasn’t long ago (2013) that those over 60 were advised to aim for blood pressure below 150/90. Now, as a result of a single large trial, the numbers are being revised in a major way. But as Dr. Gilbert Welch has pointed out at https://www.nytimes.com/2017/11/15/opinion/blood-pressure-guidelines.html , there are problems with this study. First, about 8% of patients aiming for 140 systolic (or less) had “cardiovascular events,” whereas only 6% of those in the 120 systolic group did. This is only a 2 point reduction, but as a percentage it’s a 25% reduction. This is the misleading use of percentage change instead of actual change. Second, the participants were already at higher than average risk for cardiovascular problems, so it was a study of a selected group and not of the general population.
Electrolytes are substances that become ions in solution and acquire the capacity to conduct electricity. The balance of the electrolytes in our bodies is essential for normal function of our cells and our organs. Common electrolytes include sodium, potassium, chloride, and bicarbonate. The functions and normal range values for these electrolytes are important, and if an electrolyte is at an extreme low or high, it can be fatal.
Unfortunately, a problem doesn’t always announce itself with a fanfare of trumpets. Even the highest blood pressure can be entirely asymptomatic. Similarly, low blood pressure also known as hypotension can occur in your patient despite no symptoms seemingly being present. This is particularly true if the patient is lying still in an unmonitored bed.
tilt table test – usually recommended if your doctor suspects you might have orthostatic hypotension or NMH (During this diagnostic test, a person lies on a table and then the table is tilted to raise the upper part of their body. This simulates the change in position from sitting or lying down to standing up. People with orthostatic hypotension or NMH may feel dizzy, lightheaded, or even faint when their position changes.)
This study is exploring whether use of losartan, a medicine commonly used to lower blood pressure, is effective at treating abnormal nighttime blood pressure in children and young adults who have sickle cell disease. To participate in this study, you or your child must be 5 to 25 years old and have high blood pressure and a certain type of sickle cell disease: hemoglobin SS or Sβ0 thalassemia. This study is located in Birmingham, Alabama.