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How To Use A Blood Pressure Cuff At Home
There's a reason high blood pressure is called the "silent killer:" It generally produces no symptoms. "In other words, a person may feel perfectly fine yet have dangerously elevated blood pressures," says Ian Del Conde, M.D., a cardiologist and vascular medicine specialist at Baptist Health's Miami Cardiac & Vascular Institute in Florida. "The only way to know that one's blood pressure is normal is by measuring it."
High blood pressure is very common: According to the Centers for Disease Control and Prevention (CDC), nearly half of adults in the U.S. Have hypertension, and only one in four adults have it under control .
While your blood pressure is typically checked at routine doctor appointments, it may not give a complete picture.
"Blood pressure at the doctor's office is only one point in time," says Nieca Goldberg, M.D., medical director of NYU Women's Heart Program and senior advisor of Women's Health Strategy at NYU Langone Health in New York. "Some people have normal blood pressure at home and high blood pressure at the doctor's office or normal at the doctor's office and high blood pressure at home."
This variance can be explained as "white coat hypertension," the phenomenon of blood pressure rising at the doctor's office, or "masked hypertension," which occurs when your blood pressure is higher at home . Both situations are often stress-related, which is why it's important to check your blood pressure often—especially if you're at risk for hypertension, says Goldberg. Common risk factors for hypertension include physical inactivity, an unhealthy diet, obesity, diabetes, excessive alcohol consumption and tobacco use.
What Kind of Blood Pressure Cuff Should You Use?Of the two types of at-home blood pressure cuffs—a wrist cuff and an upper arm cuff—experts generally recommend using an upper arm cuff because they are more accurate.
Experts also recommend opting for a digital blood pressure monitor over a manual one. "Automated electronic machines using an upper arm cuff are usually accurate," says Dr. Del Conde. "If there is any question about their accuracy, they can be validated against a blood pressure machine at a doctor's office."
Hospital-Grade Accuracy For Your Home
Oxiline blood pressure monitors enable you to view, store, and share all of your data with smartphone connectivity.
What Is High Blood Pressure? Symptoms, Causes, Diagnosis, Treatment, And Prevention
The following can increase your chances of developing high blood pressure.
Age The risk of high blood pressure increases as you age; the older you are, the more likely you are to develop high blood pressure. Blood vessels gradually lose their elasticity over time, which can contribute to high blood pressure.[2]
The risk of prehypertension and high blood pressure has been increasing in recent years in young people too, including children and teens, possibly because of the rise in obesity in these populations.[3]
Race High blood pressure is more common in Black American adults than in white, Asian, or Hispanic American adults.[4]
Gender Men are more likely than women to be diagnosed with high blood pressure, until age 64.[2] However, after that age, women are more likely to have high blood pressure.
Family History Having a family history of high blood pressure increases your risk, as the condition tends to run in families.[2]
Weight The more you weigh, the more blood you need to supply oxygen and nutrients to your tissues. When the volume of blood pumping through your blood vessels increases, the pressure on your artery walls also rises.[5]
Physical Activity People who are not active tend to have a higher heart rate and higher blood pressure than those who are physically active.[5] Not exercising also increases the risk of being overweight.
Tobacco Use When you smoke or chew tobacco, your blood pressure rises temporarily, partly from the effects of nicotine. Moreover, chemicals in tobacco can damage the lining of your artery walls, which can cause your arteries to narrow, increasing your blood pressure.[5] Being exposed to secondhand smoke may also increase your blood pressure.
Diet What you choose to eat (and not to eat) can increase your risk of hypertension:[5]
[6]
Stress Being under intense stress can lead to a temporary increase in blood pressure.[2] Moreover, if you try to cope with stress by overeating, using tobacco, or drinking alcohol, all of these can contribute to high blood pressure.
Chronic Conditions Having kidney disease, sleep apnea, or diabetes can affect blood pressure.[5]
Pregnancy Being pregnant can cause an increase in blood pressure. High blood pressure occurs in 1 in every 12 to 17 pregnancies in women ages 20 to 44.[7]
Birth Control Women who take birth control pills have a greater risk of developing high blood pressure. It's more likely to occur when women are overweight, have had high blood pressure during a previous pregnancy, have a family history of blood pressure, smoke, or have mild kidney disease.[8]
Causes of Secondary HypertensionWhen high blood pressure arises suddenly due to an identifiable condition, it's called secondary hypertension.
The following conditions can lead to secondary hypertension, including:[5]
Medications that you take to control other health conditions, such as arthritis, epilepsy, or allergies, can cause your blood pressure to rise.
They can also interfere with the ability of drugs used to keep blood pressure down.
The drugs below are some of the ones that may negatively affect blood pressure.[9]
Pain Medications Common pain and anti-inflammatory medicines can lead to water retention, which can increase blood pressure and create problems with the kidneys.
Examples include:
Antidepressants These drugs work by changing the body's response to chemicals that affect mood. That can also lead to an increase in blood pressure.
Examples of antidepressants that may elevate blood pressure include:
Decongestants These medicines, which include common cough, cold, and allergy drugs, are known to raise blood pressure and to alter the effectiveness of blood pressure medication.
Examples include pseudoephedrine (Sudafed, Contac) and phenylephrine (Sudafed PE).
Hormones Birth control pills can also affect blood pressure. Women who take birth control pills usually experience a small rise in systolic and diastolic blood pressure (the top and bottom numbers that are determined when you get your blood pressure checked).
Hormone therapy used to relieve symptoms of menopause can also cause a small rise in systolic blood pressure.
If you know you have high blood pressure but are considering hormone therapy, talk with your doctor about the risks and benefits of undergoing hormone therapy, as well as the best ways to control your blood pressure.
Additionally, some recreational and illegal drugs, such as cocaine, ecstasy (MDMA), and amphetamines, are also known to increase blood pressure.
Is A Catheter Treatment The Answer For High Blood Pressure?
High blood pressure or hypertension is one of the many curses of modern society. In some ways, it's the worst of the lot as it creeps on you, is silent, and you don't realize it till it begins destroying you from the inside. Based on the definition of hypertension by the American College of Cardiology as greater than 130/80, around 63 percent of adults between the age of 45-75 years are afflicted with this disease.
The recent FDA approval of two minimally invasive catheter-based treatments to help control blood pressure in patients not tolerating medications or challenging to control blood pressure despite medication has been a significant breakthrough. The billion-dollar questions are its effectiveness and how long the treatments last.
High blood pressure has been described as far back as 2600 BCE in the Chinese Emperor's Classic of Internal Medicine, quoting, "If too much salt is used in blood, the pulse hardens." Hypertension as a clinical entity came to be established in 1896 after the invention of the now store available sphygmomanometer.
Not surprisingly, the first data suggesting increasing mortality from high blood pressure came from insurance companies' actuarial data. President Roosevelt's death pushed hypertension into public awareness. The president had recorded pressures of 260/150 at the time of the Yalta conference. On the morning of April 12, 1945, he complained of a headache with a blood pressure of 300/190. He subsequently lost consciousness and died of a brain hemorrhage. The doctors finally had something to work with in the 1950s with the discovery of the diuretic chlorothiazide for hypertension treatment. The cause of hypertension is multifactorial, but diet, salt intake, and lifestyle play a huge role. The mean blood pressure in Amazonian and Brazilian tribes with limited access to salt is 110/60 throughout their adult lifespan.
High blood pressure starts damaging the inner layer of arteries, leading to progressive plaque build-up or atherosclerosis. This, in turn, causes the muscle in the arteries to increase, increasing resistance and pressure again in a never-ending cycle of chaos. High blood pressure increases your risk of heart attacks, stroke, kidney failure, vision loss, and dementia, depending on where the damage to a given artery is the worst. Despite all the developments in medicine, only four drug classes (thiazide diuretics, calcium channel blockers, ACE inhibitors, and Angiotensin receptor blockers) have been shown to reduce mortality with the treatment of hypertension conclusively. Despite all the education and awareness, only about 50 percent of treated patients reached their goal blood pressure, which made the possibility of a non-pharmacological cure all the more enticing: around $130 billion enticing.
The renal denervation procedure is relatively straightforward. A catheter is introduced from an artery in the leg into the kidney arteries, and the sympathetic nerves are ablated/destroyed using either radiofrequency or ultrasound waves. Interrupting these nerves causes decreased vascular resistance and hormonal changes that cause a drop in blood pressure. So, how much did the bloop pressure drop in the trials? In the ultrasound denervation, the catheter that got strong FDA approval (advisory panelists voted 10-2 in favor of its risk-benefit profile), the pressure drop was 8-9 mmHg at two months. The radiofrequency catheter got approval after the panel voted 6-7 that the benefits did not outweigh the risks. This was because of mixed trial results, with a mean blood pressure reduction of 6-7 mm Hg.
These results are positive but underwhelming in the fight against this colossal medical problem. The long-term findings and the translation into decreased strokes, heart attacks, and other vascular events have yet to be proven. How effective is this therapy compared to diet and salt restriction? A DASH (Dietary approaches to stop hypertension) diet with low salt (1500mg per day) decreases blood pressure in hypertensive patients by 11.5 mm Hg. The DASH diet consists of fruits, vegetables, and whole grains, with a reduction in saturated fat and sugar. There is some data to indicate a decrease in mortality and stroke with this diet. Throw in exercise and weight loss; you can get another 5-8 mm Hg drop. In an oxymoronic twist, our lifestyles are pushing our vascular health into decline while we throw millions at finding ways to control the problem. I hate to admit it, but Mom was right: eat your fruits and vegetables and stay off the sugar.
Dinesh Arab, MD, is the director of interventional and structural cardiology at AdventHealth in Daytona Beach and clinical assistant professor of medicine at Florida State University.
This article originally appeared on The Daytona Beach News-Journal: Hypertension, the silent killer, destroys you from the inside
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