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How to Get a Handle on Your High Blood Pressure

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R. Todd Hurst, MD, FACC, FASE - Blogs
By R. Todd Hurst, MD, FACCBoard-certified cardiologistMarch 18, 2019

High blood pressure is a condition that patients tend to dangerously underestimate – many people just don’t take it very seriously. But they should. It’s a leading cause of death and disability; in fact, it’s been estimated that high blood pressure is a primary or contributing cause of over 400,000 deaths per year – that amounts to more than 1,100 deaths per day.

So why aren’t we more afraid of it?

I think the answer is a mix of familiarity and treatability. The recent statistics show that roughly 50% of adults have it – so most of us probably know someone with high blood pressure. And most of us are aware that it is treatable – we can take medications and make lifestyle to keep it under control.

The problem is, we’re not keeping it under control.

According to the CDC, only about ½ of those with high blood pressure are adequately controlling their condition. Some people are unaware that they have high blood pressure. Others are reluctant to take high blood pressure medications because of real or perceived side effects; or maybe they don’t want to (or can’t) make the needed lifestyle changes. But one of the biggest reasons people aren’t controlling their blood pressure is that they’re having trouble getting an accurate view of what their blood pressure numbers are exactly.

In the past, high blood pressure was determined by the blood pressure reading your get in your doctor’s office. But data has shown that blood pressures in the doctor’s office are often not accurate – even up to up to 65% of the time.

So, if you have, or are concerned that you have, high blood pressure, monitoring your readings away from your doctor’s office is crucial.

Here are the recommendations I give to my patients about monitoring blood pressure at home:

  1. Get a monitor where the cuff goes on your upper arm.  And make sure it’s the right size for you. Well-rated devices cost between $25 and $100.
  2. Sit quietly for at least 5 minutes before you take your blood pressure.  Make sure the cuff is on your bare arm and not over clothes.
  3. Vary the time of day that you check your blood pressure. Record your results and bring them with you to your next doctor’s appointment.

Blood pressure greater than 180/120 mm Hg is called a hypertensive crisis.  If you aren’t having any symptoms, it may be reasonable to wait 5 minutes and check it again before contacting your health care professional. If you are having any concerning symptoms (at any level of blood pressure), such as chest or back pain, shortness of breath, numbness or weakness or difficulty with your vision or speaking, you should call 911 immediately. 

Appropriately monitoring your blood pressure is an important opportunity for you and your doctor to work together to make sure you get the best treatment for your blood pressure.

Dr. Hurst gratefully acknowledges the contribution of Alexandra Winski in the creation of this article.

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About the Author
R. Todd Hurst, MD, FACC

R. Todd Hurst, MD, FACC, FASE, is a board-certified cardiologist, director of the Center for Cardiovascular Health at Banner – University Medicine Heart Institute, and associate professor of medicine at the University of Arizona. He has written more than 50 publications in peer-reviewed journals and regularly speaks nationally and internationally at medical meetings, primarily on the prevention of heart disease.

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