5 steps to take to manage hypertension

Two new studies link higher blood pressure in middle-aged people to a greater risk of neurological damage. This includes people with higher blood pressure that's below guidelines for hypertension. Those with higher blood pressure have an increased risk for dementia, according to researchers. Researchers were able to show neurological damage due to higher blood pressure in MRI scans, reports UPI. The problem is that dementia diagnoses usually occur only after symptoms are quite evident.

Hypertension: We’re talking high blood pressure. The word may bring on stress when it’s part of a diagnosis, but some education and proactive shifts can allow those experiencing it to live healthier.

Two local doctors have some advice for that process, and it might help to think of it in a series of steps.

Step 1: diagnosis

First, simply getting a diagnosis is key. Self-detection of symptoms may be elusive, so seeing a general practitioner yearly is important.

“The one thing that they should certainly do is go at least annually for their checkup — make sure they get their numbers tested — have an idea of where they are with blood pressure and also maybe cholesterol and other routine labs,” Dr. Sanjay Lall, a Georgia Heart Institute cardiologist told the AJC.

He advises patients to watch for shortness of breath, headaches and nosebleeds. Some symptoms, such as chest pain, are direr and require urgent medical attention at an emergency room, he said.

A diagnosis can be discouraging or overwhelming, but it’s important to swing away from self-blame toward self-understanding and help, according to Dr. Tom Wells, an internist with Hawthorne Medical at Oconee Health Campus.

“It’s not always, ‘Hey, what did I do to myself?’ Sometimes, it’s ‘What did I get?’ And so, don’t be frustrated by that,” he said.

Step 2: education and participation

For Wells and Lall, taking care of hypertension means patient education and participation, and both doctors advise patients to learn to take their own blood pressure.

Patients should make sure they’re seated with back and foot support and that they’re using an appropriate-sized cuff, Wells said, and taking the measurement at rest is key.

“Don’t run in from doing your gardening and then try to take your blood pressure,” he said.

At-home checks may be more representative of a person’s overall condition.

“Sometimes, folks go to the doctor’s office, their blood pressure may be high from the anxiety of the visit. They may check it at home, and it may be better, so it’s a good way to kind of keep track of your health and be more proactive about it,” Lall said.

Step 3: a plan

Once a baseline emerges, a provider can come up with a treatment plan that takes into account other health conditions. The overall goal is usually decreased blood pressure, but the ideal number will vary depending on a patient’s health background, Wells said.

“I think once you’re setting goals for treatment that some patients — it may not be appropriate to get them down as low as you would other patients because they do stand a risk of adverse reactions (to some medications),” he said.

Sometimes, meeting goals involves medication. In that case, it’s essential to stick to the prescribed regimen, Wells said, adding that medications can control high blood pressure, but they’re not a cure. Patients experiencing issues with a medication should consult with their doctor before simply stopping it, he said. Establishing 90-day refills, he said, can go a long way toward convenience.

“A lot of insurances will cover that, and therefore, you’re not having to go to the pharmacy every month, and you’re more likely not to miss your medication doses,” he said.

Step 4: making changes

Sometimes, changes in diet and exercise are enough to bring blood pressure down. Weight loss, Lall said, can occasionally eliminate the need for medicine.

“There are certain things that people can do from a diet and lifestyle perspective that would certainly impact their need to stay on medicine,” he said.

When it comes to diet, Wells recommends focusing on fruits and vegetables, leaner meats, and lowering salt intake. Eating plans like the DASH diet or the Mediterranean diet, can be a good framework.

Lowering alcohol intake, stress and upping sleep and exercise are also key, Wells said.

For seniors who can handle it, he recommends 30 minutes of light-but-brisk exercise five days a week. People who can manage just 10 minutes should do that, he said.

“We’re not talking about going out and running marathons,” he said. “We’re talking about a good, brisk walk or even, some of the articles talk about gardening.”

Step 5: maintaining

Although significant weight loss and lifestyle changes can sometimes eliminate a need for medication, hypertension will still be a reality.

“I still think they have hypertension, but they’ve done the right things to control it with lifestyle and behavioral modification,” Wells said. “It’s more of a lifetime issue that if you don’t continue to take care of it, it’s going to come back or it’s going to be out of control.”

And it’s important, he said, for providers to recognize patients’ efforts in this area.

“So, I think that’s something to emphasize … and really congratulate patients and applaud them for the efforts they’re making,” he said. “As we all know, losing weight and finding the time to take a walk or go to the gym are things that are difficult because there are a billion other things pulling at us every day.”