Know Your Blood Pressure

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Get the numbers to avoid hypertension

By Merle Myerson, M.D.

Hypertension, also known as high blood pressure, is a risk factor for cardiovascular disease including stroke and heart attack, as well as kidney disease, aortic aneurysm (enlargement of the aorta — the major blood vessel bringing blood from the heart to the rest of your body), and vision loss. Many people are not aware that they have high blood pressure. In fact, many of my patients ask why they should be concerned as they do not have any symptoms. I tell my patients to think of their water pipes at home — water running at too high pressure will, over time, cause damage to the pipes, even cause them to burst. For this very reason, hypertension is often called the "silent killer."

Many people know that there are two numbers to their blood pressure. The top number, called the systolic blood pressure, measures the force of blood in your arteries (the blood vessels that carry blood away from your heart) when your heart contracts. The bottom number, called the diastolic blood pressure, measures the force of blood in your arteries when your heart is relaxed and filling with blood in between beats. Both numbers are important.

What is the goal for good blood pressure?

Normal, or ideal, blood pressure is less than 120/80. Prehypertension is 120/80 to 140/90, and hypertension is over 140/90. Patients with diabetes should aim for blood pressure less than 130/80. The "Standards of Medicare Care in Diabetes — 2010" from the American Diabetes Association recommends measurement of blood pressure at every doctor's visit for diabetes management. If blood pressure is higher than 130/80, it is reasonable to have a trial (approximately 3 months) of lifestyle modifications. Often these measures (weight loss, diet changes, exercise) can bring blood pressure to goal. If this doesn't help, or if blood pressure is very high (over 140/90), or if a patient has had a stroke, "mini-stroke," or heart disease, consideration should be given to using medications to bring down blood pressure — but always along with lifestyle modifications.

What are the things you can do to keep your blood pressure in check?

• Eat a heart healthy diet. Research done at the National Institutes of Health has shown that the DASH diet can be very helpful in controlling blood pressure.
• Eat less salt. Goal is less than 1500 mg per day. It is very hard to keep track of your milligrams! I tell my patients to learn which foods have high sodium (canned and processed foods, fast foods) and to look at the packaging. If it says that one serving has over 30 to 40 percent of your daily sodium, it probably should be avoided. Try not to add salt when cooking and avoid the salt shaker at the table — 1/4 teaspoon of salt has 600mg of sodium.
• Keep your weight down.
• Have a regular exercise program and increase the physical activity in your daily life (take the stairs instead of the elevator, walk to errands, do your own yard work).
• Keep track of your blood pressure at home. Ask your healthcare provider to write out a prescription. Often this will be covered by your insurance.
• Work with your healthcare provider to set up a good plan to keep your blood pressure controlled!

For more about treating cardiovascular illnesses, visit the Cardiovascular Disease Prevention Program at St. Luke’s and Roosevelt Hospitals.

Read Dr. Myerson's Bio here.

Read more of Dr. Myerson's columns.

NOTE: The information is not intended to be a replacement or substitute for consultation with a qualified medical professional or for professional medical advice related to diabetes or another medical condition. Please contact your physician or medical professional with any questions and concerns about your medical condition.