Blood Pressure Basics
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by DeLois Weekes, RN PhD
High blood pressure is preventable. High blood pressure is silent. High blood
pressure is also treatable.
What is blood pressure?
Measures force of blood in the arteries
High blood pressure (HBP) = hypertension (HTN)
How is Blood Pressure Measured?
Blood pressure cuff measures BP in mm mercury. Two numbers are shown as a fraction:
Systolic/Diastolic Ex. 120/80. The Systolic is the top number in blood pressure readings and measures the pressure in arteries when heart is beating. The Diastolic is the bottom number in blood pressure readings and measures pressure when heart is at rest.
Who is at Risk?
Factors beyond our control:
Individuals with Family History: Parents, brother, sister
Increasing age
Gender:
Women - after menopause
Early middle age more common in men
Race: High Blood Pressure mcore common among blacks (Occurs earlier)
Factors Within our Control:
Excess weight which increases volume of blood and increases pressure/resistance that heart must pump against---enlarged heart muscle
Inactivity—heart becomes unused to “work” = heart beats harder/faster = more force on arteries = uses more oxygen per beat = higher heart rate at rest
Tobacco use which can lead to damage of artery wall, increases heart rate, encourages narrowing of arteries
Stress, causes unpredictable blood pressure and pulse increases along with potential inflammation in the vessel walls.
How do I know I have High Blood Pressure/Hypertension?
Very few people experience symptoms. This is a silent disease. The damage is done before symptoms develop. Some symptoms may be so it’s important to screen for HBP!
Headaches
Dizzy spells
More nosebleeds than normal
Primary vs. Secondary Hypertension
Most cases are called “primary”—have no identifiable cause. Family history likely ~5-10% are secondary.
Secondary HBP is likely caused by underlying conditions such as Kidney abnormalities, Tumor of adrenal gland, and Congenital heart failure defects.
What Effect does Hypertension have on the Body?
Uncontrolled high blood pressure can damage vital organs like the:
Heart: heart attack and heart failure
Brain: stroke and “mini strokes”/transient ischemic attacks
Kidneys: slow loss of function
Eyes: small vessel damage—blindness
Arteries: narrowing in legs and bulging in aorta: aneurysm
Prevention of Hypertension by:
Maintaining a healthy weight
Being physically active most days of the week
Eating healthfully
Quitting smoking
Limiting/not using alcohol
Reducing stress
Treatments for Hypertension
Diet
Lifestyle change
Medication
Treating with DASH Diet which was developed by the National Heart, Lung & Blood Institute. The DASH eating plan that is…
Low in saturated fat
Low in cholesterol
Low in total fat
Emphasizes Fruits, Vegetables, Low fat and fat free milk,Potassium, calcium and magnesium
Lifestyle Changes:
Weight loss
Increase physical activity
Reduce stress
Limit alcohol
Even healthy people can have blood pressure increases with alcohol use, quit smoking
Injures artery wall speeds up hardening of arteries
Reduce sodium by reading the label, banishing the shaker, and preparing food with less salt
Weight Reduction & Physical Activity can be accomplished by ↑ Physical activity. Take small steps at first:
Take stairs
Park farther away
Walk the dog one extra time
Just keep moving
Stress reduction can reduce blood pressure, yet may not be a replacement for medication. Work with your Health Care Provider.
Examples:
Yoga
Meditation
Whatever relaxes YOU!
Goals of DASH Diet:
Total fat 27% of calories Sodium 2,300 mg
Saturated fat 6% of calories Potassium 4,700 mg
Protein 18% of calories Calcium 1,250 mg
Carbohydrate 55% of calories Magnesium 500 mg
Cholesterol 150 mg Fiber 30 g
Example of a DASH Diet:
Breakfast
1/2 cup instant oatmeal
1 mini whole wheat bagel
1 Tbsp peanut butter
1 medium banana
1 cup low-fat milk
Lunch
chicken breast sandwich
3 oz chicken breast, skinless
2 slices whole wheat bread
1 slice (3/4 oz) natural cheddar cheese, reduced fat
1 large leaf romaine lettuce
2 slices tomato
1 Tbsp mayonnaise, low-fat
Dinner
1 cup spaghetti
3/4 cup vegetarian spaghetti sauce
3 Tbsp Parmesan cheese
spinach salad
1 cup fresh spinach leaves
1/4 cup fresh carrots, grated
1/4 cup fresh mushrooms, sliced
1 Tbsp vinaigrette dressing
1/2 cup corn, cooked from frozen
1/2 cup canned pears, juice pack
Snacks
1/3 cup almonds, unsalted
1/4 cup dried apricots
1 cup fruit yogurt, fat-free,
no sugar added
Medications:
Most Americans will be on more than two medicines to get blood pressure to normal values.
Three main types are:
Diuretics
Beta-Blockers
Ace inhibitors
All work in different ways so more than one is commonly used to treat HBP
1. Diuretics—also known as “Water pills”, reduce blood volume and cause kidneys to release more sodium and water in urine. They have been shown to be the key in preventing heart failure caused by HBP
Commonly used diuretics are: Dyazide and Lasix
2. Beta-Blockers—blocks the effect of hormone norepinephrine on beta receptor sites in the body.
Heart beats slower and with less force, but more efficiently per beat therefore:
Reduces work load on heart
Work better when combined with diuretics, especially in African Americans
Examples: Toprol XL, Tenormin & Inderal
3. Angiotensin-converting enzyme (ACE) Inhibitors—relax blood vessels
Blocks formation of natural chemical that narrows blood vessels. Also, blocks production of aldosterone and retention of sodium and water
Examples: Altace & Vasotec
4. Other Common Medications—Calcium Channel Blockers and Angiotensin Receptor Blockers
5. Questions to ask your Health Care Provider:
Do I already have any damage to my organs from HBP? How do you find out?
What’s the name of my drug? What are the side effects? Can I stop it?
How do I know the medicine is working?
How often should I check my blood pressure?
Who do I call if I have questions?
Remember that high blood pressure is preventable and treatable. The methods shown to be most effective include:
Lifestyle changes
Diet changes – DASH
Medication
Combination approach very popular, necessary and yields best results for many