One of my observations since moving to Ballinger is that many adults seem to be unaware of the importance of treating hypertension. Treating hypertension helps with reducing morbidity and mortality more than any other intervention except for stopping smoking.

One of my observations since moving to Ballinger is that many adults seem to be unaware of the importance of treating hypertension. Treating hypertension helps with reducing morbidity and mortality more than any other intervention except for stopping smoking.

Hypertension is very common, particularly as people get older. It doesn’t necessarily have a lot of symptoms, but people can be developing hardening of the arteries, and the first sign of hypertension might be a heart attack or stroke. If you are seeing a doctor regularly for health maintenance, you probably have your blood pressure checked and managed. (If you go in just for problems, your blood pressure may be checked but may not be addressed, due to the focus on the acute reason for seeing the doctor).

There are other ways to check your blood pressure such as screening at a health fair and using the blood pressure cuff at a local pharmacy. (By convention, the blood pressure should be taken seated, after resting for 3-5 minutes.) According to the latest (2017) definitions normal blood pressure is now defined as less than 120/80, and high blood pressure is defined by the average blood pressure, based on at least two determinations on two or more different days. The top number, or systolic blood pressure (SBP) and the bottom or diastolic blood pressure (DBP) are both used to diagnose hypertension, with stage one hypertension being 130-139/80-89, and stage two hypertension being 140+/90+. If the stage for the SBP and the DBP do not agree, the stage is based on the higher of the two.

In addition to lifestyle measures to help with your blood pressure (such as restricting the amount of salt in your diet, getting enough potassium, calcium, and magnesium, getting sufficient exercise, and avoiding tobacco and excessive alcohol), your doctor will prescribe medication for hypertension. There are a large number of medications of different types, used to treat high blood pressure, but many are diuretics that work by enhancing the production of urine. It is common to prescribe more than one medication for this condition, and the average number of daily medications needed to adequately control blood pressure is between 2 and 3. Monitoring your blood pressure at home with a home blood pressure monitor can be of assistance in documenting what your blood pressure is doing when you were not in the doctor’s office, as some people‘s blood pressure is different at home than it is at the doctor’s office.

It can also be helpful if you are having symptoms of high blood pressure, such as chest pain, headache, dizziness, or swelling, or symptoms of low blood pressure such as being excessively weak or feeling like you are going to pass out. It is also important to recognize that certain conditions may be likely to affect your blood pressure, such as serious infections, diarrhea, excessive heat exposure, and dehydration. In these conditions, monitoring your blood pressure may be helpful to avoid hypotension (low blood pressure). With diarrhea, dehydration, or heat exposure, one may need to not take diuretic therapy until these conditions are corrected. Low blood pressure associated with an infection is a good reason to seek prompt medical attention.

Generally, one can have reasonable blood pressure control without excessive side effects, and although episodes of hypotension are slightly more common when blood pressure control is rigorous, monitoring your blood pressure at home and keeping in close contact with the doctor will help to avoid hypotension. The risk of developing strokes, heart attacks, and vascular disease is significantly reduced by controlling hypertension.

Dr. Hardwicke is part of Ballinger Memorial Hospital District. The Health and Wellness Coalition of Runnels County now meets every second Thursday at 7 pm. The next meeting will be April 12 at 7 pm in the conference room next to Keel Drug, 2001 Hutchins Ave. and will focus on the implementation of the Guideline for Prescribing Opioids. All interested healthcare professionals are invited.