What are the best treatment options for high blood pressure in Black adults?
|
Get answers to the most frequently asked questions about hypertension from nephrologist Leslie Thomas, M.D. Show
Show transcript for video Hypertension FAQs Hi. I'm Dr. Leslie Thomas, a nephrologist at Mayo Clinic. And I'm here to answer some of the important questions you might have about hypertension. What is the best way to measure my blood pressure at home?Measuring your blood pressure at home is a straightforward process. Many people have a slightly higher blood pressure in one arm versus the other. So it's important to measure the blood pressures in the arm with the higher readings. It's best to avoid caffeine, exercise and, if you smoke, smoking for at least 30 minutes. To prepare for the measurement, you should be relaxed with your feet on the floor and legs uncrossed, and your back supported for at least five minutes. Your arms should be supported on a flat surface. After resting for five minutes, at least two readings are taken one minute apart in the morning prior to medications and in the evening before the evening meal. Your blood pressure monitor should be checked for proper calibration every year. What could be causing my blood pressure to be quite erratic?This pattern of abrupt changes in blood pressure from normal to quite high is sometimes referred to as labile blood pressure. For those who develop labile blood pressure, heart problems, hormonal problems, neurological problems, or even psychological conditions might be present. Finding and treating the underlying cause of labile blood pressure can significantly improve the condition. Should I restrict salt to reduce my blood pressure?It's important to note that some people with high blood pressure already consume a diet significantly restricted in sodium. And those people further restriction of dietary sodium would not necessarily be helpful or even recommended. In many people, dietary sodium intake is though relatively high. Therefore, an effective target to consider for those people is less than 1500 milligrams per day. Many though, will benefit from a target of less than a 1000 milligrams per day. Following dietary sodium restriction, it may take some time, even weeks, for the blood pressure to improve and stabilize at a lower range. So it is critically important to both be consistent with decreased sodium intake and patient when assessing for improvement. How can I lower my blood pressure without medication?This is a very common question. A lot of people want to avoid medication if they can, when trying to reduce their blood pressure. A few ways have been shown scientifically to reduce blood pressure. The first, and perhaps most important, is to stay physically active. Losing weight also can be important in a lot of different people. Limiting alcohol, reducing sodium intake, and increasing dietary potassium intake can all help. What is the best medication to take for hypertension?There's not one best medication for the treatment of hypertension for everyone. Because an individual's historical and present medical conditions must be considered. Additionally, every person has a unique physiology. Assessing how certain physiological forces may be present to contribute to the hypertension in an individual allows for a rational approach to medication choice. Antihypertensive medications are grouped by class. Each class of medication differs from the other classes by the way it lowers blood pressure. For instance, diuretics, no matter the type, act to reduce the body's total content of salt and water. This leads to reduction in plasma volume within the blood vessels and consequently a lower blood pressure. Calcium channel blockers reduce the relative constriction of blood vessels. This reduced vasoconstriction also promotes a lower blood pressure. Other classes of antihypertensive medication act in their own ways. Considering your health conditions, physiology, and how each medication works, your doctor can advise the safest and most effective medication for you. Are certain blood pressure medications harmful to my kidneys?Following the correction of blood pressure or the institution of certain blood pressure medications, it's pretty common to see changes in the markers for kidney function on blood tests. However, small changes in these markers, which reflects small changes in kidney filtration performance shouldn't necessarily be interpreted as absolute evidence of kidney harm. Your doctor can interpret changes in laboratory tests following any change in medication. How can I be the best partner to my medical team?Keep an open dialogue with your medical team about your goals and personal preferences. Communication, trust and collaboration are key to long-term success managing your blood pressure. Never hesitate to ask your medical team any questions or concerns you have. Being informed makes all the difference. Thanks for your time and we wish you well.  Close Blood pressure measurementBlood pressure measurementA blood pressure reading measures the pressure in the arteries when the heart beats (top number, called systolic pressure) and between heartbeats (bottom number, called diastolic pressure). To measure blood pressure, an inflatable cuff is usually placed around the arm. A machine or small hand pump is used to inflate the cuff. In this image, a machine records the blood pressure reading. This is called an automated blood pressure measurement. To diagnose high blood pressure, your health care provider examines you and asks questions about your medical history and any symptoms. Your provider listens to your heart using a device called a stethoscope. Your blood pressure is checked using a cuff, usually placed around your arm. It's important that the cuff fits. If it's too big or too small, blood pressure readings can vary. The cuff is inflated using a small hand pump or a machine. The first time your blood pressure is checked, it should be measured in both arms to see if there's a difference. After that, the arm with the higher reading should be used. Blood pressure is measured in millimeters of mercury (mm Hg). A blood pressure reading has two numbers.
High blood pressure (hypertension) is diagnosed if the blood pressure reading is equal to or greater than 130/80 mm Hg. A diagnosis of high blood pressure is usually based on the average of two or more readings taken on separate occasions. Blood pressure is grouped according to how high it is. This is called staging. Staging helps guide treatment.
Sometimes the bottom blood pressure reading is normal (less than 80 mm Hg) but the top number is high. This is called isolated systolic hypertension. It's a common type of high blood pressure in people older than 65. TestsIf you are diagnosed with high blood pressure, your provider may recommend tests to check for a cause.
Taking your blood pressure at homeYour health care provider may ask you to regularly check your blood pressure at home. Home monitoring is a good way to keep track of your blood pressure. It helps your care providers know if your medicine is working or if your condition is getting worse. Home blood pressure monitors are available at local stores and pharmacies. For the most reliable blood pressure measurement, the American Heart Association recommends using a monitor with a cuff that goes around your upper arm, when available. Devices that measure your blood pressure at your wrist or finger aren't recommended by the American Heart Association because they can provide less reliable results. More Information
TreatmentChanging your lifestyle can help control and manage high blood pressure. Your health care provider may recommend that you make lifestyle changes including:
Sometimes lifestyle changes aren't enough to treat high blood pressure. If they don't help, your provider may recommend medicine to lower your blood pressure. MedicationsThe type of medicine used to treat hypertension depends on your overall health and how high your blood pressure is. Two or more blood pressure drugs often work better than one. It can take some time to find the medicine or combination of medicines that works best for you. When taking blood pressure medicine, it's important to know your goal blood pressure level. You should aim for a blood pressure treatment goal of less than 130/80 mm Hg if:
The ideal blood pressure goal can vary with age and health conditions, particularly if you're older than age 65. Medicines used to treat high blood pressure include:
Other medicines sometimes used to treat high blood pressureIf you're having trouble reaching your blood pressure goal with combinations of the above medicines, your provider may prescribe:
Always take blood pressure medicines as prescribed. Never skip a dose or abruptly stop taking blood pressure medicines. Suddenly stopping certain ones, such as beta blockers, can cause a sharp increase in blood pressure called rebound hypertension. If you skip doses because of cost, side effects or forgetfulness, talk to your care provider about solutions. Don't change your treatment without your provider's guidance. Treating resistant hypertensionYou may have resistant hypertension if:
Having resistant hypertension doesn't mean your blood pressure will never get lower. If you and your provider can determine the cause, a more effective treatment plan can be created. Treating resistant hypertension may involve many steps, including:
High blood pressure during pregnancyIf you have high blood pressure and are pregnant, discuss with your care providers how to control blood pressure during your pregnancy. Potential future treatmentsResearchers have been studying the use of heat to destroy specific nerves in the kidney that may play a role in resistant hypertension. The method is called renal denervation. Early studies showed some benefit. But more-robust studies found that it doesn't significantly lower blood pressure in people with resistant hypertension. More research is underway to determine what role, if any, this therapy may have in treating hypertension. More Information
Request an Appointment at Mayo Clinic There is a problem with information submitted for this request. Review/update the information highlighted below and resubmit the form. Sign up for free, and stay up to date on research advancements, health tips and current health topics, like COVID-19, plus expertise on managing health. Email ErrorEmail field is required ErrorInclude a valid email address To provide you with the most relevant and helpful information, and understand which information is beneficial, we may combine your email and website usage information with other information we have about you. If you are a Mayo Clinic patient, this could include protected health information. If we combine this information with your protected health information, we will treat all of that information as protected health information and will only use or disclose that information as set forth in our notice of privacy practices. You may opt-out of email communications at any time by clicking on the unsubscribe link in the e-mail. |
