How to Monoge Your B|ooo| Pressure

How to Monoge Your B|ooo| Pressure
 A Hypertension
i CANADA
How to Manage Your Blood Pressure
What is high blood pressure?
Your heart pumps blood around your body. Blood
pressure is the force of blood against your blood
vessels as it circulates through your body. This force
is necessary to make the blood flow, delivering
nutrients and oxygen throughout your body. However,
high blood pressure, also called hypertension, means
there is too much pressure in your arteries. This can
damage your arteries and cause health problems.
Hypertension is defined as blood pressure that is con-
sistently above the normal range. Anyone can develop
high blood pressure, but it becomes more common
as you get older and requires even more aggressive
management if you also have been diagnosed with
diabetes. Once high blood pressure develops, it
usually lasts for life unless lifestyle changes are made,
and medications taken consistently if prescribed.
High blood pressure is one of the leading health
problems in Canada. It causes strokes, heart attacks,
heart failure and kidney failure. It is also related to
dementia and sexual problems. Finding and treating high
blood pressure early helps prevent these problems.
How is it measured?
We describe blood pressure with two numbers
(e.g. 124/84 millimetres of mercury). Millimetres of
mercury is a standardized measurement of pressure.
The first number is called the systolic pressure and the
second is called the diastolic pressure.
Systolic pressure occurs when your heart contracts
and is the higher of the two numbers. Diastolic pressure
is the lower number and it occurs when your heart
relaxes and fills with blood. The higher your systolic
or diastolic pressure, and the longer it stays high, the
more damage there is to your blood vessels.
Should | monitor my blood pressure?
Whether or not you have high blood pressure,
it is important to have your blood pressure checked
regularly. Nine out of 10 Canadians will develop
high blood pressure during their lifetime. High blood
pressure has no warning signs or symptoms — which
is why it is often called a ‘silent killer.” Have your blood
pressure checked at least once every two years by a
health care provider or more often if your blood
pressure is high. You can also check your blood
pressure at home. If home blood pressure readings
are done properly they may reflect your usual pressure
more than those done in the doctor’s office. Regular
blood pressure checks help make sure that high blood
pressure is diagnosed and controlled before it leads
to serious health problems.
Know what your blood pressure is and remember that
both numbers are important. If either the systolic or
diastolic number is consistently high, you need to
make changes in your lifestyle.You may need further
blood pressure checks and drug treatment. Blood
pressure of 135/85 mmHg or more measured at home
or 140/90 mmHg or higher measured in a doctor's
office is considered high.
ES ———
Canadian Hypertension Education Program CHEP
ee ей
Regular blood pressure monitoring is especially
important if your blood pressure is high normal
(130 to 139/85 to 89 mmHg when measured in a
doctor's office). More than half of people with high
normal blood pressure develop hypertension within
4 years unless they make lifestyle changes. Have a
health care professional check your blood pressure
at least every year if it is high normal.
Most people Less than
140/90 mmHg at
the doctors office
(Less than
135/85 mmHg
at home
People with Less than
diabetes or 130/80 mmHg
kidney disease
What should your blood pressure be?
Checking your blood pressure regularly at home,
and keeping a record, can be very useful. The
record helps your health care professional know
whether you are at risk of developing high blood
pressure, and how well your blood pressure is
controlled. If you have been diagnosed with high
blood pressure, keeping track helps you see the
benefits of treatments and lifestyle changes.
It also reminds you to stick to your treatment plan.
Home monitoring can help:
o find out if you have hypertension all the
time or only have high readings when you
visit your doctor
® detect blood pressure that is elevated at
home but not in the doctors office
e find out if your medications are controlling
your blood pressure at home
e remember to take your medication and to
stick to lifestyle changes
Advice for home blood pressure monitoring
DO rest quietly for 5 minutes before taking a measurement.
DO sit with your feet flat on the floor, back and arm supported, and arm at heart level.
DO put the cuff on a bare arm or one that has a thin sleeve
DO measure your blood pressure twice in the morning and twice in the evening for 7 days before
your appointment, or after a change in blood pressure medication and keep the readings in a log
DO NOT wear tight clothing during the test.
DO download and view the video and written material on how to measure blood pressure at home
(www.hypertension.ca)
DO NOT smoke or drink caffeine for 30 minutes beforehand.
Buying a blood pressure device
Blood pressure devices can be purchased A
in most pharmacies. Be sure to buy a e
blood pressure device that has this label: |
A list of approved devices is available under device endorsements
at: www.hypertension.ca
It is very important to buy a device with the right size of cuff for
your arm. Larger arms need a large cuff. Ask for help.
Do’s and Don’ts
There are several things that you can do to prevent hypertension
and to lower your blood pressure. Blood pressure increases with
age and more than 9 in 10 Canadians will develop hypertension
unless they follow a healthy lifestyle.
eBe physically active for 30 to 60 minutes on most days of the
week. Try walking, biking, swimming, cross-country skiing or
any other physical activity that you enjoy. Remember, even a
little bit of physical activity is better than no activity at all.
e Choose the following more often: fresh vegetables, fruit, low-fat
dairy products, whole grains and lean meat, fish and poultry. Limit
fast foods, processed meats, canned foods or foods that are bought
prepared and foods high in salt, sugar, saturated or trans fat.
e|f you are overweight, losing about 10 Ibs (5 kg) will lower your
blood pressure, and reducing your weight to within a healthy
range will lower your blood pressure even more.
eFat less salt. In general, the more processed a food is, the
higher the salt content. Try not to add salt to your cooking and
remove the salt shaker from the table.
e |f you drink alcohol, limit the amount to 2 drinks a day or less.
A regular-sized bottle or can of beer, 1.5 ounces (45 ml) of hard
liquor, or a regular-sized glass of wine (4 ounces or 120 ml) are
all equal to single alcoholic drink.
Stop smoking. Smoking increases the risk of developing heart
> problems and other diseases. Living and working in places that
are smoke-free are also important.
What YOU can do.
Eating less sodium can reduce your blood
pressure and prevent high blood pressure.
Aim for 1500 mg sodium per day if you
are aged 18 to 50 years, 1300 mg if aged
51 to 70 years, and to 1200 mg per day if
older than 70 years. Children are advised
to eat even less sodium
Ways to reduce sodium in your diet
* Buy and eat more fresh fruit and
vegetables
e Fat less food at restaurants and fast
food outlets and ask for less salt to be
added
* Avoid processed foods whenever
possible. When using, choose process
foods with brands and labels with the
lowest % of sodium on the food label.
e Fat foods with less than 120 mg of
sodium and/or less than 5% of the daily
value per serving
* Avoid foods with more than 360 mg of
sodium or more than 15% of the daily
value per serving
* Avoid buying or eating heavily salted foods
(e.g. pickled foods, salted crackers or
chips, processed meats, etc).
* Don't add salt in cooking or at the table.
* Wash canned foods or other salty foods
in water before eating or cooking
e If desired, use unsalted or sodium free
spices to make foods taste better
* Use less sauces on your food e.g.
ketchup, seafood sauce.
‘White coat’ hypertension
* Some people have higher blood
pressure when they visit the
doctors office. However, as
they go about their usual daily
activities they have normal blood
pressure. This condition is called
‘white coat’ hypertension (referring
to the white coat worn by the health
care provider).
* People with white coat hypertension
may still have some increased risk of
health problems. However, the risk is
lower than in those with raised blood
pressure at the doctors office and
at home. Regular monitoring is still
required, as many people with white
coat hypertension will develop high
blood pressure over time.
‘Masked’ hypertension
* ‘Masked’ hypertension is a term used
to describe how some people have
normal blood pressure when
measured in the doctor’s office, but
have high blood pressure in other
situations.
* The doctor may not suspect masked
hypertension unless blood pressure
is measured at home or other places
between visits. If your doctor suspects
masked hypertension, you may be
asked to monitor your blood pressure
at home.
e [tis important to ‘unmask’ high blood
pressure, since those with masked
hypertension are at higher risk for
heart disease and stroke.
Endorsed by the following Organizations:
Medications
Many drugs that lower blood pressure also prevent heart attacks
and strokes. The drugs known to lower blood pressure and
therefore prevent heart attacks and strokes include diuretics
(water pills), beta blockers (in those younger than 60), angiotensin
converting enzyme inhibitors (ACE inhibitors), angiotensin receptor
blockers (ARBs) and calcium channel blockers. All reduce blood
pressure by the same amount on average, but some people have
better results with one drug than another.
The drugs have different costs and different possible side effects.
If you have diabetes or kidney disease, an ACE inhibitor or ARB is
usually recommended first. Often people with diabetes or kidney
disease also need to take diuretics. If you have heart disease a beta
blocker and ACE inhibitor are commonly used. It is best to ask your
doctor or pharmacist what type of medication you are on
If you are unsure.
Most people with high blood pressure need 2 or more medications,
together with lifestyle changes, to lower their blood pressure. Many
types of blood pressure drugs work best when taken together and
often they come combined in a single tablet at no extra cost. Keep
in mind that many drugs can take up to 6 weeks before showing full
effects. Your doctor may change your medication to find a
combination that is best for you.
Based on CHEP Guidelines
Canadian Council of Cardiovascular Nurses and Canadian Pharmacists Association
Hypertension Canada
3780 14th Avenue
Markham, ON L3R 9Y5
Phone: 905-943-9400
Fax: 905-943-9401
Email: [email protected]
www.hypertension.ca P1000EN2011
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