What to expect from your doctor when you are diagnosed with hypertension.

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Title: What to expect from your doctor when you are diagnosed with hypertension.

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Author: Ted Crawford

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What to expect from your doctor when you are diagnosed with hypertension.

Copyright 2006 Ted Crawford

Hypertension (high blood pressure) affects about 50 million

individuals in the United States. Of these, about 70% are

aware of their diagnosis, but only about a half of those

are receiving treatment and only 25% are under control

using 140/90 as the cutoff guideline. A new category has

been designated as “pre-hypertension” and that is when the

blood pressure is 120-139 systolic over a diastolic of

80-89.

Blood pressure readings vary greatly in individuals

depending on the time of day, where the patient is at when

they get it checked, how soon they have eaten, smoked, or

even drank a cup of coffee. A diagnosis of hypertension

should not be based on one reading unless that reading is

extremely high and/or there is evidence of end organ damage

such as renal (kidney) or heart involvement. The diagnosis

of hypertension should be made only after two or more

readings on two or more office visits.

The frightening thing about hypertension is that it usually

does not cause any symptoms. Unless you are getting your

blood pressure regularly checked, you could be walking

around for years with elevated blood pressure and not know

it. That is why it is referred to as the silent killer.

If you are being diagnosed with hypertension for the first

time, there are certain tests that your doctor should

order. Blood tests including a complete blood count,

fasting lipids (cholesterol), fasting blood sugar, renal

(kidney) functions, liver functions, and electrolytes

(potassium, sodium levels), along with a urinalysis should

be checked. You should also have a chest xray to check for

enlargement of your heart which can occur over time with

hypertension, and an electrocardiogram to check for any

cardiac (heart) abnormalities.

Treatment of hypertension is multi-faceted. Lifestyle

modification should include smoking cessation, daily

exercise implementation, dietary changes, alcohol

moderation, and sodium restriction. One should consume a

diet with plenty of vegetables, fruit, and low dietary fat.

Exercise should consist of daily brisk exercise such as

walking at least 30 minutes per day most days of the week.

A 10% weight loss can make a significant difference in

blood pressure readings. Alcohol consumption should be

limited to no more than two drinks per day (24 oz. of beer,

10 ounces of wine, or 3 oz. of “hard” liquor such as gin,

whiskey, or vodka). You should also reduce salt intake to

no more than 2.4 grams of sodium per day. I tell my

patients not to add any salt to any foods and restrict high

sodium items.

If your blood pressure is not extremely elevated, say in

the 145/95 range, and you are determined to make

substantial lifestyle changes, then perhaps you can bring

your blood pressure down to normal range with these

measures. I always give my patients in these situations

the option to try lifestyle modifications first if they

wish as long as their blood pressure is not seriously high.

Most patients, however, end up having to take a medication

for their hypertension.

There are a wide variety of medications available that we

can prescribe and the majority of patients require more

than one type of medication to reach a desired blood

pressure goal. Discuss with your physician the side

effects of each and what would be the most suitable

medication for you. Medications have come a long way for

treating blood pressure in the past twenty years and the

side effect profiles are much more favorable than they used

to be overall. I have found that a good portion of my

patients have an aversion to taking a pill everyday for the

rest of their lives. But what I tell them is that they

ought to look at it like a vitamin, or better yet, an

insurance policy. If it prevents you from having a heart

attack or stroke and from either premature death or perhaps

becoming confined to a wheel chair and not being able to

take care of yourself, then taking a daily pill or two

should not even be an issue.

Don’t be afraid to talk to your doctor about treatment and

asking about the tests I have discussed. Most importantly,

please get into your physician at least once a year to get

your blood pressure taken, and more often if it has been on

the high end of normal.

About the Author:

Dr. Ted Crawford is a family practice physican in Tucson,

Arizona and has a website devoted to helping patients find

reliable health information and products. His article

" What to expect from your doctor when you are diagnosed

with hypertension " can also be found at

http://www.babyboomersdoc.com