1) What is blood pressure?
Blood pressure is the driving force in our body that keeps blood flowing to every organ. It is first generated by the powerful heart muscle and then maintained and transmitted by our blood vessels. Blood pressure has become synonymous with high blood pressure. For decades now, high blood pressure has been a well-recognized risk factor for heart attacks, strokes, and early death. High blood pressure is frequently referred to as the "silent killer" as no one knows what their blood pressure is, high or low, until they actually measure it. A majority of people will develop high blood pressure during their lifetime.
2) How do I know what my blood pressure is?
Figuring out what your blood pressure is, is easy. Any doctor appointment you go to will check your blood pressure. Health fairs, home blood pressure cuffs, even your neighbor who is a nurse can accurately measure your blood pressure.
3) What should my blood pressure be?
Over the years, goal blood pressure has been a moving target in terms of what your blood pressure should be, or more importantly what is should be under! Again every patient is different but as a general starting point, your systolic blood pressure (that’s the top number) should be less than 140 mmHg, and the diastolic blood pressure (that’s the bottom number) should be less than 90mmHg. If you are asking if one of those numbers is more important than the other, the answer is yes, it is the systolic (top) blood pressure that carries the most weight.
4) What can I do about it?
The first step to managing your blood pressure to change how you eat by greatly decreasing the amount of salt in your diet. In 2017, a vast majority of salt in a typical American diet comes from 2 places: 1) eating outside of the home. Whether it is a fast food meal or the finest 5-star restaurant, the food tastes good because it is loaded with salt and 2) you salt your food after it hits the plate before you eat it. By limiting eating outside of the home to two times a week or less and throwing away your salt shaker, you can help your blood pressure. Making dietary and lifestyle changes (exercise) you can on average lower your blood pressure by about 10 mmHg (i.e. 145mmHg -> 135mmHg).
5) So what about medication?
As you can see from the paragraph above, if your blood pressure is significantly elevated (>150/100 mmHg) it is very unlikely that diet and lifestyle changes alone will be enough to bring your blood pressure in a range that will reduce your risk or heart attacks, strokes, or early death. You need medications. The great thing about meds to treat your blood pressure is that there are A LOT of them. This means that you and your doctor should be able to find a regimen that works for you from a side effect standpoint.
6) What about cost?
A vast majority of blood pressure medications are generic and very affordable. In fact, if you are on an expensive brand medication for your blood pressure, ask your doctor about switching to a cheaper alternative that will be just as effective. You can also look at it in other ways, think of the cost to be admitted to the hospital with a heart attack with costly procedures or high risk surgeries. Spending pennies a day on your blood pressure pills may, in the future, save you tens of thousands of dollars.
7) When will I stop the medication?
More than likely you won’t. Very rarely does high blood pressure have a “cure.” A vast majority of people will need lifelong therapy for their blood pressure. Remember that heart disease is a disease of aging, and so being vigilant about controlling our risk factors (like high blood pressure) is a lifelong task.