High Blood Pressure

High Blood Pressure, also known as hypertension, affects more than 65 million Americans and is known as the silent killer because many don’t experience any symptoms at all. If left untreated, hypertension contributes to thousands of death every year, mostly due stroke, heart attack, heart failure, and kidney disease. The good news is that successful treatment of hypertension can greatly reduce your risk.


Questions

Q:

My BP can alternate from a typical low of 116/59 to a sometimes high of 162/75 within 12 to 24 hours. My systolic can change by 20 or so points within the hour. The diastolic number is almost always 60 pts lower, often 70 pts or more. How concerning is this and why does it occur? Thank you.

A:

It is typical for blood pressure to vary throughout the day. Most people’s systolic blood pressure varies about 30 points throughout the day. This is a result of response to changing needs of the body during the day, response to what we eat and drink, changes in activities, and sometimes changes to the medications that we take. Your blood pressure variation of about 40- 50 points is a little more than most. The variation is not as much as concern as what is the average blood pressure during the day. We aim for an average blood pressure during the day of about 140, in people over the age of 55. The diastolic is not as important as the systolic blood pressure, so I would not be concerned about that.

Q:

Once you start B.P. pills are you on them forever? I`ve had good pressure for awhile now and I still have to take them.

A:

Most people who start on blood pressure medicatons stay on them for life. It is important to take the medicationto to keep blood pressure as best controlled as possible. Control of blood pressure reduces risk of stroke, heart attack, heart failure and kidney damage.

Q:

This may seem like an odd question but I can’t seem to find information on this in my online searches so here goes: Can high blood pressure cause lack of concentration?

A:

Uncontrolled blood pressure leads to decreased cognitive function. So yes, if blood pressure is not controlled, it might manifest as an inability to concentrate as well as one did earlier in life.

That is one of the reasons why it is important to control blood pressure. In a National Institute of Health sponsored trial (its name is SPRINT) that is being conducted at UMass, we are testing if cognitive function is better preserved if systolic blood pressure is less than 120 or less than 140.

If you have high blood pressure and want to participate in this study, please call us at 508-856- 1014.

Q:

What is normal blood pressure for 45 year old 5'5 woman who weighs 128 lbs?

A:

Normal blood pressure would be a systolic less than 140 and a diastolic less than 90 (less than 140/90). Because people who naturally have blood pressure less then 120/80 have less risk of heart attack, stroke, heart failure and kidney damage, it is thought that it is best to have a blood pressure below 120/80. For people who already have high blood pressure, we do not know if it is better to have a systolic blood pressure less than 140 or less than 120. We are trying to answer this question in the SPRINT trial.

Q:

How long does is typically take to lower high blood pressure? I started on RX last month, changed my diet and work out 3x per week. I have an appointment (follow up) in 2 weeks and wondering if my physician will see a change in my bp. Thanks!

A:

First of all – congratulatoins for all of the changes that you have made – this is a fantastic start. When you see your physician it is very likely that you will have already had a decrease in blood pressure. Don’t be disappointed if your physician still decides to increase the dose of the medication, as even with all of the positive changes you have made, it can take some extra medicicne to get the blood pressure down.

Q:

How does low blood pressure affect kidney function? Are the two related?

A:

People who chronically have low blood pressure usually have better kidney function over time. If someone is seriously ill and has very low blood pressure as a result of that illness, then sometimes that can make kidney function worse.

Q:

Is high blood pressure genetic. I am in great overall health but both of my parents had high blood pressure and my mother had a stroke in her early 60’s. I am in my late 30’s and wondering if this should be a health concern even though I do not smoke and my weight and chlolesterol are good. Not on any medications either.

A:

High blood pressure does have a genetic component to it. Because of your family history, you want to make sure that over time your blood pressure is in the normal range. Adding exercise to your already healthy lifestyle could also be of benefit to you to prevent development of hypertnesion.

Q:

Can losing weight cause low blood pressure? What causes low blood pressure? My doctor didn’t seem concerned but the more I read, the more concerned I have become.

A:

Losing weight can lower blood pressure. People who have lower blood pressure tend to have less strokes, heart attacks and kidney problems. I am not sure what you are reading about the dangers of low blood pressure, but I would listen to your doctor. If you lose weight, it is very unlikely that you will have any problems from achieving a lower blood pressure, and more likely than not you will get the benefits of a lower blood pressure with lower risk of getting a stroke, heart attack or kidney problems.

Q:

Is there a certain age where an individual should start seeing a cardiologist?

A:

You only need to see a cardiologist if you have a heart problem that your primary care physcian believes extra expertise is required to manage.

Q:

Are hot tubs bad for high blood pressure? We are purchasing a hot tub and I have heard mixed messages on this issue. Appreciate your time, thanks so much.

A:

The issue with hot tubs is that they lead to lowering of blood pressure. When getting out of the tub with the lower blood pressure, people can feel dizzy, and sometimes people do fall and can hurt themselves. That being said, many people with high blood pressure do fine with hot tubs. My advice is that you consult your physician and discuss this before the purchase.

Q:

Can certain foods cause sudden drop in BP? I monitor my bp at home and seemed to drop quickly after I eat certain things. I called doctors office too but a second opinion is always reassuring!

A:

Some people do get a drop in blood pressure after eating. Some people get it after every meal, some people only after certain foods. It is not clear why this occurs but probably has something to do with the amount of insulin that is released with certain foods. Insulin can dilate blood vessels, which can lead to a lowering of blood pressure.

Q:

Is high blood pressure genetic? My husband is in good health and at 47 is very active but has a stressful corporate job and I am concerned about his blood pressure due to his family history. His sisters both have high blood pressure in their early 40’s and his parents did as well and his brother recently had a minor heart attack. What signs or symptoms might we should watch for between his DR visits that could indicate a problem if any?

A:

There is a genetic component to high blood pressure, and a genetic component to heart attacks at an early age. With your husband’s family history he should discuss with his doctor a plan for prevention. The advice that he gets will depend on the risk factors that his family members and brother had for high blood pressure and heart attacks (for example – were they smokers, were they overweight, did they have high cholesterol, did they exercise?).

Your husband might be advised to alter his lifestyle, exercise more, take some medications (perhaps a baby aspirin each day). With all of the knowledge that we have, your husband is sure to get good advice that will help reduce the risk of cardiac problems.

Q:

What causes high BP and is poor circulation a concern for bp issues?

A:

High blood pressure is caused by many factors, and each individual who has it has one or more of these factors. Poor circulation is often caused by high blood pressure, and sometimes it can get better with good control of it.

Q:

How low is too low in BP?

A:

For people who have natural low blood pressure without taking any medicaitons, there does not seem to be a lower limit that causes problems. Sometimes people who are on medications for high blood pressure can get dizzy when they stand up because their blood pressure drops. If this is the case, then the doctor can usually make an adjustment in the medications so that this does not occur.