How To Keep Your Blood Pressure Less Than 200/110

BRYCE CANYON AT SUNRISE JUNE 13TH, 2001
The above photograph is very calming - I like to look at it and feel my blood pressure come down.

Speaking of blood pressure - did you know that hypertension (high blood pressure) is probably the most common condition I treat? Here are some thoughts from a handout I use in my office:

• Your blood pressure measurement has two parts; the top number is the systolic number - the pressure when the heart contracts. The bottom number is the diastolic number - pressure when the heart relaxes.
• Both numbers are important. Average values greater than 140 on the top number or 90 on the bottom number have been clearly associated with higher long term complications of stroke, heart attack, and kidney failure in multiple clinical studies. Evidence indicates that people with diabetes should have even lower blood pressures - less than 130/80.
• Blood pressure goes up and down from moment to moment. Thus the blood pressure at the start of your office visit might be quite different from one taken 5 minutes later.
• What really counts in reducing your risk of bad things from high blood pressure is that your long term average blood pressure be less than 140/90.
• Since you don't live long term in my office (although with our wait times it might seem that way) the best way to know your long term average is to take it yourself at home. There are a number of very good automatic blood pressure monitors on the market. In checking these cuffs in my office I have found the best agreement with my equipment with the auto-inflating arm cuffs like those sold in our pharmacy for $45 - $60. I have been less impressed with the finger and wrist cuffs. I have noted that lots of patients have high blood pressure in my office but not if they follow it at home. (This is called ''white coat hypertension'' even though I don't wear a white coat .)
• When you get your blood pressure cuff it is not a bad idea to bring it along to a doctor's appointment and let us compare it to our wall mounted unit.
• Once you are up and running monitor your blood pressure as frequently as suggested by your doctor; do some in the morning and some in the afternoon or evening. You should be seated for 3 to 5 minutes before you check your blood pressure. Please record the readings and bring them with you to your doctor visit.
• Since we are interested in your long term blood pressure control, please keep an average of your blood pressure. This is best done by adding up 10 consecutive systolic (top) numbers and dividing by 10. (example 140 +130 +142 +128 +154 +162 +130 +145 +138 +142 = 1411 which divided by 10 is an average systolic of 141.) Do the same for the diastolic (bottom) numbers.
• Don't freak out over the occasional elevated blood pressure. But if your average blood pressure is consistently greater than 140 over 90 (either number) we should talk. Please leave me a message at 571-4044 (Larry Lapsley).
• For further and/or more detailed reading on blood pressure visit the National Library of Medicine page on High Blood Pressure

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