Thread: Your Blood Pressure Reality Check

By Paula Kue, MD

I am often told by women, "I have low blood pressure." Then, when they are faced with an elevated blood pressure reading during a doctor's visit, they are first in disbelief and a minute later anxious that something is wrong.

Often, they speculate on what is causing the rise: "There was so much traffic on the way here." Or, "Work is really stressing me out this week."

Enough excuses! It is important that you acknowledge what your pressure runs and then do something about it, so you can avoid long-term consequences such as kidney, heart, and eye disease.

First, let's dismiss this myth about adults having low blood pressure. Blood pressure runs a continuum from as low as 60 systolic in infancy (systolic refers to the top number, which reflects the highest blood pressure, when the heart contracts) and rises as we grow up.

Then, it rises still further as we age. Having low blood pressure is a good thing, and the lower the better (as long as you're not ill with a fever or passing out). But don't take your present low blood pressure for granted - age, genetics, and lifestyle are all likely to encourage its climb.

Blood pressure is thought to increase significantly over time if a person consumes a high salt diet, and especially if that person has inherited a genetic predisposition. That's why sodium content (sodium is the culprit in salt) is listed on the Nutrition Facts of every food label.

Take a peek at these labels and you may be surprised to learn that high-salt foods are not necessarily all that salty tasting. We all know that cured meats and canned goods are full of salt, but sodium is also found in breads and beverages. And once you get familiar with these labels, consider what must be in all those great-tasting fast foods and restaurant meals!

Now consider your own blood pressure numbers. Anything over 120/80 is classified as prehypertension and over 140/90 is considered full-blown hypertension. This is another continuum: for every 20/10 increase above 115/75, the risk of cardiovascular disease doubles!

The diagnosis of either prehypertension or hypertension is never based on a single reading. Make sure you are relaxed and rested before getting a reading because blood pressure increases (as it should) when we exert ourselves, as in exercise. If you repeatedly have elevated readings, however, it is time to look for a cause.

Have you been drinking a significant amount of caffeinated beverages? Coffee? Tea? Sodas? Red Bull? Consider cutting down.
Have you been taking an allergy medicine or cold formula that contains pseudoephedrine or phenylephrine? Consider stopping them or seeking alternatives.
Are you overweight? Losing the excess may bring your pressure down.
Are you taking diet pills? Many of these are stimulants that reduce your appetite. Further, many diet foods cover up the lack of calories and fat by adding loads of tasty salt! Read those food labels.
Do you take any herbal supplements? Be sure to learn about all of the ingredients in them and of any adverse effects.
Have you recently started taking an oral contraceptive pill?
Do you snore? Sleep apnea can contribute to high blood pressure.
Is your pressure elevated on readings in both arms? If there is a significant difference between the two, then you may need an evaluation for narrowing in a major blood vessel (called a coarctation of the aorta).
Have you been jittery, sweaty, and suffering from diarrhea? You may have an overactive thyroid.
Does everyone in your family have high blood pressure or take medicine to keep their pressure normal? Your genetics may be working against you. This is the most common cause and is often referred to as essential hypertension.
If you have looked for reasons and worked to improve what you can, and your pressure is still too high, then it may be time to consider treatment.

Don't think of this as a failure but as an opportunity to take action to reduce your risk of stroke and heart attack simply by taking a pill!

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