Walk in appointments 7- 4:30
Lansdowne Medical Pavilion
19415 Deerfield Ave, Suite 213
Lansdowne, Virginia 20176
What is High Blood Pressure? High blood pressure is one of the most common cardiovascular medical concerns. It is often known as a silent killer, as many patients are unaware that they have it. This is why regular blood pressure screening is essential to prevent the complications of this disease. Blood pressure is usually expressed as two numbers. The top number represents the pressure in your blood vessels while the heart is contracting, the bottom number represents the pressure inside your blood vessels while your heart is relaxing. A normal blood pressure is defined as 120's/70's. Mild blood pressure elevation is 130's/80's. Moderate is defined as 140's/90's and severe is defined as anything greater or equal to 150/100.
What are the complications of high blood pressure? High blood pressure takes it's toll on many important organs in the body. By causing damage to the inner lining of the blood vessels, plaques and clots can form. In the brain this can lead to a devastating stroke. In the heart, this damage can lead to a heart attack. In the retinal artery, the damage to the blood vessel can cause blindness. In the kidney, the damage can result in kidney failure requiring dialysis. High blood pressure is second only to diabetes as the leading cause of kidney failure and loss of vision in the United States.
Exercise. Regular exercise is key to well being. People who exercise regularly can also reduce their blood pressure. Ideally we should exercise three times a week for at least 30 minutes. Two thirds of the time should be aerobic and get your heart rate up, one third should be anaerobic muscle strength workouts. For those who can not fit large workouts into their routine, I ask for five minutes of exercise before hitting the shower. Just do as many sit ups, push ups or jumping jacks as you can. The results will speak for themselves.
Nutrition. Eating properly to avoid sugar or caffeine highs or lows is important to keep your appetite under control. Eating processed, carbohydrate heavy meals and snacks, will usually result in a high sodium diet, and therefore should be avoided. Eating multiple small unprocessed natural snacks and meals will help to keep your sodium consumption to a minimum. Additionally you should avoid fast food, and should never add salt to your food.
Weight Loss. Reducing your weight 10-15% will have a substantial effect on your blood pressure. For many of our patients eating properly and exercising work as well to reduce blood pressure as standard medications that are prescribed. For more detailed weight loss information, click here.
There are several classes of medications that are commonly used to treat high blood pressure. Although in depth information is available through other websites (Rxlist.com and others) some summary information is provided below.
B blockers are used to relax the smooth muscle lining of the blood vessels and lower your heart rate, thus reducing your blood pressure. In some pateints they cause impotence or excessive fatigue. B blockers should be used with caution in patients who have respiratory disease or congestive heart failure. They are particularly useful in preventing heart attacks in patients who have had their first heart attack.
Diuretics (water pills) are medications that force your body to waste salt. According to the commonly accepted standard for the treatment of high blood pressure, a diuretic should be the second, if not the first medicaiton prescribed for the treatment of high blood pressure. It works synergistically with other blood pressure medications, and reduce the rate of heart attacks and other cardiovascular complications better than most other medications used to treat high blood pressure. Patients taking diuretics should have blood work done on a regular basis, as it is possible for sodium or potassium levels too fall to low.
ACE Inhibitors (Angiotensin receptor inhibitors) are a hormonal therapy for high blood pressure. They are very effective pills that work particularly well to delay the progression of kidney disease so often seen in patients with diabetes. They control both blood pressure and heart failure in patients with heart failure and to prevent heart attacks in patients who have coronary artery disease. They can cause an annoying cough, and in rare cases an allergic reaction. Patients taking Ace Inhibitors should also have blood work taken on a regular basis to prevent potassium levels from getting to high. High or low potassium levels are not well tolerated by the body. ARB's (Angiotensin Receptor Blockers) are similar to ACE Inhibitors in most respects, except they cause few side effects. Patients who are pregnant or who intend to become pregnant should never take ACE Inhibitors or ARB's.
Ca Channel Blockers are the last major common group of medications. The older first generation blockers reduced heart rate and relaxed the blood vessels to lower blood pressure. The newer second generation blockers do not affect heart rate, but more dramatically relax blood vessels to reduce blood pressure. The second generation medications also commonly can cause swelling in the lower legs, and therefore may sometimes be given with a diuretic to cancel out the side effects. It is rare to manage patients only with Calcium Channel blockers, as they do not have the advantages that the other classes of medications possess. They are usually but not always used in addition to other medications.
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