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Suggest Treatment For High BP
Question: my wife is showing high blood pressure on a home BP machine that seems erratic. Most of the readings are high at 183/90, 173/85, 171/88.....some drop to 145/86 but mostly way out of her norm. She has not been prescribed to take BP medicine. She started taking aspirin today just in case but other than a cold has no other problems. Her ankles are swollen though which is unusual
Brief Answer:
Confirm the high readings
Detailed Answer:
Hello,
the first thing that has to be done when high blood pressure readings are found is to confirm that the readings are accurate. I'll present some of the basic rules for measuring blood pressure:
(1) the patient should be relaxed and sitting for 5-10 minutes
(2) no smoking, psychological stress or physical activity close to the measurement
(3) use a good quality device
Let me add some "tricks" that may help:
- when you find a high reading, take another one after 1-2 minutes. If the readings are identical then this is the blood pressure. If not, then take a third reading 1-2 minutes later. You can use the mean of the second and third value but the real blood pressure is more likely close to the lowest values.
- do not measure the blood pressure when a headache or any kind of pain bothers the patient. You can measure it if you'd like but this measurement should not be considered accurate or credible.
If the blood pressure is indeed high then she'll need an evaluation of target organ damage (namely the heart, kidney, brain and blood vessels) by her doctor and evaluation of her risk factors for cardiovascular disease.
If you have been checking the blood pressure every so often and you found it within normal range every time then this unexpected and sudden increase may indicate secondary hypertension and she'll need evaluation for that.
A biochemical panel would be appropriate.
Besides that, consider reducing salt intake, quitting smoking (if she smokes), engaging in a daily physical activity program (walking for 30 minutes or more, unless contraindicated for medical reasons), maintaining a healthy diet and body weight and if the need arises (depending on risk factors and blood pressure measurements) medications against hypertension.
Swollen ankles, if accompanied by shortness of breath may denote heart failure. In any case investigation for the cause is warranted.
I hope I've helped!
If you'd like me to clarify anything, please let me know.
Kind Regards!
Confirm the high readings
Detailed Answer:
Hello,
the first thing that has to be done when high blood pressure readings are found is to confirm that the readings are accurate. I'll present some of the basic rules for measuring blood pressure:
(1) the patient should be relaxed and sitting for 5-10 minutes
(2) no smoking, psychological stress or physical activity close to the measurement
(3) use a good quality device
Let me add some "tricks" that may help:
- when you find a high reading, take another one after 1-2 minutes. If the readings are identical then this is the blood pressure. If not, then take a third reading 1-2 minutes later. You can use the mean of the second and third value but the real blood pressure is more likely close to the lowest values.
- do not measure the blood pressure when a headache or any kind of pain bothers the patient. You can measure it if you'd like but this measurement should not be considered accurate or credible.
If the blood pressure is indeed high then she'll need an evaluation of target organ damage (namely the heart, kidney, brain and blood vessels) by her doctor and evaluation of her risk factors for cardiovascular disease.
If you have been checking the blood pressure every so often and you found it within normal range every time then this unexpected and sudden increase may indicate secondary hypertension and she'll need evaluation for that.
A biochemical panel would be appropriate.
Besides that, consider reducing salt intake, quitting smoking (if she smokes), engaging in a daily physical activity program (walking for 30 minutes or more, unless contraindicated for medical reasons), maintaining a healthy diet and body weight and if the need arises (depending on risk factors and blood pressure measurements) medications against hypertension.
Swollen ankles, if accompanied by shortness of breath may denote heart failure. In any case investigation for the cause is warranted.
I hope I've helped!
If you'd like me to clarify anything, please let me know.
Kind Regards!
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Raju A.T
Answered by
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