It’s the “leading preventable cause of death and disability around the world.” What is hypertension and what can you do to manage or prevent it?

May 29, 2019Get Well, Keep Well
blood pressure monitor, hypertension

“Hypertension is the leading preventable cause of death and disability around the world and can lead to heart disease, stroke, kidney disease, and dementia. Over 7.5 million Canadians have hypertension, and 7.4 million more have high blood pressure that will lead to hypertension without preventative action,” according to Hypertension Canada.

These are alarming stats, but the good news is that you can take steps to prevent and control hypertension.

Know your number

The first step is knowing your number. Blood pressure is comprised of two measurements—systolic pressure when your heart contracts, (the higher number); and diastolic when your heart relaxes and fills with blood (the lower number). Your blood pressure should be less than 140/90. If you have diabetes, blood pressure readings should be below 135/85.

Wello Nurse Practitioners can assess, diagnose and treat high blood pressure.

Our Wello Nurse Practitioners can assess, diagnose, and treat high blood pressure. As a virtual healthcare provider, our nurse practitioners ask our patients to assist us in arriving at a diagnosis and developing a treatment plan. They also follow the Hypertension Canada guidelines.

If a patient has / or have had a history or high blood pressure, or a family history of hypertension, our nurse practitioners would advise them to attain a blood pressure monitor and record readings twice daily for a total of seven days.

Monitoring blood pressure at home:

There are many options on the market for blood pressure measurement devices that can be used for home readings.

  • Measurements should be taken using a validated electronic device.
  • Here is an example of a blood pressure log.
  • Choose an arm cuff matched to the size of your arm. Select the cuff size as recommended by its manufacturer.
  • You should perform measurement before breakfast and 2 hours after dinner, before taking medication.
  • Do not drink caffeine or use tobacco in the hour, and do not exercise 30 minutes before taking the measurement.
  • Apply the cuff to your non-dominant arm, unless the systolic blood pressure (top number) difference between arms is > 10 mm Hg, in which case the arm with the highest value obtained should be used.
  • Rest comfortably for 5 minutes in a seated position with back support.
  • Your arm should be bare and supported with the BP cuff at heart level.
  • Take duplicate measurements in the morning and in the evening for seven days.
  • Average the results, excluding the first day’s readings.

Other Monitoring Options

If using a home blood pressure monitor isn’t an option, our nurse practitioners would have the patient get regular blood pressure checks at a walk-in clinic, pharmacy, or grocery store that has a blood pressure monitor. We would have them assess their blood pressure on at least two different occasions, preferably at varying times of the day, following the general guidelines above.  The patient would record their readings and report back to Wello at a later date.

Another option our nurse practitioners may pursue is to send a patient for a 24-hour ambulatory blood pressure monitoring. For this assessment, they would refer our patient to a clinic that hooks them up to a 24-hour blood pressure monitor that they take home with them. The monitor takes readings at periodic intervals to assess the patient’s blood pressure at various times of the day and night. This gives our nurse practitioners a clear picture of the client’s average blood pressure readings and allows us to come to a diagnosis of hypertension and develop treatment strategies.

Managing Hypertension

Depending on the severity of the blood pressure elevation, our nurse practitioners would advise on:

  • DASH diet
  • Smoking cessation
  • Caffeine reduction
  • Stress reduction

If all other strategies have been implemented, with little to no improvement of the blood pressure, our nurse practitioners would then go ahead and prescribe anti-hypertensive medication.

Regular follow-up appointments would also be scheduled in conjunction with having the patient continue to monitor their blood pressure until the blood pressure is within therapeutic parameters. At that point, the patient could then decrease the frequency of monitoring, but they should still periodically monitor their blood pressure. Wello Nurse Practitioners advise patients to contact Wello if their blood pressure is consistently above 135/85.

Elevated blood pressure can also cause damage to various organs within the body. If high blood pressure is suspected, our nurse practitioners will also order various laboratory and diagnostic evaluations. In addition, patients will also require routine hands-on physical exam and routine monitoring by their family doctor to look for certain physical symptoms that are often associated with high blood pressure. A patient’s family doctor or primary practitioner can complete the physical exam.

Tips for preventing high blood pressure:

If you don’t have high blood pressure, work on prevention by adopting a healthy lifestyle:

Schedule an appointment with a Wello Nurse Practitioner today to discuss your blood pressure.