Hypertension Guidelines Explained For Real Life

We break down the new hypertension guidelines and explain how unchecked pressure harms the brain, heart and kidneys. We show how to measure blood pressure the right way, when lifestyle is enough, when meds are needed and when to head to the ER.

• new American Heart Association thresholds and targets
• why hypertension causes stroke and organ damage
• genetic stiffness versus lifestyle-driven pressure
• headache and other warning signs to treat as emergencies
• lifestyle changes that lower sustained readings
• clear cutoffs for starting one or two medications
• how to size an arm cuff and avoid wrist devices
• logging trends, timing checks and noting stressors
• when to contact a clinician versus go to ER
• how we support team-based blood pressure care

Go to HamiltonTelehealth.com. Click on get see now, chat now, and we will get started

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Transcript

Welcome And Disclaimer

SPEAKER_00 0:17

Hey guys, welcome back to another episode of Tattoos and Telehealth. This is my friend and great colleague, Nicole Baldwin. She's a board-certified family nurse practitioner, and I'm Kelly White, again, a board-certified family nurse practitioner. And we are just two gals chatting it up today. We're going to talk about a few things that are exciting. There's been some changes in the world of medicine, as per usual, but we want to update you guys on some guideline changes. And it does reflect some things that we get to treat here in the world of telehealth. So as always, this does not constitute medical advice. We're just two gals chatting it up. And this podcast does not insinuate a patient-provider relationship. And so saying all of that, Nicole, the American Heart Association has released some new guidelines about the diagnosis of hypertension, when we should start treating it, what that looks like for patients. And then I know you and I have some pretty specific information that I know I talk about with patients and you do too, about how to check their blood pressure, the correct way to do that, and then what it looks like when they're trying to keep track of what high blood pressure truly is. Because I know a lot of patients use, you know, like smartwatches, wrist cuffs, they're not used correctly. They don't know when to check it, what's high, what's not, things like that. So what does what do what are the new guidelines? Kind of let's start there.

What High Blood Pressure Does To Vessels

SPEAKER_01 1:34

So blood pressure. So start with that. Blood pressure is exactly what it says. It's the pressure of blood inside your vessels, inside your arteries and your veins, right? Mostly inside your arteries, because arteries pump blood away, veins bring blood back up. But to keep it simple, blood pressure is the pressure of blood through your vessels. So when you have high blood pressure, your vessels think of the strength of a fire hose through a garden hose. So your vessels are like, you know, pulsing, right? And eventually that garden hose will spring a leak. And that's where strokes come from that are driven by high blood pressure, because the most delicate vessels in our in our body are in the brain. So after so much time, your that garden hose, that vessel is gonna spring a leak. That's that's nobody's immune from that, right? And so to keep your blood pressure down, to keep the walls of your vessels nice and healthy, keeping blood pressure down and normal is essential for a long life. It just is. When you spring a leak in the brain and with high with high with uncontrolled hypertension, it's almost certain you will at some point. The stroke, there's two types of strokes. There's where you can have a clot or you can have a brain bleed, which is from hypertension frequently. And what happens is sometimes it can cause death, that stroke, sometimes it can cause you to be paralyzed on one side of your body. You can be a vegetable, you can lose your ability to speak. It really is like throwing the dice. So not knowing your blood pressure is dangerous. And also because you if you don't know, you don't know. And number two, not getting medical help or you know, getting some kind of oversight to make sure that it's within a normal range can lead to a stroke. And that is not something that is to be taken lightly. So the guidelines, the American Heart Association has changed it, has changed the guidelines. And so we're going to talk a little bit about that today.

SPEAKER_00 4:08

And there's some things that I think are also important when we talk about blood pressure. So, like Nicole was saying, you know, if you think about, you know, a fire hose or a garden hose, think about the wall of that hose as your vessel. So there's a lot of things that can cause high blood pressure, not just the amount of stuff inside the hose, but sometimes it's the stiffness of the hose itself. I mean, sometimes that can be genetic, right? Like sometimes you're just born with stiff walled vessels, and there may or may not be a whole lot you can do from a nutrition and lifestyle standpoint to correct that. You can do a lot of things, but oftentimes you do have to use whether it's supplements or medications or other things to lower your blood pressure because genetically you were born with stiff walled vessels, and that can increase your risk for developing high blood pressure later in life. And so oftentimes it's a matter of, you know, everybody's body is different. God made us differently. Thank, thank, thank the Lord. And so you can sometimes be predisposed to having high blood pressure because if you think about all the different types of hoses, some of the walls are thicker than others. And so oftentimes you have to consider all the different reasons why you may have high blood pressure.

Genetics, Stiff Arteries, And Risk

SPEAKER_01 5:19

Absolutely, absolutely. And, you know, just to be clear, there are no nerve endings on the inside of our vessels. So this is silent. You don't usually get a warning until it's a headache because your vessels are literally pushing on other parts of your brain, causing a headache. If you have a headache from hypertension, that is a medical emergency. That is a 911 emergency past urgent care, past primary care, it is emergent. When you have a headache, it is beyond beyond in the vessels. It is now pressing on the other sides, the outside things that are your brain, right? And so when there, your vessels are open. If you have a headache, that is bad news bears. That is time to seek emergency medical care. So it is hypertension is the leading modifiable risk factor. It contributes to heart disease, stroke, kidney disease, dementia, and overall mortality. So the goal for most adults is to keep it less than 130 over 80. So in the 120s, even in the 110s, but it is the silent killer. It is this the silent killer.

Warning Signs And When To Call 911

SPEAKER_00 6:35

And understanding also that controlling your blood pressure isn't something that sometimes you can do on your own. Once you are diagnosed with high blood pressure, or once your blood pressure starts to become an issue, that can oftentimes be a team-based job. Like that's something that it takes a team to do. You know, it takes a village to raise a child, it takes a team to control hypertension when it gets to this point. Because it involves a lot of aspects, like we talked about, it may be your vessels, it may be your diet, it may be exercise induced, it may be because there's damage, what we call end organ damage, which is damage to the organs that your vessels are feeding. It's kind of like spraying against a brick wall. There's a lot of pressure there because there's a wall there. And so sometimes it's if there's damage at the end of that vessel where the blood is traveling, it can cause there to be pressure buildup behind it. And so there's a lot of factors that go in. And so it's not, it's not something you have to tackle by yourself. Please know that your healthcare team is here for you. Nicole and I are here for you. But it is a team-based care. And so there's a lot of things that we can do to help you do that, whether it's, you know, lifestyle or medications or exercise, nutrition, et cetera. Just know that this isn't something that you have to tackle by yourself.

Targets, Lifestyle, And Meds Thresholds

SPEAKER_01 7:48

Absolutely. And, you know, lifestyle, when your pressure is between 130 and like in the 130s for those, for the for the top number, maintaining a healthy weight, following a good diet, reducing your sodium. Sodium increases blood pressure, exercise, manage stress, limit alcohol, all of those things rise that pressure. Smoking rises that pressure. And if you can take care of that, you maybe don't have to start medication. But once you start getting over 130, we're really looking at consistently, we're looking at starting a medication. You're you're gonna have to take a medication. I mean, if you can't get it down within three to six months of lifestyle changes in that, you know, 130 range, medication has got to be started. And if you're over 140 for that systolic number, two medications usually need to be started. So severe hypertension is uh over 170 is where I say you need help. Over 180, you really need help. But you know, over 180, you got to go to the ER. Over 170, you need to go. You need to go as well. But you know, sustained. You always want to take it and then take it again to make sure that it's that it's high. You might, you know, sometimes you get a fluke. When you go to the grocery store, you go to CBS or Walgreens, sit down, put your arm in the machine, take a photograph of your blood pressure number. Take it at random times. Don't always take it at night when you're settled down and you're watching TV and you're relaxed. Take it in the middle of the day when things are crazy, when you run into the store for something, sit down. Takes one minute, and then just snap a picture of it so you can see a trend of kind of where you're at with your blood pressure. Knowing is a great start. And, you know, especially, you know, even in your 20s, even in your 20s, if you're if you have whether you have a family history or not, start learning what your blood pressure is. It this is not rocket science, this is not mumbo jumbo, that you know, you just don't, it's not easy to understand. Treatment is left to us. Leave that to us. But if it's consistently in the 130s or higher, you need to reach out. You need to reach out and get some help because, you know, it's it's not gonna take care of itself. Something has to change.

How To Measure BP Correctly At Home

SPEAKER_00 10:13

And let's talk about blood pressure cuffs for a minute. You were talking about going and getting it checked. So those cuffs are uh calibrated and they are measured appropriately. It will, it will determine, you know, the size of your arm whenever you go in and squeeze appropriately. However, if you're checking your blood pressure at home, guys, I want you to be really, really sure that what you're using is calibrated for your arm. And what that means is that's not a wrist cuff. A wrist cuff can often read lower than what is normal, especially if you're not using it correctly. That's not using your smartwatch or Apple Watch, garment, whatever instrument you have around your wrist that's not using that. We want you to use a calibrated arm cuff that is correct for the size of your arm. So, what that means is that you measure your bicep. You measure around your bicep at that largest point where that cuff is going to go. And it will tell you in inches, which you can translate to centimeters, what that size, that circumference is. And then look on the cuff and make sure that your arm fits into the range that's listed on that cuff. It's very simple. You you measure your bicep, look at the cuff, make sure your size falls into range. Because if it's too small, if the cuff is too small, your blood pressure reading is inadequately high. If your blood pressure cuff is too big, it'll make your readings inadequately low. So you got to be sure that your cuff size is appropriate. And then checking your blood pressure at different times of the day. Don't do it at the same time every single day. Do, you know, sometime in the morning, sometimes in the afternoon, evening here, there, random times. And if for some reason you get a really high reading that's not normal for you, go ahead and write it down. We still want to see that, but maybe jot off to the side and why you think it was high, like I had extra cups of coffee that day, or I had a fight with my spouse that day, or I wrecked my car, or you know, some whatever happened that day, just jot it down so we know how your body reacts to stress. That's good information for us too. And it helps us get you through that moment when we decide if we're going to start treating blood pressure, we know how your body reacts to stress because we've seen what it does when you have those moments. So go ahead and write those down too. Those are all very important things. Just know that if you are having those times of stress and your blood pressure, like Nicole says, does hit that 180, 190, you're getting that systolic, that top number is getting high and you have symptoms and it's not coming down, guys. That's a trip to the ED every time.

Tracking Readings And Interpreting Spikes

SPEAKER_01 12:28

Absolutely. Absolutely. So if you feel like you could benefit from some further education, or you want us to take a look at your numbers, or you just want to just chat about your blood pressure, your family history, even, please let us know. Go to HamiltonTelehealth.com. You can click on get see now, chat now, and we will get started. I mean, we want to make sure that you live a long life, a healthy life. And we don't always want to start medications and a one-off high blood pressure isn't a reason to, but consistent ones are. And, you know, we can even talk about what your lifestyle is like and and your family history to figure out your risk factor, you know, and those are things that you know we can we can certainly help you with. So you can connect with with Kelly and I, both of us at hamletontelehealth.com. We'll be happy to see you, happy to give you a call. Please measure your blood pressure, whether you see us or you see somebody else or or whatever. Please just know that it is so important. And just because you don't have symptoms doesn't mean it's not high. There's no nerve endings on the inside of our vessels. Often when you have symptoms, it's it's a ticking time bomb. So please see someone. Doesn't have to be us. See someone if you feel like you have high blood pressure or you need further help understanding. We are more than happy to do that.

SPEAKER_00 13:55

All right, guys. If you have any questions, please let us know. You can comment below in the comments. Otherwise, please like, subscribe, follow, share with your friends and family. And we're always here to help you. You guys have a wonderful rest of your week, and we'll talk next time. Bye.