In the United States, the lifetime risk of developing hypertension is very high thus making it one of the most common reasons for office visits. Ideally, we should aim for a blood pressure of less than 120/80 mmHg, but we often allow more flexibility in older patients who are at risk of excessive lowering of blood pressure, which could potentially lead to falls. When the blood pressure is consistently above 130/80 mmHg, this is classified as stage 1 hypertension and medical therapy is usually started using a variety of available medications.
Before diagnosing hypertension, we make sure to exclude white coat hypertension which occurs when blood pressure at home is normal but elevated in the physician’s office. Home blood pressure checks are essential in establishing this diagnosis, but there are other studies available such as ambulatory blood pressure monitoring. This study can last up to 24 hours to assess for nocturnal hypertension, which has an increased risk of cardiovascular disease and heart failure.
Before starting medications, lifestyle modifications such as diet and exercise are highly encouraged. One of the key things is tracking daily sodium intake. Even a 1000 mg reduction in current daily sodium intake has a significant effect on blood pressure control. Studies have even shown that as we age, we have a more profound lowering of blood pressure with a salt-restricted diet.
When the blood pressure remains difficult to control despite multiple medications, we explore different causes such as medication side effects or excessive alcohol intake. Further studies may even be needed to evaluate secondary causes such as sleep apnea, endocrine disorders, or renal artery stenosis.
Hypertension can be a silent condition with long-term detrimental effects such as heart failure, heart attacks, and strokes if left untreated. Therefore, it is vital to implement effective preventative measures by closely following up with your physician.
Dr. Christian Avalos, DHR Health Cardiologist
4316 N. McColl Rd., McAllen, TX 78504
To schedule an appointment, call (956) 362-8810
To learn more about cardiology services at DHR Health, visit https://dhrhealth.com/services/cardiology/
