High Blood Pressure: How to Stop the Silent Killer

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High blood pressure is a serious health concern, especially for African Americans. More than 40 percent of African Americans have high blood pressure―and because of this, are more likely to have a heart attack or stroke, or suffer kidney failure.


Untreated high blood pressure can lead to health problems that can prevent you from living a long, healthy life. No one knows exactly why African-Americans have such a high rate of high blood pressure, but some experts believe that diet, higher stress levels and genetics, among other factors, all play a role.


High blood pressure is more severe and occurs earlier in life among African Americans, so it’s important to be aware of your risks. It is often called a “silent killer” because many people with high blood pressure have no symptoms. The good news is that you can take steps to prevent, detect and treat high blood pressure. By doing a few simple things, you can make sure you stay healthy.


Simple Steps to Prevent and Manage High Blood Pressure
1. Starting at age 18, have your blood pressure checked at least once a year by a healthcare professional. If you’re uninsured, check your local health department or pharmacy as many offer free blood pressure screenings.
2. Eat a diet with less salt. Click here to learn more about low salt options.
3. Try to exercise more. Start small if you do not regularly exercise, like going for a 20 minute walk every day. Small amounts of exercise will make a big difference.
4. If you are overweight, try to lose a few pounds. Even a 5-10 pound weight loss can lower your blood pressure.
5. If you are found to have high blood pressure, partner with your doctor and healthcare team to control it. The treatment usually means changing your diet, regular exercise, taking medications regularly, limiting alcohol, and having routine blood tests.


Facts about Proper Blood Pressure Checks and Inaccurate Readings
It is important that your healthcare professional takes your blood pressure properly before he or she diagnoses or treats you. Unfortunately, some physicians and their staff do not consistently follow all the recommended steps in measuring blood pressure, perhaps due to time pressures or lack of proper equipment. The American Medical Group Foundation's Measure Up/Pressure Down campaign is providing tools and training for healthcare teams to learn how to take the best blood pressure readings. Visit www.measureuppressuredown.com to learn more and see if your medical group is participating.


You can be an active partner in your healthcare and your blood pressure by making sure all the following steps are followed:


1. The blood pressure cuff should be on the bare skin of your arm, not wrapped around your clothing. So be prepared when visiting your healthcare team by wearing a short sleeved or loose-fitting shirt.
2. The size of the cuff is very important. If you are very thin, a smaller cuff is needed, and if your arm is larger, then the larger cuff is required. A cuff too narrow or too wide for your arm will throw off the readings.
3. You need to be seated in a chair with back support, with your feet firmly on the ground.
4. You should not have consumed alcohol within the past 3 hours.
5. You should not be talking or eating during the blood pressure measurement.
6. Most importantly, wait at least five minutes after your arrival into the exam room before having your blood pressure taken. This will allow you time to relax a little and will prevent what is called "white coat syndrome."


What Is “White Coat Syndrome?”
White coat syndrome occurs when a person's blood pressure readings in the office are higher than the usual readings outside the office ― at home, for example. This could lead to too many medications being prescribed because the person's true blood pressure is not really elevated. It is important to know, however, that there are only a small number of patients who have this white coat syndrome, and the vast majorities of those with high blood pressure measured in the doctor’s office are at higher risk for heart attacks or stroke if not treated.


If you and your healthcare professional suspect you may have white coat syndrome, there are some steps you should take. First, make sure that several blood pressure readings are done in the office, at least two each visit with one done near the end of the visit. You should buy a home blood pressure monitor and check your blood pressure two to three times a day for a few weeks to see what your blood pressure is in your "natural" environment. Make sure to keep a log and bring it to your next office visit. Another option is to visit your local pharmacy since many now offer free blood pressure screenings. Make sure to have your home blood pressure device checked for accuracy at your doctor's office.


Follow Your Treatment Plan
Less than half of all patients with high blood pressure have it under control. One reason is that many patients stop taking their medications when they start to feel better. It’s important that you continue to take your medication as prescribed, even if your blood pressure appears normal. If you’re worried about costs of medication, there are programs that can help pay for prescription drugs including the Partnership for Prescription Assistance.


For resources including brochures and fact sheets on how to prevent and manage high blood pressure, visit MeasureUpPressureDown.com.


About the Author
Jerry Penso, M.D., M.B.A., is Chief Medical and Quality Officer at the American Medical Group Association (AMGA). AMGA represents some of the nation's largest, most prestigious medical practices, independent practice associations, accountable care organizations, and integrated healthcare delivery systems. AMGA's mission is to support its members in enhancing population health and care for patients through integrated systems of care. More than 130,000 physicians practice in AMGA member organizations, providing healthcare services for 120 million patients (approximately one in three Americans). The American Medical Group Foundation (AMGF), the nonprofit arm of the AMGA, launched Measure Up/Pressure Down, a three-year national campaign to improve care and reduce the burden of high blood pressure, on November 29, 2012. Measure Up/Pressure Down includes more than 140 medical groups, health systems and national partners such as the U.S. Department of Health and Human Services. The goal of the three-year campaign is to have 80 percent of high blood pressure patients in control of their condition by 2016

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