By Dr. Christian Avalos
DHR Health Heart Institute
In the United States, the lifetime risk of developing hypertension is very high, thus making it the most common reason for office visits. Ideally, we 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, potentially leading to falls. When blood pressure is consistently above 130/80, this is classified as at least 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 other studies are 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–including diet and exercise–are highly encouraged. One of the key necessities 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 see a more profound lowering of blood pressure with a salt-restricted diet.
When 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 be needed to evaluate secondary causes, such as sleep apnea, endocrine disorders, or renal artery stenosis.
If left ignored, hypertension can be a silent condition with long-term detrimental effects, including heart failure, heart attacks, and strokes. Therefore, it is vital to implement effective preventative measures by closely following up with your physician.
If you have questions regarding your heart health or would like to speak to one of our experts, please contact the DHR Health Heart Institute at (956) 362-8340 to schedule an appointment.