In the past, high blood pressure was defined as measuring 140 over 90 or higher for systolic/diastolic readings. Late in 2017, the American Heart Association adjusted guidelines for high blood pressure to 130 over 80 or higher. This was the first change in 14 years and is reflective of the complications and damage that can occur at even these lower numbers. Health risks for heart attack, stroke, and other serious consequences begin with readings anywhere above 120 mm Hg systolic pressure. Risks for these incidents double when systolic pressure is above 130!
Before the new guideline, 1 in 3 U.S. adults had high blood pressure (hypertension), and now almost half of the adult population qualify as having hypertension. Because the guidelines have been lowered, additional importance has been placed on acquiring accurate readings. As a healthcare professional, you have been monitoring blood pressure on patients for most of your adult life. But with these tighter guidelines, it is important to recognize things that can inflate a reading.
- Slouching with an unsupported back or feet
- Patient has a full bladder, take the time to ask
- Sitting with crossed legs
- The patient is talking or moving around while being measured
- The arm being measured is unsupported and not level with the heart
- The cuff is wrapped over clothing
Even with the adjusted threshold, the AHA is not anticipating a large increase in the numbers of people who will be prescribed medications for their blood pressure. Patients who are now in the lower zone of blood pressure readings will be advised to make the appropriate lifestyle changes to achieve healthier pressure. Let’s review some of the recommended lifestyle changes that you can discuss with your patients to improve blood pressure measurements.
- Weight loss. To put this in the simplest terms, for every 2 pounds lost, your patient can expect to drop their systolic pressure number by 1 mm Hg.
- Increase activity. Encourage your patient to move more until they are achieving between 90 to 150 minutes per week with some type of physical activity.
- Better diet. For starters, highlight the importance of cutting down on salt and saturated fats. Ask them to add more fruits and vegetables to their diet, whole grains, and low-fat dairy. Also, discuss the benefits of foods that are higher in potassium, like bananas, potatoes, dark leafy vegetables, and avocados (who doesn’t like Guacamole!)
- Limit alcohol. For your female patients, tell them to limit alcohol to one drink or fewer per day, while men should be limited to two drinks or less per day.
The above is good advice for all of us. Especially, for those who work in more stressful care settings. Hypertension, the “silent killer” is a danger that is not to be ignored and by following the advice that we are giving to our patients we can minimize the risks.
Tell us about your strategies for discussing lifestyle changes with patients in the comment section below. You can also join the discussion on our Facebook page.