Communications: Patient Education

Patient Education: Focus on Blood Pressure Before It Gets Too High

Monday, March 15, 2004  
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Minnesota family physicians say taking steps to control your blood pressure now could keep many patients from suffering the consequences of full-blown hypertension (high blood pressure) later.

"The impact of mildly elevated blood pressure has been at times underappreciated,” said Amy Bonifas, a Brooklyn Center family physician and member of the Minnesota Academy of Family Physicians. "Physicians are learning more and more every year about how important it is to recognize and treat hypertension in the very early stages.”

New blood pressure guidelines established last spring by the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure now place an estimated 45 million Americans into a prehypertension category. This is defined as anyone whose systolic blood pressure (top number) is between 120-139 mm Hg and diastolic pressure (bottom number) is 80-89 mm Hg. Prior to these new guidelines, a blood pressure in that range was considered normal. A blood pressure of 140/90 or higher was, and is still, considered high.

"We now have a way to classify those people who will likely develop hypertension if they don’t do something about it. By taking these patients out of the normal blood pressure range, we can make a better case for getting them to make some lifestyle changes to prevent hypertension,” Dr. Bonifas said.

Many people underestimate the consequences of high blood pressure, but family physicians stress that hypertension is a dangerous condition if left untreated. The higher the blood pressure, the greater the risk of heart attack, stroke or kidney disease. Mildly elevated blood pressure generally has few or no symptoms, but over time damages blood vessels of the brain, heart and kidneys.

People who fall into the new prehypertension category probably don’t need medication, unless it is required by another condition like diabetes, but those in the prehypertension range should take steps to manage their blood pressure before it gets any higher. These steps include maintaining a healthy weight, getting regular exercise, eating a diet rich in fruits, vegetables and low-fat dairy products, decreasing your intake of salt, saturated fat and total fat, avoiding tobacco and limiting the amount of alcohol you drink. All of these measures can have beneficial effects on blood pressure.

The new guidelines also say that not only is it important to have a low bottom number, but it is even more important to have a low top number. In fact, the recommendations suggest physicians treat all patients over the age of 50 who have high systolic pressure, no matter what the diastolic blood pressure is.

"If you have a concern about your blood pressure, be sure to talk to your family physician. They can help you sort out what all the numbers mean and what steps you need to take to keep your blood pressure under control,” Dr. Bonifas said.

The Minnesota Academy of Family Physicians is a professional association of approximately 3,000 family physicians, family medicine residents and medical students organized to assist family physicians in providing quality medical care in Minnesota. The MAFP is the largest medical specialty organization in Minnesota and is a state chapter of the American Academy of Family Physicians, one of the largest national medical organizations in the United States with more than 103,000 members.

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