I have hypertension, I don’t eat salt, but now my doctor wants me to eat salt because my iodine levels are low. Isn’t that backward?
Salt provides only a fraction of daily iodine intake for most people. Iodine comes from many other foods and supplements. Talk with your doctor about this. Also visit our new dedicated website, LowerYourHBP.org, with resources to help you understand your blood pressure numbers, access healthy lifestyle resources and prepare to discuss blood pressure with your doctor.
Medications for high BP tends to make the patients face swell… what are those meds? My wife won’t take her meds because of it.
Some medication classes, “Calcium Channel Blockers” and “ACE Inhibitors” are two classes of medications can do this. If facial swelling occurs, call your doctor. They are many alternatives that shouldn’t do that.
What would be the best blood pressure home meter?
We don’t endorse any one brand or model, however, we do recommend using only upper arm devices that are automated, clinically validated, and have memory storage. Talk to your pharmacist or doctor if you have questions. Most BP monitors in the U.S. are sold in pharmacies so they can make sure the device is the right size and is clinically validated.
What are the long-term side effects from the medication?
Most blood pressure medications are safe and the long-term effects are preventing heart attacks, strokes, kidney disease, and heart failure. For most, the health benefits greatly outweigh the side effects that some people can have. Some people have allergies to specific medications, and some can develop swelling in the lips, face, or legs. Most medications, however, are extremely well tolerated. Talk to your doctor if you are concerned
I did not hear WHY the ratings changed for high blood pressure. Can he explain that better?
Blood pressure risk starts to rise at blood pressures between 110-115 / 75-80 and double every 20/10 mm Hg above that, but under the previous guideline, high blood pressure wasn’t diagnosed until BP reached 140/90. The threshold was changed to 130/80 based on new evidence as well as the idea that recognizing high BP earlier and initiating lifestyle changes for most people will have benefits (even if medication is not started until 140/90 in low-risk people).
So to summarize – the reasons are: to diagnose high BP earlier, in order to get more people treated and thereby lower their risk of suffering consequences of high BP (heart attacks and strokes and heart failure) by starting treatment sooner, mostly lifestyle changes that we discussed in the interview, and sometimes medication at this new lower level.
What about red wine? Can it lower high blood pressure?
Alcohol should not be started as a treatment for someone who doesn’t drink. Although there may be some health benefits of drinking a glass of wine a day (or other alcohol) in people who drink, it is not recommended as a treatment for high blood pressure. More than a drink a day in women can worsen high blood pressure, and more than two drinks a day in men can worsen high blood pressure. A drink is considered a glass of wine, a beer, or a shot of hard alcohol.
Doctor, does sleep apnea affect blood pressure? Is a sleep study recommended?
Yes. Sleep apnea is a common contributor to high blood pressure and anyone suspected of having sleep apnea should have a sleep study.
Lately, when monitoring my BP it’s been high. Could it be related to the dental problem I’m having? My appointment with the dentist is next week.
Yes. Good dental hygiene is very important, and pain, in particular, can increase blood pressure, as well as worrying about a health problem. I should caution you that you should follow up when the dental problem is cleared up to make sure that you haven’t developed high blood pressure that is unrelated to your dental problem and you need additional treatment. So make sure you follow up and have your blood pressure checked when the dental problem is resolved.
What do you do if you’re maintaining a healthy lifestyle but your numbers are still high? They fluctuate, one day low, the next day high and your on several different medications what do you do?
This is where it is important to work with your doctor to make a plan. There are ways to self-monitor your blood pressure at home, and if you are already doing that you might be a good candidate for a 24-hour ambulatory BP monitoring test that will track your BP every 15-20 minutes for 24 hours, including sleep. Your doctor can talk to you about this test.
Does vinegar lower blood pressure?
There are no scientific studies that have shown that vinegar is an effective way to lower your blood pressure, although it is a commonly used home remedy. Make sure your doctor knows that this is part of your plan, and don’t stop your medication if you are on it unless you are told to do so by your doctor.
Will you please provide a perspective on the connection between antiseptic mouthwash and HBP plus diabetes?
A recent article did raise the question about using mouthwash twice a day – participants in the study using mouthwash twice daily were twice as likely to develop diabetes than those who didn’t. And the risk only occurred if the mouthwash was used twice daily or more. However, these people were at high risk for developing diabetes already. Between 70% and 80% of people with diabetes do have high blood pressure, so if diabetes developed in these people, they may also have high blood pressure.
But in this case, it would be diabetes having an association with high blood pressure, not mouthwash causing high blood pressure directly. There are some preliminary studies questioning a link between mouthwash impacting bacteria in the body which could raise high blood pressure. It is too early to say for sure, but we cannot say it isn’t a factor either. More studies need to be done.
Regarding blood pressure, the doctors here in Milwaukee have said when people get over 65 the top number should be between 130 to 150. My mom has been on medication for over 50 years and now her kidneys are declining.She’s 81. Is this true?
With declining kidney function, this can be more complicated than a simple guideline recommendation. Although the AHA/ACC Guideline for High Blood Pressure recommends a treatment target for people with kidney disease and people over age 50 to be <130/80, this varies depending on what type of kidney disease and the severity.
So it is very important that her doctor manages her blood pressure based on her individual situation. Clinical judgment by a doctor is more important for each individual than a blanket guideline statement for the entire population. As doctors, we have to treat everyone individually.
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