Hi. I'm Dr. Leslie Thomas,
a nephrologist at Mayo Clinic.
And I'm here to answer some of
the important questions you might
have about hypertension.
What is the best way to measure my blood pressure at home?
Measuring your blood pressure at home
is a straightforward process.
Many people have
a slightly higher blood pressure
in one arm versus the other.
So it's important to measure
the blood pressures in the arm
with the higher readings.
It's best to avoid caffeine, exercise
and, if you smoke, smoking
for at least 30 minutes.
To prepare for the measurement,
you should be relaxed
with your feet on the floor
and legs uncrossed,
and your back supported
for at least five minutes.
Your arms should be supported
on a flat surface.
After resting for five minutes,
at least two readings are taken
one minute apart in the morning
prior to medications
and in the evening
before the evening meal.
Your blood pressure monitor
should be checked for
proper calibration every year.
What could be causing my blood pressure to be quite erratic?
This pattern of abrupt changes in
blood pressure from normal to quite high
is sometimes referred to
as labile blood pressure.
For those who develop labile blood pressure,
heart problems, hormonal problems,
neurological problems,
or even psychological conditions
might be present.
Finding and treating
the underlying cause
of labile blood pressure can
significantly improve the condition.
Should I restrict salt to reduce my blood pressure?
It's important to note that some people with
high blood pressure already consume a diet
significantly restricted in sodium.
And those people further
restriction of dietary sodium would
not necessarily be helpful
or even recommended.
In many people, dietary sodium intake
is though relatively high.
Therefore,
an effective target to consider for
those people is
less than 1500 milligrams per day.
Many though, will benefit from a target
of less than a 1000 milligrams per day.
Following dietary sodium restriction,
it may take some time,
even weeks,
for the blood pressure to improve and
stabilize at a lower range.
So it is critically important to
both be consistent with
decreased sodium intake and
patient when assessing for improvement.
How can I lower my blood pressure without medication?
This is a very common question.
A lot of people want to
avoid medication if they can,
when trying to reduce their blood pressure.
A few ways have been shown
scientifically to reduce blood pressure.
The first, and perhaps most important,
is to stay physically active.
Losing weight also can be
important in a lot of different people.
Limiting alcohol, reducing sodium intake,
and increasing dietary
potassium intake can all help.
What is the best medication to take for hypertension?
There's not one best medication
for the treatment of
hypertension for everyone.
Because an individual's historical
and present medical conditions
must be considered.
Additionally, every person
has a unique physiology.
Assessing how certain physiological forces
may be present to contribute to the
hypertension in an individual
allows for a rational approach
to medication choice.
Antihypertensive medications
are grouped by class.
Each class of medication
differs from the other classes by the way
it lowers blood pressure.
For instance, diuretics, no matter the type,
act to reduce the body's
total content of salt and water.
This leads to reduction
in plasma volume within
the blood vessels and consequently
a lower blood pressure.
Calcium channel blockers reduce
the relative constriction of blood vessels.
This reduced vasoconstriction also
promotes a lower blood pressure.
Other classes of antihypertensive
medication act in their own ways.
Considering your health conditions,
physiology,
and how each medication works,
your doctor can advise
the safest and most
effective medication for you.
Are certain blood pressure medications harmful to my kidneys?
Following the correction of blood pressure or
the institution of certain
blood pressure medications,
it's pretty common to see changes in
the markers for kidney function
on blood tests.
However, small changes in these markers,
which reflects small changes
in kidney filtration performance
shouldn't necessarily be interpreted
as absolute evidence of kidney harm.
Your doctor can interpret changes in
laboratory tests following
any change in medication.
How can I be the best partner to my medical team?
Keep an open dialogue with your medical team
about your goals and personal preferences.
Communication, trust and collaboration are
key to long-term success
managing your blood pressure.
Never hesitate to ask
your medical team any questions
or concerns you have.
Being informed makes all the difference.
Thanks for your time and we wish you well.