- Hey guys, what's going on?
I wanna take the time out and talk about
a specific medical topic that's been making headlines
all across the news this week.
- Who should be diagnosed with high blood pressure?
- [Announcer] Blood pressure.
- Half of all adults.
- [Announcer 2] Redefining the danger zone.
- Plus it's a medical issue
that effects one in three individuals,
at least here in the States.
That topic is, hypertension.
Before we start talking about what hypertension is,
let's talk a little basic anatomy.
The human body has a human heart,
the human heart has two ventricles.
The left ventricle is the strongest ventricle
and that part of the heart squeezes
and pumps blood to the rest of the body.
It does so through blood vessels called arteries.
Arteries take blood and allow it
to travel away from the heart.
The way we memorize that in medical school is
A away from the heart, A for artery.
When you measure blood pressure
all you're doing is your measuring the pressure
that's on the arterial walls.
And there are really three major factors
that play a role in this pressure.
Number one is cardiac output which is
how much blood your heart pumps out with each beat,
number two is blood volume, and number three is
that resistance your heart has to pump against.
Normally when you visit a doctors office
or a hospital and you have a health professional
measure your blood pressure you see them use a cuff.
That cuff has a name, it's called a sphygmomanometer.
That's a mouthful I understand
so we tend to use the term blood pressure cuff.
The way that the blood pressure cuff works is
by constricting the arteries within your arm
and while the doctor
or other health professional's listening
at the brachial artery you hear
that first sound of blood rushing through the artery
that's know as the systolic blood pressure
which is measured in mm of mercury.
And then when that sound disappears
that's known as the diastolic pressure.
Sometimes you see the numbers written as a fraction.
The top number's the systolic number
and the bottom number's the diastolic number.
The top number also known as the systolic blood pressure
is the pressure during maximal contraction of your heart,
and the diastolic or bottom number is
when your heart is completely relaxed.
While it sounds like taking a blood pressure
is a fairly simple process there's a lot
that can go wrong and there's a lot of room for error:
the blood pressure cuff is too small,
if the blood pressure cuff is used over clothing,
if the patient hasn't rested for at least five minutes,
if the arms, back, or feet are unsupported,
if the patient's in an emotional state,
if the patient is talking,
if the patient just had a cigarette,
if the patient just drank a cup of coffee
or had some alcohol, if the patient is cold,
if the patient has a full bladder
and really needs to use the bathroom.
All those things can throw off the blood pressure
and make it look like your patient has high blood pressure
when they really don't.
Because there are so many external factors
that influence a person's blood pressure
we don't give the diagnosis of hypertension
until we have two elevated readings
from two separate visits.
Let's do a little hypothetical here.
You, or even your family member,
is diagnosed with hypertension.
What does that mean?
What are you at risk for?
Doctors make a really big deal about hypertension
so let's talk about it.
Hypertension damages the blood vessels
throughout your entire body,
starting from your brain, to your eyes,
to your lungs, to your heart, to your kidneys,
and even to your penis, if you have a penis that is.
Normally I don't like to be the doctor
that's all doom and gloom but it's really important to say
that having hypertension significantly raises your risk
of having a heart attack, stroke,
heart disease, and kidney disease.
This is precisely why hypertension is know as
the silent killer because you don't have symptoms
until you already have some serious complications.
Having your blood pressure well controlled
decreases the risk of dying by 25%
and it lowers your risk of having a heart attack
and stroke by 30%.
Now, you wanna treat your hypertension
and you're not necessarily keen
on going the pharmacologic approach right away.
There are lifestyle changes you can make
in order to lower your blood pressure naturally.
In fact, 90% of hypertension is caused by poor diet,
lack of exercise, and other bad habits.
So if you're not exercising you should be doing
moderate intensity exercise for 30 minutes
on most days of the week.
Next comes diet, probably the most important thing
that you can do to alter your blood pressure.
The DASH diet, which is a specific diet
which I'll link down below is one that's been proven
to lower your blood pressure by 11 points,
one of the highest successes we've seen for a diet.
The two bad habits that have been proven
to elevate your blood pressure
is heavy alcohol consumption and smoking.
When we say heavy alcohol consumption
what we mean is more than two drinks per day,
per week for a man, and more than one drink per day,
per week for a woman.
When we speak about smoking we're actually talking
about smoking in any amount.
So do not be a smoker and do not be a heavy drinker
if you don't want your blood pressure elevated.
Now these lifestyle modifications
to lower your blood pressure work exceptionally well
to prevent you from getting hypertension in the first place.
So I always like to think in terms of prevention
rather than cures so follow these habits,
live a healthy lifestyle,
and don't develop high blood pressure.
Now let's get into the numbers of the matter
and talk about some of these new guidelines
that are making a splash in the headlines across the news.
Before we had these cutoffs where we diagnosed people
with either having normal blood pressure, pre-hypertension,
or what we called stage one hypertension, or stage two.
And now those cutoffs have completely changed.
Now a normal blood pressure is less than 120 over 80,
and an elevated blood pressure is 120-129 over 80.
And at that point we should
recommend healthy lifestyle changes
and check it every three to six months.
Stage one high blood pressure is now 130-139 over 80-89
which used to fall into the pre-hypertension range.
That's the major change within these new guidelines.
Basically what we do is we plug in some
of your statistics into a calculator
and what it does is it spits out a risk or percentage
of you having a heart attack or stroke
within the next 10 years.
If you have less than 10% risk we have
to stress the lifestyle changes
and again reassess in three to six months.
Now if your blood pressure is over 140 over 90
that's considered stage two high blood pressure.
At this point we can start
to consider a pharmacologic approach
in addition to lifestyle changes
in order to get your blood pressure to the normal values.
Now, under these new guidelines,
approximately 30 million more people
in the Unites States will be defined as having hypertension.
And while that sounds like a dream
for pharmaceutical companies it's not a party
for them just yet.
The reason being is that these 30 million people
will be defined as having hypertension
but only about four million out
of those 30 million people will
actually need pharmaceuticals
to keep their blood pressure in check.
There are a few things these guidelines do really well.
The best research done in the last two decades proves
that controlling blood pressure to a tighter limit
of 120 over 80 actually yields better results,
it allows people to live longer
and avoid heart attacks and strokes.
Number two there's a strong emphasis placed
on measuring blood pressure in the correct manner.
And number three they put a great deal
of focus on lifestyle changes.
This is something I preach everywhere I go
and with every patient I meet.
It's much better to prevent this problem than
to take a pill once it's already there.
In the medical community we know
we don't treat hypertension well.
There's a couple of reasons for that.
Number one, patients don't often come in for screenings
unless there's already a problem
and we don't catch hypertension when we should.
And number two is when we actually do catch hypertension
and we've tried lifestyle factors
and they haven't worked, we prescribe a medicine,
and often times patients are reluctant
to take their medicines.
Here's the thing.
If a doctor recommends a medication,
I'm not saying you have to take it.
What I'm saying is if you tell your doctor your
gonna take it, take it,
because if you don't you're ultimately
putting yourself at risk.
Some people decide to not take a medicine
because of it's side effects.
There are alternatives.
Your not stuck to taking one medication
or these two medications.
There are definitely options and you should always talk
about your worries with your doctor
because the last thing that we want as doctors is for you
to have a problem and not have it treated simply
because of a miscommunication.
High blood pressure is a complex topic
and it has major implications for your health.
I hope this video was able to demystify a little bit
of what the illness is and steps
that you can do to not only prevent it
but to treat it in case you already have it.
I know I didn't cover everything there is
to know about hypertension within this video
so if you have some remaining unanswered questions
leave them down below in the comments so I can respond.
Also if you enjoy this format please let me know
because I wanna continue making content
that you guys enjoy.
As always, stay healthy and happy, see ya next Sunday.
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Why can't I say blood pressure, brood pressure.
Blah, blood pressure.
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It's called a sphygmamometer,
a sphygmoma, a sphygmomanometer.
That's the right word, see.
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Can these sirens stop today, like I just don't understand.
Is there an emergency everywhere on 42nd Street?
Just leave guys, come on.
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High blood pressure.
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But only about 4 million out of those 30 million will
actually need pharmaceuticals
to keep their blood pressure under check.
Under check?
(laughs) Let's do that again.
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(upbeat music)