♪ Bob and Brad ♪
♪ The two most famous physical therapists ♪
♪ On the internet ♪
- Hi folks, Brad Heinie, physical therapist.
- I am Chris The Pharmacist.
- And today we're gonna talk about blood pressure.
How high is too high, possibly life-threatening,
and top three options to correct it safely.
But before we go any farther
we wanna talk about some platforms that were on-
- Yeah.
- And if you go to bobandbrad.com
we have a giveaway and we've got it right here.
We'll talk about it in just a little bit
but go to there, go to the giveaway section.
You can go to Facebook, go to the top of the page,
it'll get you to the giveaway.
And if you want a short version 60 seconds,
go to the Twitter, the Instagram and the TikTok platform,
and we're there,
if you cannot stand us for more than 60 seconds.
Now the giveaway is a sleep ovation mattress
and they have 700 tiny mattresses.
I love mine, It's changed my life
sleeping in the last two years.
They have a nice dual cover mattress
and again a 700 tiny mattresses,
which makes you feel so good.
But let's get on with blood pressure.
- All right, here we go.
- Any questions about the mattress, Chris
before we go on any further.
- Oh, it looks fantastic.
- I love it. We could lay on it later.
- All right. - Anyways,
let's get to this blood pressure,
'cause this is a serious topic.
I've dealt with a borderline of blood pressure myself
and been able to successfully treat it without medications,
but we need to know the big thing, blood pressure,
what is too high and what's not too high, but let's go back.
There's two numbers with blood pressure.
Let's kinda clarify this, systolic, diastolic?
- Systolic, diastolic, top and bottom,
so it kinda whatever way is easier for you to remember,
but basically the systolic is the first number
that we see up here, that 120 over 80,
that's a normal blood pressure,
but that one is when the heart beats.
So think of your heart as a pump,
as soon as it presses that pressure
that they feel in the vessels,
that's what that top number is measuring.
- So that's the big push.
- Yap, that's the big push there.
And then when the heart is relaxed
and it's filling back up with blood,
that's what the diastolic number is measuring.
So that's what that 80 is right there.
- We don't need to know this,
but it's in millimeters, that's a technical-
- Millimeters of mercury is how they recognize it.
- I always remember diastolic, D for down.
So that's the lower number.
- Yeah, that's an easy way to remember it
- But you really don't need to know that
but you do need to know the numbers
and where you're safe and where you need to be concerned,
and then of course the extreme.
- Absolutely, absolutely.
- So we've got the chart here.
Chris made this really nice chart.
Let's start out with the normal blood pressure
that is acceptable and you're safe.
- Yap, absolutely.
Everybody we'd like to see that 120 over 80.
I think that's just a reasonable standard number
that the American Heart Association,
American Cardiology Associates,
they all kind of recognize that.
And it can be lower, it can be a little bit higher.
And so as we progress through the whole chain here.
So that's where we want to strive for.
And when people are healthy, that's what we ceases.
- Now we're talking about high blood pressure
and sometimes it's called hypertension.
Is there any other terms you might hear?
- No, I think high blood pressure and hypertension
are used interchangeably.
So I think that most physicians and nurse practitioners
and PAs would probably say hypertension,
but for you and me, blood pressure, high blood pressure.
- Okay, so let's start out.
We've got normal and then these are actual classifications.
- Yep.
- Okay, that I recognized and the first one says elevated.
So that's, if you're just a little over normal.
- A little bit over normal. - But it's not dangerous yet.
- Not dangerous yet, but it's a sign of things to come.
So we do wanna make sure that we're paying attention.
When you go into your doctor's office
and all of a sudden these type of numbers pop up,
doctors will do a couple different things.
They're gonna measure it in a couple of different occasions.
They might measure both arms
just to kind of see what's going on
'cause there's a thing called lab coat syndrome
which suddenly-
- I just call it white coat- - White coat syndrome.
So basically when somebody walks in the room
and they're in a very formal looking doctor
and I say, "Oh my gosh he's gonna figure out
that something's wrong with me."
People do get tense and it does raise your blood pressure.
It's a known fact unfortunately.
- Sure, it's just a natural feeling.
- Yep, it's natural.
Everybody, a lot of us experienced that.
So it's just something,
so they wanna take a couple of different
and they'll even actually
maybe at the end of the appointment
they'll strap you up on a cuff again,
kind of catch off guard.
So you're more relaxed 'cause you've been talking
about some things and I'll say,
"Oh, look at that, it's normal."
So sometimes it's just due to the stress.
Maybe you walked up a couple flights of stairs
to get the office.
- Sure.
So anyways, can you read this well, Mike?
Okay.
Then we'll go to the stage one.
- Stage one.
- So that's another step in the wrong direction.
- Yep, another step in the wrong direction.
And you know I guess I didn't preps it in 2017,
they changed all these numbers.
- 2017?
- 2017.
- Three years ago.
- Yep, it used to be the old norm before stage one.
It used to be just 140 over 90.
It was like, "Okay, that's bad."
Well, they decided to add this designation,
this 130 over 39, over 80 to 89.
And that's stage one hypertension
or a stage one blood pressure.
And so it's kind of that first stage
that when your doctor gets a couple of measurements,
'cause they aren't gonna put you
on blood medication right away.
They're gonna look at it and observe it.
And they might have you come back in three or four weeks
and do it again and all of a sudden, oh it's still there.
So at this point, the doctor's in a lot of times
they probably would have had this discussion
about your lifestyle changes and things of that nature.
What can we do to affect this?
We'll move on to that.
- Okay, we'll talk about what you can do without,
so you can avoid medication.
- Yes, yes.
This group I think is a really good one to focus on
and then we're in that point.
And that's kind of the hallmark what most cardiologists
and physicians are gonna talk to the patients about.
- But you could come in maybe you have progressed
to stage two or maybe you came in before that
and all of a sudden you see these numbers 140 over 90.
Okay, so that things are starting
your eyes are open a little bit.
(indistinct) a doctor.
- Oh yeah, you got 24 million Americans
in this group right here.
- So what percentage is that?
- Probably right in that 30% range.
- Okay, are touching up into that?
- All adults
Yep, so it's something and this is definitely gonna require
mention, this is stage two.
So this is the one we're still gonna stress
lifestyle changes
but there's definitely gonna be medications added.
And they might even add medication
depending upon your circumstances, genetics,
cardiac risk factors.
So there's a lot of other things that go into this but-
- Individual factors.
- Yeah, for these as simplicity,
this is something that your doctor
will probably at one point,
you're gonna be on medication
to try and help to control that and keep you safe.
- Right, 'cause you might say,
"Well can I do this with diet and exercise?"
But you're saying maybe you can
but you're putting yourself at risk.
- Yeah, I mean, you're gonna have to one,
your doctor's gonna have to be on board
with your exercise plan and keep in mind
exercise can be something as simple as a 30 minute walk.
So I mean, that's enough if we're just,
you gotta raise your breath a little bit
and get that heart rate pumping.
And I think that's gonna do a nice job of helping
and it's exercise.
Diet are pillars of treating hypertension
at any one of these ranges.
So we have to make sure that when we're using that
and then your doctor is gonna be paramount,
he's like I've said before in other videos,
he's your quarterback.
So you're the team, he's the quarterback.
And basically you're gonna work together
to try and make sure that we can bring it back
towards this level.
- Right, right.
So let's say, 'cause a lot of people may be living at this.
- Don't even know it. - They don't even know it.
And if that goes on for a number of years,
that's actually causing problems with your arteries
which can lead into strokes, other-
- You name it, stroke, heart attack, vascular dementia,
kidney problems, organ failure, vision problems.
I mean, it's a big umbrella that hypertension
all of a sudden,
you hear hypertension and everything underneath
that umbrella kind of fills in.
So there's lots of other things that can happen.
- All these diagnosis is that?
- Correct, that you're associated with it.
- And so if you can correct that higher blood pressure early
that doesn't eliminate,
but reduces your risk for all these other problems
that can come down the road.
- Correct, and yeah, just to kind of put
that perspective.
I mean you get 3 million Americans each year
are getting diagnosed with high blood pressure
or hypertension.
So that's a lot of people.
- So that means they're at stage two.
Not necessarily, it could be one, two.
But they're gonna call it hypertension one and two.
So there's 3 million patients a year.
We lose 500,000 to hypertension.
- So you're saying 500 people-
- 500,000, half a million.
- Half a million people die every year worldwide
or in the United States?
- United States of America.
- So a half a million people die
as a result of hypertension or associated causes.
- Correct.
Yep, hypertension with associated causes.
- Okay, so that could be a stroke.
It could be vascular problems, heart attack.
- Exactly, exactly.
So it's all encompassing.
We have to be careful.
- So now we're getting to that part of the title,
life-threatening.
So we got it in red-
- Hypertensive crisis.
- Hey that's officially what they call it?
- Yup, that's the big word that they,
and it's nothing to sneeze at.
This is a big deal.
So if you are testing your blood pressure at home
and you're caught popping in with a 180 over 120,
it's kinda like monopoly,
you go directly to jail or you go directly to the hospital.
So you should certainly call your doctor
if you feel it's necessary.
- Would that mean that an emergency room or urgent care?
- I would say an emergency room probably at this point,
'cause they're gonna be the ones that are gonna decide.
I mean, you got here for a reason.
We don't know why.
And if it goes sideways, stroke, attack could be eminent.
So it's something that we just don't want
to mess around with.
- And I always think of this as a therapist
I've worked with a lot of people with strokes.
I don't work with people with heart attacks
except for after the fact, if the rehabbing,
but a stroke I see them very quickly after the event.
It makes so much sense
because what happened is the pressure is getting so high.
It bursts through the arteries, the vessels,
the blood vessels in the brain,
starving the brain of blood and oxygen,
and then you have a stroke and it's a life changing
- It is, (mumbling).
- And it could be fatal.
- Yup exactly.
- So there's no joke about high blood pressure
when you get this high
Oftentimes people are feeling symptoms like headaches.
There are some other things that-
- Well actually the scary thing about all of this,
more often than not people don't feel anything.
And that's the scariest part about this aspect.
And that's why they call blood pressure the silent killer.
So when you have high blood pressure,
it's something that you just may not even notice.
You people go for years.
Let's say they had an appointment in their twenties
and you're healthy as a horse and you're feeling good.
Also they haven't been to a doctor in years
which is oftentimes the case.
I'll sit in there 45 years old,
they go in and see the doctor and they're like,
"Oh my gosh you're 170 over 98."
"What's going on?"
"I don't know if you're great."
And all of a sudden it becomes this type of issue,
and there's lots of long discussions at that appointment
to how can we get this better and keep you safe?
- And so I think nowadays,
and this has been going on for years actually,
people are taking their own blood pressure at home
but it's easier now.
I remember years ago with my father,
he had high blood pressure and he'd be pumping that thing
up around his arm and measuring his own at home to monitor.
But now you just put the cuff on, push the button.
- Push the button, it's really easy.
So, and you always wanna make sure too
when you're getting a blood pressure cuff,
unless you have an absolute problem
where you can't get the cuff around your arm,
you never wanna do the wrist one.
The wrist one, basically these two bones in your arm,
you have one over here and one over here,
it does not allow it to squeeze properly
to give you a good accurate measure of blood pressure.
But when you get it around the arm,
you get that good, accurate measure.
I mean, same way in the doctor's office,
they don't measure your wrist,
they always measured around your arm.
- And if we're talking about this will minimize
be comprehensive with this video.
If you are taking your own,
the same same thing my dad had one of the wrists
and the numbers weren't good.
We ended up going back to this.
And this was later on.
This was just within the last 10 years,
but you should take it in a consistent posture.
- Perfect posture.
- So you should have sitting,
well, we got the table in the way,
but sitting with your knees bent at 90,
with good posture and take it on the same arm,
write it down or sometimes the digital ones have a history
but if you're not comfortable with that, write it down,
that's me, write it on paper so it's there
and do it in the same location or same atmosphere.
- Yeah, I always wanna be consistent with it.
So you always wanna sit for five minutes.
So maybe a walk, you had some breakfast
and then you're like,
"Oh it's time for me to do my blood pressure."
So you wanna sit again with both feet on the floor,
like you said, perfect posture,
just kind of sit and relax.
- Relax.
- And then wait five minutes
and then put your cuff on your arm.
And it's actually important to make sure your cuff
is on your own properly too.
So depending upon the unit that you use
and I will tell you what consumer reports
the most widely recommend one is made by Omron.
So it's a fantastic-
- O-M- R- O-N.
- Yup.
So it's the one that I recommend routinely at work
because I just can trust their accuracy.
So it's excellent, it rates well,
they're reasonable in cost.
So, and you can get it anywhere,
pharmacies, online, wherever you wanna shop
for something like that.
But before I forget, you wanna make sure
there's actually...
The nice thing about the Amron product actually
is they show you a nice little pictures.
Your pictogram showing you how you should use it.
So you have your arm like this.
It's gonna be around your cuff and there's a little line,
that's the tube that goes to the unit.
And so you just wanna make sure
it falls down the center of your arm.
And then while you're relaxed,
you hit the button and basically about 35, 40 seconds,
you're gonna get your pressure and your heart rate.
- All right, so we know where
that really high blood pressure is,
get to the doctor right away.
Let's go back in here
and let's look at the second part of our title.
What are the three options?
- Well basically, number one that,
depending upon where you fall,
it's always gonna be exercise and diet,
which are under that lifestyle changes.
And sometimes if you use that exercise and diet
is one and two, medications are probably number three.
So from that standpoint,
but medications you can easily become the primary course
of treatment depending upon what your doctor and you
decided is best for you and your particular case.
- Do you know how many people
are on blood pressure medications
in the United States right now?
- Yeah, roughly about 30 million people
are on blood pressure medications right now
or at least should be.
And about many of those are actually falling
in that 140 over 90 range.
So, it's a large number.
- And success rate with blood pressure medications?
- 25 percent of people on blood pressure issues
are well controlled.
So everybody else is not.
- So they gotta monitor it? - They need to monitor it,
and so that home monitoring,
I think it's a very invaluable tool
for us to utilize at home
so that we kind of know where you are
and you can always fill in the gaps with your doctor
and just say, "Hey, I did really well."
And you go to the office when it's up 10 points,
so maybe it was you're just stressed out
about seeing the doctor, but it helps them.
- So, you were talking top three, diet and exercise
but really that's kinda they're two separate topics,
but they fit together.
They do, they do, and exercise is so critical
because we wanna get that heart rate up
as long as your doctor approves you to do exercises.
So that's one of the first things
that we have to clear that hurdle before we just.
I mean, it's always good to exercise,
you and I are firm for proponents of that.
But I mean, it's something that
if there's something cardiovascular in nature
you wanna make sure that what you're doing is safe for you,
because if we're maybe somewhere between this
or really super high,
your doctor might want you to ease
into an exercise program
because too much, too soon, too fast
could have some very serious consequence.
- So you could escalate or even cause a problem?
- Cause some serious problems.
- Right, if you have not
if you're not an exercise person historically,
and you don't wanna go on meds and you think,
"Oh, I'm just gonna get after this right now.
You better think again and you're gonna gradually.
You're not gonna go out and start running a marathon,
you're gonna start by walking.
- You're gonna walk.
Walking is great.
I mean, 30 minutes, five days a week,
just so that you're breathing a little bit harder
than usual.
It's probably the easiest way to kind of determine
how hard am I really working?
Well, if I'm kind of taking some deep breaths,
you know you're working hard enough.
So if you're not, you know, if it's too easy
to have a conversation, I mean, you could exercise
and have a perfectly good conversation,
and that's probably the training range you want,
but you're gonna want that heart rate
bumping a little bit too
- Casual, look at the birds walk and stop,
you're gonna-
- No, brisk walk where you're moving.
Something they have.
It's a nice, cool morning, it helps you warm up.
- I wanna mention,
we're gonna do another video,
follow up on this probably a couple of weeks.
And we're gonna go into more detail
about diet and exercise and the medications
I do wanna come up with the good news
is I looked at mine in my twenties
and I was always in this range, just elevated range.
- Back then it wasn't a big deal.
It changed that 2017.
- But actually at that point because my dad had it,
I was looking at it and it was a little red flag for me.
So I started back when I was about 30 years old,
I started running.
I didn't like running because boring.
I was in karate at the time punching and kicking people
is a lot more fun.
(laughing)
- Its always more fun.
- But it wasn't a rollback enough necessarily
a lot of times.
So I started running, went back to college.
I needed something (indistinct) desk board anyways,
started running and I dropped down 10 to 15 points
at both ends.
Dropped it down since I started running
and actually my heart rate dropped way down too
which is another benefit of cardiovascular exercise,
you know, aerobics.
- Yeah, exactly.
- So, and I haven't had a problem since.
So I think if you catch it in here and you're motivated
to change your lifestyle,
and then recently I've changed my diet,
which probably has helped,
but I haven't had a problem anyways.
So get in early, get here
and you don't have to get to the medication.
I'd forget to take them, that's a problem.
- Well, and that's a big thing in my world.
(mumbling)
- Is it really?
- Oh yeah huge,
60% of people don't take the medications properly.
- They don't take them daily or they forget.
- Just forget, taking the wrong time, maybe not,
you know, not consistently.
Actually we do things called adherence calls
and things of that nature.
So it's actually how insurance companies
reimburse pharmacies actually now.
So it's a big deal.
- If people don't take their meds on time
then-
- We don't get paid.
- Insurance doesn't pay the pharmacy as well.
- Not as well.
- Yeah, that interesting - It's a big deal.
- Yeah, so you gotta make sure you call people
and get them on time?
- Yeah we do.
And it's actually more with Medicare part D patients.
So this is a long sideways sidebar,
but it probably puts people to sleep.
- We're getting at the end of the video anyways
but there's a lot of things that revolve around this,
so stay tuned, we're gonna have another video
on details of diet, exercise, and some more on meds as well.
You know, what people that view this
I think are hoping to stay away from the medication
like most people are.
- Well, you know and exercise and diet
are a huge component of that.
And if we work at it,
if you treat yourself like your own best investment,
I think it can be very doable, but you got to work at it.
It's not just something you're just gonna hop off the couch
and run a marathon and I'm good.
I mean, once you stop exercising,
all those good benefits that you received go away.
So it's a lifestyle change, means forever.
- Now, I don't know if this fits right in,
we can fix just about anything-
- Except a broken heart.
- But we're right on there.
- We're working on it, we're working.
- All right, very good.
Take care. - Thanks everyone.
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