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How can I tell I have it?


Unfortunately, most people have no obvious symptoms and only come to know of it after they have suffered from some complications.


The only way to know if your blood pressure is high is to get it checked regularly by your doctor. This is especially true when you have diabetes.


Your doctor will always measure your blood pressure and you too, must go regularly to your doctor to measure the pressure even though you may be feeling "fine"!


Because hypertension doesn't cause symptoms, it is important to have blood pressure checked regularly. Blood pressure is measured with an instrument called a mercury sphygmomanometer. This is something all of you are familiar with. You must have seen your doctor use it so often and possibly, he may have even used it on you.


A cloth-covered rubber cuff is wrapped around the upper arm and inflated. When the cuff is inflated, an artery in the arm is squeezed to momentarily stop the flow of blood. Then, the air is let out of the cuff while a stethoscope placed over the artery is used to detect the sound of the blood spurting back through the artery. This first sound is the systolic pressure, the pressure when the heart beats. The last sound heard as the rest of the air is released is the diastolic pressure, the pressure between heart beats.


Aneroid sphygmomanometer


Many doctors now use a device called the aneroid meter. This type of device does not contain mercury. A metal membrane located in a case translates the blood pressure transmitted by the cuff. This type of device is very practical to use and is generally reliable if it is regularly controlled.


This method constitutes a good alternative to the sphygmomanometer with mercury.


What can I do about it? ·

  • Lifestyle changes· Take medicine the way your doctor tells you.
  • See your doctor regularly
  • Know what your blood pressure should be and work to keep it at that level.


There is no cure for primary hypertension, but blood pressure can almost always be lowered with the correct treatment. The goal of treatment is to lower blood pressure to levels that will prevent heart disease and other complications of hypertension.


Lifestyle Changes


Initially your doctor may just ask you to take certain steps which are called as lifestyle modifications. Most of these changes are similar to those which you may have been asked to make because of your diabetes.


Lifestyle changes that may reduce blood pressure by about 5 to 10 mm Hg include:

  • Weight control
  • Reducing salt intake
  • Reducing fat intake
  • Getting regular exercise
  • Quitting smoking
  • Reducing alcohol consumption
  • Managing stress.


Controlling your weight is a very important step that you can take to reduce your high blood pressure. Losing just a few extra pounds can help lower your blood pressure. Research has shown that weight reduction, even as little as 10 pounds reduces blood pressure in a large percentage of overweight persons with hypertension, makes blood pressure medications more effective and reduces cardiovascular risk


Whilst all weight loss in a person who is overweight will help, your doctor may prescribe exercises which decrease "central" obesity, or waist size as most call it.


Your diet will also need to be further modified. You will have to control the amount of salt and fats which you eat. Recently, one diet which has been found to be very effective in people with high blood pressure. It is called the DASH diet.


The DASH eating plan significantly lowered blood pressure in the recent Dietary Approaches to Stop Hypertension (DASH) study, and it may also help prevent and control high blood pressure.


DASH Eating Plan
Food GroupDaily Servings*Serving Sizes
Grains7-81 slice bread; ½ cup cereal or cooked rice, pasta, or cereal
Vegetables4-51 cup raw leafy vegetable; ½ cup cooked vegetable; 6 ounces vegetable juice
Fruits4-51 medium fresh fruit; ¼ cup dried, frozen, or canned fruit
Low-fat and nonfat dairy2-38 ounces milk; 1 cup yogurt; 1.5 ounces cheese
Meats, poultry, and fish2 or fewer3 ounces cooked meat, poultry, or fish
Nuts, seeds, and legumes Fewer than 1 (4-5 per week)1.5 ounces or 1/3 cup nuts; ½ ounce or 2 tablespoons seeds; ½ cup cooked legumes
* Number of servings is based on eating 2,000 calories a day. If your caloric needs are higher or lower, you may eat more or fewer servings.

You should remember that you still have to follow the diet which your doctor has prescribed to you for your diabetes. So please discuss the DASH diet with your doctor and see how it fits into your diet plan.


Drug Treatment


For some of you, your doctor may prescribe tablets along with the lifestyle changes. Even in some of you who have only been advised to make some lifestyle modifications, your doctor will monitor your blood pressure closely.


Patients, with diabetes, whose blood pressure remains higher than 120/80 may be asked to take medications to further lower their blood pressure.


Numerous drugs have been developed to treat hypertension. The choice of medication will depend on the degree of high blood pressure, the side effects, the presence of other medical conditions besides the diabetes, as well as other medicines you may be taking.


Please do not take any medications unless it has been prescribed by your doctor. You must understand that many of these medications may not be good for your diabetes and so your doctor will carefully choose and monitor the effects of the medicines which are prescribed to you.


Follow instructions carefully. Many drugs do not work properly unless you take them exactly as directed.

Your doctor will tell you the side effects which you should look out for. Watch carefully for any of these and if they do occur, report them to your doctor immediately.


Some of the commonly used drugs for treating high blood pressure are:


High Blood Pressure Drugs
DiureticsSometimes called "water pills," they flush excess sodium and water from the body through the urine, lessening the amount of fluid in the blood.
Beta-blockersThey make fewer nerve impulses happen in the heart and blood vessels. This slows the heart, which beats less often and with less contracting force-so blood pressure drops and the heart doesn't work as hard.
ACE inhibitors(angiotensin- converting enzyme) and ARBs (angiotensin receptor blockers)They block the formation or the action of a hormone made in the kidney. The hormone narrows the blood vessels and causes blood pressure to rise.
Calcium channel blockersBy barring calcium from entering the muscle cells of the heart and blood vessels, they make the blood vessels relax.
Alpha-blockers
They work on the nervous system to relax the blood vessels, letting the blood pass more easily.
Nervous system inhibitorsBy controlling nerve impulses, they relax blood vessels.
VasodilatorsThey open blood vessels by relaxing the muscle in the vessel walls.

Most Importantly

Do not stop taking medication or cut down without prior approval from your doctor. Many patients when they see that the blood pressure is "controlled" stop taking the medications.

Please do NOT do this.

Abruptly stopping medication may result in rapid rise in blood pressure.


Finally,

It is TRUE that high blood pressure is much more common in people with diabetes.

It is TRUE that both together can lead to serious complications;

BUT

It is also TRUE that high blood pressure can be kept under tight control; and

It is also TRUE that YOU have the major role to play in controlling it!


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