Know your numbers: Your guide to proactive blood pressure monitoring

By Dr. Kelly Clinning B.Sc., N.D.

Reviewed by Dr. Raj Padwal MD

 

Know your numbers | Make a plan with your health care practitioner | Monitor at home

If you have been diagnosed with high blood pressure, have a family history of high blood pressure, or are simply being pro-active with your health, monitoring your blood pressure can keep you on track and prevent serious cardiovascular events! Having high blood pressure is the number one risk factor for stroke and a major risk factor for heart disease, dementia and kidney failure. High blood pressure is known as a ‘silent killer’, meaning it has no symptoms so it can go unnoticed for years if not being properly monitored – yet it can be managed.

We suggest using this easy three-step strategy for optimal blood pressure management and monitoring.

Step 1: Know your numbers

Step 2: Make a plan with your health care practitioner

Step 3: Monitor

 

Fast Facts on blood pressuring monitoring at home:

  • Home blood pressure, if done correctly using an approved device2, is a better predictor of future cardiovascular risk than in-office blood pressure.
  • Blood pressure monitoring frequency is dependent on many factors, such as is the degree of blood pressure elevation, the presence of other risk factors, and medication usage. In general, you should monitor more frequently if your blood pressure is not controlled, you have diabetes or cardiovascular disease, or if you are on medication.
  • Studies have found that up to 80% of the at-home blood pressure monitoring devices used in the world are inaccurate! A list of Canadian approved monitors can be found here and an international listing can be found

STEP 1: KNOW YOUR NUMBERS

High blood pressure usually has no signs and symptoms. This means that many people are unaware that they are living with high blood pressure and it’s associated risks. The only way to know if you have high blood pressure is to check it. The first step in a plan to control your blood pressure is to identify what your baseline number is and what those numbers mean.

Blood pressure measurement contains two numbers. The top number is known as systolic blood pressure and is your blood pressure when your heart contracts. The bottom number is known as diastolic blood pressure and is your blood pressure when your heart relaxes.

The following chart shows you what is considered normal systolic and diastolic blood pressure as well as the stages of high blood pressure1. The higher your systolic or diastolic blood pressure is (and the longer these numbers stay high) the greater pressure and damage done to your blood vessels and organs. Please note that if your systolic blood pressure is higher than 180 mmHg OR your diastolic blood pressure is higher than 120 mmHg you have very elevated blood pressure and should consult your health care provider immediately.

These categories vary across different guidelines in different countries and there are some exceptions to the above categories. For example, if you have diabetes, your blood pressure should be less than 130/80 mmHg to reduce the risk of diabetic complications.

As people age, the arteries become stiffer and blood pressure can increase naturally to an extent. Talk to your healthcare practitioner to determine what your target blood pressure is.

 

Did you know?

If you bring your blood pressure down the damage done to your arteries can be repaired over time. Similar to how the lungs of a once smoker can repair themselves, arteries can do the same!

Did you know?

Having diabetes raises the risk of heart disease, stroke and kidney disease. High blood pressure also increases these risks! If you have both high blood pressure and diabetes, your blood pressure target is typically lower for this reason. Many of the diet and lifestyle changes that can lower blood pressure can also lower blood sugar and reduce your risk of both!

 

STEP 2: MAKE A PLAN WITH YOUR HEALTHCARE PRACTITIONER

Depending on your numbers and other risk factors, several treatment options can safely and effectively reduce your blood pressure and reduce your risk. The appropriate treatment can range from diet and exercise changes to multiple medications based on your unique case and every person should have an individualized plan.

Your plan with your health care provider should include:

  • Your current blood pressure number
  • Your target blood pressure number
  • A detailed treatment plan, including one or all of the following: diet and lifestyle changes, medications, natural health products
  • A blood pressure monitoring schedule including at home, including how often should you be monitoring, and how to monitor
  • A timeline for when you need to re-assess your plan

 

Open communication with your healthcare practitioner around medications, lifestyle factors as well as any alternative treatments you are using to control your blood pressure is essential.  You are an important part of your health care team and you and your practitioner should act as partners working towards a common goal.

Natural health care products can and do interact with some medications and your healthcare practitioner should always be informed so they can confirm the safety of your treatment. PreCardix® bioactive marine peptides are a natural health product, clinically proven to lower blood pressure within eight weeks1. If you are considering taking PreCardix® as part of your blood pressure treatment, this should be communicated to your healthcare practitioner and be discussed as part of your overall plan.

Always communicate the following to your healthcare practitioner:

  • All blood pressure readings you have taken yourself including the date and time. You can use a phone application such as the PreCardix App to record all of your readings. Using an app allows you to flexibly calculate averages and better understand your numbers. You can also use a printable blood pressure monitoring log like the one found here
  • All medications you are on, the dose, and how often you take them
  • All alternative health care products you are on, the dose, and how often you take them
  • Any changes to your signs and/or symptoms or any changes to your treatment plan

Did you know?

Many of the risk factors that increase blood pressure can be modified and lead to significant reductions alongside medications or supplements. Some of these risk factors include:

  • Being overweight or obese
  • Too much salt (sodium) in your diet
  • Not being physically active
  • Drinking too much alcohol

As you can imagine, the more risk factors you have the higher the likelihood your blood pressure is elevated. The opposite is also true! As you reduce your risk factors, your blood pressure should reduce accordingly!

Did you know?!

Any changes to your treatment should always be communicated to your health care practitioner. When certain blood pressure medications are stopped there can be a rebound effect where blood pressure elevates even higher. This is a dangerous situation that can be avoided with proper communication.

STEP 3: MONITOR

The last step in the road to blood pressure management is to monitor over time. High blood pressure is one of the few conditions where patients can participate directly in their care by monitoring outside of the doctor’s office.

Out of office monitoring includes two techniques; home blood pressure measurements (HBPM) and ambulatory blood pressure measurements (ABPM). HBPM are self-recorded blood pressure levels taken with a validated device. HBPM is commonly recommended if a patient has been newly diagnosed with high blood pressure, to monitor the effectiveness of treatment and to improve adherence to treatment.

ABPM is a different technique, which requires the patient to wear a monitor for a 24-48 hour period. This device monitors blood pressure every 15 to 20 minutes during the daytime and every 30 to 60 minutes during sleep. ABPM is particularly helpful in those who are suspected of having episodes of high blood pressure, especially at night, or in those experiencing low blood pressure symptoms while on medication.

For our purposes, the following will discuss the benefits of HBPM only because ABPM is only available through a medical provider.

Why monitor blood pressure at home?

Heart & Stroke Canada recommends all patients with high blood pressure monitor at home to determine if their treatment is effective. Tracking blood pressure at home is not a substitute for office visits with your healthcare practitioner, but provides additional information to guide treatment.

Research has found that monitoring blood pressure at home is a better predictor of future cardiovascular risk than in-office measurement if done correctly and with an approved device2. Home blood pressure monitoring has also been found to significantly reduce both systolic and diastolic blood pressure and increase the number of individuals who can reduce their antihypertensive medication3One study even found that patients who regularly monitored their blood pressure were 4 times more likely than those who didn’t monitor regularly to have controlled their blood pressure levels4!

 

How often should I be monitoring my blood pressure?

As mentioned above, the frequency of monitoring is dependent on many factors such as; how high your blood pressure is, if you have other risk factors such as diabetes, and how recently you started or changed your medication. Your healthcare practitioner will work with you to determine how frequently you should be monitoring.

In general, it is a good idea to do a week of monitoring every month if your blood pressure is not controlled to target and, if it is controlled, a week of monitoring every three months is sufficient.  When performing a week of monitoring, it is recommended that you take your blood pressure twice in the morning and twice in the evening. Taking these measurements before eating is preferred. The PreCardix app helps to prompt you to perform these measurements properly, store them, and make sense of them, thereby optimizing your BP monitoring.

 

How do I properly monitor my blood pressure at home?

Ensuring at-home blood pressure measurements are done accurately and with approved devices is very important so you are not overly or under medicated.

Detailed instructions on how to monitor your blood pressure properly from home can be found here.

High blood pressure can be prevented, managed, and even reversed by knowing your numbers, having a plan and monitoring blood pressure regularly. Remember, hypertension is not a disease, it’s simply a signal that your body needs some cardiovascular TLC!

 

Bio Dr. Kelly Clinning B.Sc., N.D.

Bio Dr. Raj Padwal MD

 

References

 

  1. Musa-Veloso, K., Paulionis, L., Pelipyagina, T. and Evans, M. (2019). A Randomized, Double-Blind, Placebo-Controlled, Multicentre Trial of the Effects of a Shrimp Protein Hydrolysate on Blood Pressure. International Journal of Hypertension, [online] 2019, pp.1-13. Available at: https://www.hindawi.com/journals/ijhy/2019/2345042/.
  2. McGrath, B. (2015). Home monitoring of blood pressure. Australian Prescriber, [online] 38(1), pp.16-19. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4654038/ [Accessed 24 Oct. 2019].
  3. George, J. and MacDonald, T. (2015). Home Blood Pressure Monitoring. European Cardiology Review, [online] 10(2), p.95. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6159400/ [Accessed 24 Oct. 2019].
  4. Kim, J., Han, H., Song, H., Lee, J., Kim, K. and Kim, M. (2010). Compliance With Home Blood Pressure Monitoring Among Middle-Aged Korean Americans With Hypertension. The Journal of Clinical Hypertension, [online] 12(4), pp.253-260. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4517578/.