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March is a month to show love and appreciation towards our loved ones, but we must not forget to take care of our own hearts as well.
A healthy heart allows you to enjoy quality time with your loved ones; according to the Canadian Heart and Stroke Foundation, 8 in 10 cases of premature heart diseases and strokes are preventable through healthy lifestyle behaviours.
High blood pressure is one of the highest risk factors for stroke and major heart disease. Fortunately, it is also one of the most reversible risk factors.
Blood pressure can be self-measured at home and is an important component of managing one's health. However, it must be done appropriately, as the incorrect technique can lead to inaccurate blood pressure measures.
What is blood pressure (BP)?
Blood pressure is the measurement of the pressure of blood against the walls of your blood vessels. It is expressed by two numbers; the top number refers to the systolic blood pressure, and the bottom number refers to the diastolic blood pressure.
Systolic blood pressure represents the pressure in the blood vessels when the heart contracts and pushes the blood through the arteries. Diastolic blood pressure represents the pressure in the blood vessels when your heart relaxes between beats.
Based on the readings of blood pressure, you can be categorized as a low risk, moderate risk or high risk.
- Low risk: 120/80
- Medium risk: 121-134/80-84
- High risk: 135+/85+
Please note, these are general guidelines, and for some medical conditions (such as diabetes), the threshold for a high-risk category is lower.
Selecting the right BP monitor is crucial
BP monitors which carry the logo of Canadian Hypertension Society mean that they are validated, making them the most reliable monitors. Here are examples of the logos to look for:
Hypertension Canada
BPM Device Logos
How to measure your Blood Pressure?
Step 1
- Avoid smoking, eating, or drinking caffeinated products for 30 minutes prior to taking your blood pressure reading.
- Remove any tight clothing from your arm, and ensure that your arm is bare and supported.
- Choose the appropriate cuff size for your arm and place the middle of the cuff at heart level. The lower edge of the cuff should be 3 cm above your elbow crease.
- Sit comfortably with your back supported.
- Sit with your legs uncrossed and feet flat on the floor.
- Remain still and quiet during the measurement.
Step 2
- Begin by measuring your blood pressure (BP) on both arms.
- Repeat the measurement on the arm which measurement highest another three times, taking a one-minute break between each measurement. In total, you will take four readings. If the first reading was very high, disregard it. The average of the next two readings will provide the most accurate results.
- Record all readings, along with the date and time, and share this information with your healthcare provider.
Your physician can use the blood pressure readings to determine if any further tests are necessary and diagnose hypertension (high blood pressure) if present. If you are already taking medication for high blood pressure, it's important to take it as directed. Sudden stopping of a medication can pose a significant risk to your health.
Consult with your doctor or pharmacist to understand your medications. Your pharmacist can provide a comprehensive review of your medications and help find ways to ensure you are taking them as intended.
Adopt a healthy lifestyle, including a balanced diet (such as the DASH diet) and regular exercise (aim for 150 minutes per week) to maintain a healthy heart. These changes can help keep your blood pressure in check.
What is white-coat Hypertension?
This answer is provided by Dr. Michael Heffernan, Cardiologist, Halton Healthcare.
White coat syndrome, sometimes referred to as white coat hypertension, refers to when someone has a normal blood pressure reading at home, but when they see a doctor, nurse practitioner or other medical professionals, their blood pressure is elevated. This is quite common and happens in about 25 per cent of people.
White coat syndrome is ultimately due to anxiety. People may be anxious for several reasons when they have their blood pressure checked. It could be that the individual is nervous about visiting a healthcare professional. They may be anxious about being in a medical facility.
They may be nervous about being on time for their appointment – or it may be a combination of these things. It all comes down to feeling some sense of worry or nervousness about the situation, which raises the blood pressure.
To try to prevent this high blood pressure reading in the medical office, it’s important for patients to try to relax. Patients may want to try closing their eyes or taking several deep breaths to calm themselves. In my practice, when someone is nervous, I try to take the blood pressure reading at the end of an appointment when patients have had time to get used to the environment, and their level of anxiety may be relieved.
I also try to distract patients with conversation - I try to find something they like talking about - maybe asking them if they’re a fan of the Blue Jays or Toronto Maple Leafs. I also think it’s important to take the patient’s blood pressure in an area that is quiet and without distractions.
For someone that has white coat hypertension, we do try to encourage them to take their blood pressure at home, if it’s possible. It’s important to take the blood pressure in a quiet place, to relax for about five minutes, sit in a chair with uncrossed legs and use your arm at the level of your heart supported by a table.
I suggest that patients take several readings – ignoring the first and using an average of the next two readings. They should do this a few times each week and record the readings to show us at their next appointment – home blood pressure readings play an important role in helping us manage blood pressure control.
