Managing hypertension

Dr. Brent M. Egan, who is the study’s lead author, a professor at the University of South Carolina School of Medicine, and the American Medical Association’s vice president of cardiovascular disease prevention, told Healthline that it’s crucial for people to understand that maintaining healthy blood pressure is an ongoing process. “Individuals with high blood pressure need to be aware of their condition, so they can take steps to control it. For many individuals, management includes both a healthy lifestyle and medications,” Egan said. “Effective self-management includes taking necessary and sufficient medication together with a healthy lifestyle to control blood pressure. [It is] a consistent, long-term, ongoing process and not an episodic event.” Egan points out that blood pressure that’s not managed well can increase the risk of heart attack, heart failure, and stroke, due to the way hypertension can affect the blood vessels and heart. Other somewhat less serious side effects can include headaches, fatigue, reduced exercise tolerance, and blurred vision. A wrinkle that can lead to confusion among doctors and patients is the fact that there’s more than one way to get a blood pressure reading, said Mintz.

Tha Ambulatory Blood Pressure Monitoring

While physicians have taken blood pressure readings using a stethoscope for years, there is a different method. It’s called ambulatory blood pressure monitoring, which takes readings for a 24-hour period, and is considered to be more accurate. “The challenge to make ambulatory blood pressure management the gold standard for diagnosing hypertension involves a focused education against the ingrained stubbornness of the majority of physicians,” said Mintz. “Many physicians balk at the cost of an ambulatory blood pressure monitor, which ranges from $1,500 to $3,000 depending on the type of monitor. The reluctance to purchase an ambulatory blood pressure monitor is also related to the limited insurance coverage for this procedure. However, recently there has been improved coverage.”

Getting it under control

Egan said that it’s important for people to know their blood pressure numbers by getting a reading at least once per year. They should also be aware of which blood pressure category — normal, elevated, stage 1 hypertension, or stage 2 hypertension — they fall into. From there, it’s important to follow up with a doctor to determine which lifestyle interventions or medications might be needed to manage their blood pressure. “For many patients, training in self-monitored blood pressure, including recording values and relaying those to the healthcare team is beneficial in improving blood pressure control,” said Egan. But it isn’t just the individual and their doctor who can help, says Egan. Family members can also be a great support. “Lifestyle changes are better done together,” he said. “Walk together. Have healthy meals and snacks together. Sometimes, help getting medication and keeping medical appointments require assistance with transportation or costs.” Egan also notes that the American Heart Association (AHA) and the American Medical Association (AMA) have launched a national initiative, known as Target:BP, which is trying to help medical providers across the country improve blood pressure control rates. He said healthcare professionals can also utilize programs proven to improve blood pressure control. That includes the AMA’s MAP BP program, which stands for measure accurately, act rapidly, and partner with patients and families. “The AMA and AHA are partnering on Target:BP and the MAP BP program to improve hypertension control rates nationally and to improve equity in blood pressure control and cardiovascular outcomes,” Egan noted. Finally, it’s critical for everyone to be aware of the serious risks associated with hypertension. “Hypertension remains the ‘silent killer’ because there are no symptoms and it’s a major risk factor for heart attack, stroke, and progressive kidney disease,” said Mintz.