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Blood Pressure - Back to Basics

Written by: Sarah Matunis, R.Ph., Rite Aid Pharmacist and Corporate Clinical Coordinator

Blood pressure impacts our health and well-being. You hear the numbers when you see your healthcare provider or stick your arm in a free-standing blood pressure machine, but what do they mean? Why should you care?

The force created when the heart pumps blood into your blood vessels is called blood pressure. Blood pressure is needed to deliver blood throughout your body, to organs such as the brain, liver and kidneys. Blood pressure levels can vary greatly. It can go up when you are excited or nervous, and go down when you are sleeping.

What do the numbers mean?

Blood pressure readings are made up of two numbers, for example 120 / 80:

• 120 is the Systolic pressure, which measures the pressure when your heart is pumping
• 80 is the Diastolic pressure, which measures the pressure when your heart is filling with blood

Category	Systolic Blood Pressure mmHG (top number)		Diastolic Blood Pressure mmHG (bottom number)
Normal	‹120	And	‹80
Prehypertension	120 - 139	Or	80 - 89
Hypertension, Stage 1	140 - 159	Or	90 - 99
Hypertension, Stage 2	≥ 160	Or	≥ 100

Why should you care?

Did you know that if you have diabetes, you are at an increased risk for a heart attack or stroke? Blood pressure can go up when your blood vessels tighten or constrict. This can happen for a number of reasons and when it does, the blood can press on the vessel walls with too much force. When this occurs it is considered high blood pressure (hypertension). The heart has to work extra hard to pump blood throughout the body. This extra work can lead to serious health problems. Damage to the kidneys, heart, brain or eyes may occur.

Controlling your blood pressure is important. Yet, a recent report¹ indicated that only 36% of adults with diagnosed diabetes had a blood pressure of ‹130/80mmHg - the blood pressure goal recommended by the American Diabetes Association² (ADA).

The ADA Standards of Medical Care recommend lifestyle therapy alone for up to three months when systolic blood pressure is 130 - 139mmHg or diastolic blood pressure is 80 - 89mmHg. If systolic blood pressure is ≥140 or diastolic blood pressure ≥90mmHg, medication like an ACE inhibitor or angiotensin receptor blocker (ARB) is recommended along with lifestyle therapy. When additional measures are needed to reach blood pressure targets, a diuretic medication may be added. Generally, multiple medications are needed to achieve blood pressure targets.

What can you do?

If you aren't at your target weight, work with your diabetes management team to make the appropriate dietary changes and increase your physical activity. Controlling weight can have a positive impact on your heart health, as well as improve your glucose control. Talk to your doctor about the most appropriate first steps for you to take.

Medication Tips

• If you take medication, always take it as instructed.
• Take only medication that was prescribed specifically for you.
• To avoid interactions, be sure your healthcare providers, including your doctor and pharmacist, know of any over the counter or alternative therapies you may be taking.
• Unless otherwise instructed by your healthcare provider, continue taking your medication, even if your blood pressure becomes normal.
• Always keep a list of medications with you.
• If you experience any side effects, be sure to talk to your Rite Aid pharmacist and healthcare provider about them.

Many people monitor their blood pressure at home. There are many different types of blood pressure monitors to help you do this. As you choose a monitor, talk to your Rite Aid Pharmacist for help in selecting the best monitor for you.

Healthy living with diabetes requires you to be aware of the impact of the lifestyle choices you make, and how to prevent or treat the additional health conditions that may accompany your diabetes. While it may at times be overwhelming, taking the steps to increase your understanding of every aspect of your health puts the control back in your hands. Make full use of your diabetes management team. Your Rite Aid pharmacist is available to support your diabetes management efforts.

References

1. Saydah SH, Fradkin J, Cowie CC: Poor control of risk factors for vascular disease among adults with previously diagnosed diabetes. JAMA 291:335-342, 2004
2. American Diabetes Association: Executive Summary: Standards of Medical Care in Diabetes - 2008. Diabetes Care 31:S7

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