[av_one_full first min_height=” vertical_alignment=” space=” custom_margin=” margin=’0px’ padding=’0px’ border=” border_color=” radius=’0px’ background_color=” src=” background_position=’top left’ background_repeat=’no-repeat’ animation=”]
[av_heading heading=’THE DOCTOR IS IN ‘ tag=’h3′ style=’blockquote modern-quote’ size=” subheading_active=’subheading_below’ subheading_size=’15’ padding=’10’ color=” custom_font=”]
BY JESSICA SEGOVIA-YAP, MD
[/av_heading]
[av_textblock size=” font_color=” color=”]
(A guide to knowing if you already have high blood pressure / hypertension or not)
I OFTEN encounter patients in the clinic asking me if their particular blood pressure is already high or normal FOR THEIR AGE.
Actually, when we use age as a factor for diagnosing hypertension, there are only two types: those who are younger than 60 or older than 60.This is based on the latest classification of hypertension from the JNC 8 or the Eighth Joint National Committee.
We all know that hypertension is one of the most important preventable contributors to disease and death. It can lead to myocardial infarction or heart attack, stroke, and renal failure when it is not detected early or not controlled appropriately.
Cardiovascular diseases still rank as the No. 1 cause of mortality and morbidity (or death and disease) worldwide. Thus it is important that early detection and diagnosis of hypertension and consequent proper management should be instituted as soon as possible.
So at what levels of blood pressure can we then say that our patient is already hypertensive and needs medication?
According to JNC 8, in the general population of adults younger than 60, pharmacologic intervention should be initiated when the systolic pressure is 140 mm Hg or higher, or when the diastolic pressure is 90 mm Hg or higher. The target systolic pressure should be less than 140 mm Hg and the diastolic blood pressure should be less than 90 mm Hg in this population.
For patients 60 years and older, medical management should be started if systolic blood pressure is 150 mm Hg or higher and diastolic blood pressure is 90 mm Hg or higher. The cut off level is a bit higher as compared to the general population because older patients can tolerate higher blood pressure than younger ones.
A special group of patients, those with diabetes mellitus and chronic kidney disease 18 years old and above follow the same target blood pressure as those for the general population younger than 60 years old.
This is due to research results proving that lowering blood pressure further would slow down the progression of chronic kidney disease nor improve the overall health outcomes of patients with diabetes.
Hypertension is confirmed if blood pressure readings went beyond the target goals more than twice with blood pressure taken on separate days. Hypertensive work up is then requested to check for other risk factors that may contribute to cardiovascular complications such as dyslipidemia (elevated bad cholesterol) and diabetes mellitus (elevated blood sugar).
Of course, aside from pharmacologic management or giving of what we call maintenance medications to lower your blood pressure to target levels, it is also important to modify your lifestyle such as eating healthy, doing exercises to lose weight, and to stop smoking and drinking alcoholic beverages.
I strongly suggest that you start monitoring your blood pressure, more so if there is a strong family history of hypertension and cardiovascular diseases, if you are overweight, or a smoker and an alcoholic beverage drinker.
Need I emphasize again that prevention is better than cure? And we also have to remember that early intervention will prevent future complications.
Jessica P. Segovia-Yap, M.D., FPAFP is a Diplomate and Fellow of the Philippine Academy of Family Physicians. She is a practicing Family Medicine Specialist and holds clinic at the Medical Arts Building of Iloilo Mission Hospital. For comments, questions and suggestions, you may email at drjec.is.in@ gmail.com./PN
[/av_textblock]
[/av_one_full]
