Paid Content by PRMC – New Blood Pressure Guidelines

Paid Content by PRMC – New Blood Pressure Guidelines


>>>THIS SECTION OF
DELMARVALIFE IS BROUGHT TO YOU BY PENINSULA REGIONAL MEDICAL
CENTER. TAKE MOST OF EVERYTHING YOU
THOUGHT YOU KNEW ABOUT BLOOD PRESSURE AND TOSSED IT OUT THE
WINDOW. WE WILL TAKE YOU OUT OF YOUR
COMFORT ZONE.>>YES, BLOOD-PRESSURE
GUIDELINES HAVE CHANGED. YOU THOUGHT YOU KNEW MIGHT NOT
BE THE CASE A LESS TRY TO SORT IT ALL OUT.>>HERE TO HELP US IS PRMC’S
CHIEF CARDIOLOGY AND MEDICAL DIRECTOR, THIS IS DOCTOR
JEFFERY WIELAND. THANK YOU SO MUCH FOR JOINING
US THIS AFTERNOON.>>THANK YOU FOR HAVING ME. THAT THIS IS BECOMING A HOT
POTATO OF CONVERSATIONS HERE. WHAT IS GOING ON WITH THESE NEW
GUIDELINES.>>OH, NOVEMBER 2017, THE
AMERICAN COLLEGE OF CARDIOLOGY CAME OUT WITH NEW
RECOMMENDATIONS FOR BUT BLOOD PRESSURE CONTROL. HISTORICALLY, THE NUMBERS WERE
140/90, AND IF YOU ARE BEYOND THAT YOU WERE GOOD BUT BEYOND
THAT YOU NEED TO BE ON MEDICINE AND IF YOU WERE OVER 60 THEY
WOULD LET IT GO UP TO 150.>>OF THESE ARE THE NEW
NUMBERS?>>THESE ARE THE NEW NUMBERS. YOU CAN SEE A DRAMATIC
REDUCTION, SLIGHTLY ELEVATED IF YOU’RE UP TO 129, AND IF YOU
ARE IN THE 130, 139 PHASE, YOUR IN STAGE I HYPERTENSION, AND
OVER 140 AND 90 IS STAGE II, WHICH IS SORT OF A CLASSIC
DEFINITION. SO, WHAT INSPIRED THE CHANGE?>>THERE’S A HUGE TRIAL THAT
WAS PUBLISHED WITH THE NEW ENGLAND JOURNAL OF MOST CALL
THE SPRINT TRIAL WHERE THEY TOOK 10,000 PEOPLE AND RAN A
STANDARD TREATMENT IN AN INTENSIVE TREATMENT, AND
INTENSIVELY TREATED PATIENTS HAD LESS HEART ATTACKS, LESS
HEART FAILURE, AND IMPROVED OVERALL MORTALITY, SO THEY
WROTE THE TRIAL EARLY AND THAT HAS LED TO THE NEW GUIDELINES.>>I WAS GONNA SAY, WE HAVE
BEEN TALKING HEART HEALTH MONTH ALL MONTH LONG AND HIGH BLOOD
PRESSURE, YOU JUST MENTIONED A WHOLE BUNCH OF THINGS, BUT HIGH
BLOOD PRESSURE, I DON’T HAVE TO WORRY ABOUT THAT, RIGHT?>>WELL, THE THING ABOUT HIGH
BLOOD PRESSURE IS THE CALL OF THE SILENT KILLER. YOU HAVE NO SYMPTOMS SO WHEN
YOU DON’T HAVE SYMPTOMS YOU TEND TO NOT WORRY ABOUT IT. IN TAKING MEDICATION TO IMPROVE
YOUR BLOOD PRESSURE DOESN’T MAKE YOU FEEL BETTER. IT DOES REDUCE YOUR LIKELIHOOD
OF HAVING HEART FAILURE OR KIDNEY DISEASE OR STROKE, AND
THAT IS WHY I THINK A LOT OF PEOPLE THINK HIGH BLOOD
PRESSURE, WHAT IS THE BIG DEAL?>>THEY TEND TO BLOW IT OFF.>>EXACTLY.>>SO, LET’S TALK A LITTLE BIT
ABOUT HIGH BLOOD PRESSURE AND SYMPTOMS, WHAT ARE THEY? THERE ARE REALLY NO SYMPTOMS
WHICH IS WHY IT IS CALLED THE SILENT KILLER. AND WHAT HAPPENS IS PEOPLE GO
IN FOR ROUTINE CHECKUPS WITH THE DOCTOR OR THEIR GIVING
BLOOD, THEY HAVE A BLOOD PRESSURE TEST, THEY ARE TESTED
BEFORE THEY DONATE BLOOD AND FIND OUT THAT THEIR NUMBERS ARE
UP. AND I THINK THAT IF YOU FIND
THAT YOUR NUMBERS ARE UP, THEN YOU NEED TO REALLY STRONGLY
CONSIDER, DO I HAVE THIS PROBLEM AND HOW DO I DEAL WITH
THAT? THE FIRST WAY TO DEAL WITH IT
IS TO MAKE SURE THAT THESE NUMBERS ARE ACCURATE. SO, PEOPLE HAVE THIS WHAT WE
CALL A WHITE COAT SYNDROME WHEN THERE NUMBERS GO UP IN THE
DOCTOR’S OFFICE. OFTEN TIMES, REPEATING THE
MEASUREMENT IN A DIFFERENT SETTING WILL LEAD TO A MORE
ACCURATE ASSESSMENT FOR WHICH HER BLOOD PRESSURE IS.>>OH, I HAVE A LITTLE HOME
BLOOD PRESSURE MONITOR FOR THE REST,
>>AND OVER-THE-COUNTER THING.>>YES, AND YOU RECOMMEND THAT
PEOPLE HAVE THESE?>>WE DO RECOMMEND IT FOR
EXACTLY THAT TYPE OF PATIENT WHO COMES INTO THE OFFICE AND
THERE BLOOD-PRESSURE MEASURES THAT, LET’S SAY, 160/100 OR
WHATEVER, AND THEY SAY WILL DOCTOR, WHEN I CHECK IT AT HOME
IT IS ALWAYS GOOD. SO THAT IS IMPORTANT WHEN WE
MAKE DECISIONS ABOUT TO TREAT PEOPLE AND HOW AGGRESSIVELY TO
TREAT THEM, WE WANT TO MAKE SURE THAT WE ARE TREATING
PEOPLE WHO NEED TO BE TREATED AND NOT OVER TREATED THE PEOPLE
WHO DON’T NEED TO BE TREATED, SO BRINGING IN THE BLOOD
PRESSURE DIARY TO YOUR PHYSICIAN THAT YOU HAVE
MEASURED AT HOME IS VERY HELPFUL.>>OH, I HAVE ACTUALLY ALWAYS
HAD LOW BLOOD PRESSURE THROUGHOUT MY LIFE, AND I NEVER
WORRIED ABOUT IT, BUT THEN I TURNED 50 AND ALL OF A SUDDEN,
MY BLOOD PRESSURE WAS ELEVATED. IS THAT A COMMON THING? DO PEOPLE ALL OF A SUDDEN GET
HIGH BLOOD PRESSURE?>>AS YOU AGE, YOUR BLOOD
PRESSURE TENDS TO GO UP. IT IS PROBABLY RELATED TO SOME
OF THE ELASTICITY IN YOUR BODY IN GENERAL. AS YOU KNOW, YOU TEND TO GET
MORE STIFF AND TIGHT, LESS FLEXIBLE, AND SIMILARLY, THE
BLOOD VESSELS HAVE LESS ELASTIN IN THEM AND GET LESS RIGID, SO
THERE IS NOT AS MUCH FLEXIBILITY IN THEIR.>>OH, ARE THE THINGS ACCURATE? CAN WE TRUST THESE?>>YES, THEY ARE. MY ONE CAVEAT WOULD BE, IF
THERE IS A MAJOR DISCREPANCY, JUST BRING THE DEVICE AND WHEN
YOU SEE YOUR PHYSICIAN, AND HAVE YOUR PHYSICIAN CORROBORATE
THAT IT IS MEASURING ACCURATELY, BUT GENERALLY, THEY
ARE QUITE ACCURATE.>>ALL RIGHT, LET’S TALK ABOUT
HOW DO WE GET THE NUMBERS WERE WE NEED THEM TO BE? WHAT DO WE NEED TO DO?>>WELL, FIRST AND FOREMOST,
WHILE WE ALWAYS TALK ABOUT WITH HEART DISEASE IS LIFESTYLE AND
HEALTHY HABITS. TYPICALLY WITH HIGH BLOOD
PRESSURE, LIKE MANY OTHER CHOLESTEROL ISSUES, IT IS
EATING HEALTHY, AND IN THIS CASE, WE ARE TRYING TO AVOID
SALT, AND IT IS WEIGHT LOSS, MAKING SURE YOU’RE NOT
STRETCHING YOUR WAIST LINE, AND IT IS EXERCISE. AGAIN, EXERCISES HELPING WITH
BURNING CALORIES AND PREVENTING SOME WEIGHT LOSS ISSUES.>>ALL RIGHT.>>WE CAN HANDLE IT. WE CAN BEAT IT?>>YEAH, AND IF THOSE EFFORTS
DON’T WORK, THEN WE HAVE SOME GREAT MEDICATIONS. YOU KNOW, IT USED TO BE THAT
OUR PHARMACY SELECTIONS WERE LIMITED BUT WE HAVE A LOT OF
MEDICATIONS THAT ARE LIMITED THAT YOU ONLY TO TAKE ONCE A
DAY WITHOUT A LOT OF SIDE EFFECTS, SO, IF YOU NEED TO BE
ON MEDICINE, WE HAVE SOMETHING THAT WILL WORK FOR YOU.>>THANK YOU, DOCTOR WILLETT.>>THANK YOU SO MUCH, VERY GOOD
INFORMATION, PENINSULA REGIONAL MEDICAL CENTER.

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