Patient Information

Blood pressure is one of the four vital signs that indicate overall health. Your blood pressure is the force of blood against the walls of your blood vessels. High blood pressure (hypertension) means there is too much pressure in your blood vessels which, over time, can damage your blood vessels and organs. Low blood pressure is a concern when you’re feeling dizzy or faint, in which case you should speak to your health care professional.

Some risk factors for high blood pressure such as family history, age, and gender, can’t be changed. Other factors are controllable, such as: smoking status, alcohol intake, exercise, and diet. Adopting healthy habits is an integral part to reducing your blood pressure and cardiovascular risk over the longer-term.

In the short term, the human body can accommodate a wide range of blood pressures without any issue. Over the long-term (years – decades), however, high blood pressure causes cumulative stress and damage to your vessels and essential organs, including the heart, brain, eyes and kidneys. As a result, long-term uncontrolled hypertension is a major risk factor for developing heart attacks, heart failure, strokes, vascular dementia, blindness (hypertensive retinopathy), and kidney failure. By managing hypertension soon after diagnosis, we can significantly reduce the risk of these events occurring.

Blood pressure is measured on the upper arm using a device with an inflatable cuff. Blood pressure readings have two numbers, one on top of the other, as in 120/80 mmHg. The abbreviation “mmHg” represents millimeters of mercury, a standard measurement of pressure. The top number is your systolic blood pressure and is the highest level of pressure reached in your largest arteries as your heart beats. The bottom number is your diastolic blood pressure and is the lowest level of pressure in these same vessels as your heart relaxes between beats.

• Take your blood pressure after 5 minutes of calmly sitting, ideally in a chair.
• Avoid caffeine or tobacco in the 30 minutes prior to measuring your blood pressure.
• Your arm should be bare and supported on either a table or armrest close to the level of your heart.
• Sit upright with your back supported and your feet flat on the floor.
• You should avoid talking, clenching your hand, doing other activities, or crossing your legs when measuring your blood pressure
• Take 2-3 readings and discard the highest reading
• Record your blood pressure in a log
• We recommend measuring your blood pressure once first thing in the morning and again closer to bedtime.

It’s helpful to know the target when aiming to lower blood pressure. Generally speaking, a ‘normal’ blood pressure is approximately 120/80mmHg, with clinical hypertension typically diagnosed with blood pressure readings consistently above 140/90 as per Hypertension Canada guidelines.

Treatment of hypertension should always involve lifestyle changes such as diet modifications, exercise, and stress reduction. There are a wide variety of medications that are used in the treatment of hypertension, with common classes such as: diuretics, ACE inhibitors and Angiotension Receptor Blockers (ARBs), beta-blockers, and calcium channel blockers. Your doctor will select the most appropriate medication or combination of medications for you based on your age and other vascular risk factors.

Hypertension is often called the “silent killer” because it usually doesn’t have noticeable symptoms. Some people may experience headaches, shortness of breath, or nosebleeds, but these are not reliable indicators.

Reducing sodium / salt intake is an important dietary modification for most hypertensive patients. It’s important to consume a diet rich in fruits, vegetables, whole grains, lean proteins, and low-fat dairy products. Many of these changes make up the DASH diet, which has been proven to help reduce blood pressure in hypertensive individuals.

It is important to remain calm. If you have new concerning symptoms such as central chest pain, a new tearing type pain between your shoulder blades, sudden new visual disturbance, or signs of an acute stroke (slurred speech, face, arm, or leg numbness / weakness) you should seek immediate medical attention by calling 911.

For the vast majority of individuals, however, a very elevated reading in the absence of symptoms is not cause for immediate alarm. Measure your blood pressure at least twice after 5 minutes of calm and using the other instructions mentioned above. If your blood pressure remains elevated on repeated measurement using proper technique, and presuming you have not forgotten to take your prescribed blood pressure medications, please call our office to book an urgent follow-up appointment.

Even for patients with significantly elevated blood pressure readings, unless in the case of hypertensive emergency, blood pressure should ideally be lowered over days to weeks. Rapidly lowering blood pressure to ‘normal’ within hours is more likely to cause harm such as symptoms of dizziness, feinting episodes, and fatigue. For the vast majority of cases, blood pressure treatment is best approached as a marathon, not a sprint.

No. Exercise is an important part of controlling high blood pressure over the long term, and guidelines recommend a minimum of 30 minutes of moderate intensity aerobic exercise 4 times a week. Even resistance activities that temporarily increase your blood pressure such as weightlifting are safe and more likely to be beneficial than harmful.