New goals for the treatment of high blood pressure were
recently released. The standards were loosened a bit for patients older than
60, mainly because the panel that issued the recommendations was concerned
about low blood pressure.
Our blood pressure is not static; it changes according to
the body’s needs. In order not to pass out when you get out of bed, your heart
needs to pump enough blood upstairs to perfuse your brain. If you need to
suddenly run to catch a train, your body needs to get enough blood to your
large leg muscles to get you going. On the other hand, one of the goals of
blood pressure control can be to blunt this response since suddenly moving a
large volume of blood can put a big strain on the heart.
The metabolism of blood pressure medications also changes
with time. As we mature, we can expect kidney function to decrease. Therefore,
medications that are metabolized by the renal system may appear to be
‘stronger’ to the body, requiring a change in dosage. Tighter control of blood pressure may be
important to prevent consequences of other diseases such as diabetes.
Blood pressure that is too low for the patient can have a
dreaded consequence: a fall with a head injury. Breaking a hip or an arm is no
fun either. Since diuretics are usually a part of blood pressure regimens,
blood tests are needed to monitor electrolytes.
I like to see my hypertensive patients every three months for
a blood pressure check. Depending on the individual patient, blood tests may be
drawn at these visits. It’s a chance to monitor the patient’s weight and also
review the potential side-effects of medication. Of course – the primary reason
for the visit is to make sure that the blood pressure is in control.
More information:
A nice summary from Harvard Health Publications.
The full set of guidelines.
No comments:
Post a Comment