By Lynne Perry-Bottinger, M.D., F.A.C.C.

Your loved one may be suffering from hypertension, also known as high blood pressure, and neither one of you may know it. The American Heart Association reports more than 72 million Americans have high blood pressure and of those, one-third aren’t aware they have it.

Labeled “the silent killer,” this condition has no symptoms and puts your loved one at greater risk for heart attack, stroke, and kidney disorders. The best way to know if your loved one has high blood pressure is to have his or her blood pressure checked regularly by a healthcare professional. As a caregiver you need to understand what high blood pressure is, and what signs to look for that may signal its presence. 

“Signs” of High Blood Pressure

When the heart beats, pressure is created to pump blood through the arteries. In between beats, the heart is “at rest.”  Having high blood pressure means there’s too much pressure when the heart is pumping and so, blood vessels are strained.  As a result, your loved one may have high blood pressure, particularly if he/she is experiencing:

• Nose bleeds
• Persistent headaches
• Chest pain
• Buzzing in one or both ears
• Vision changes
• Unexplained fatigue

You should know too that some over-the-counter and prescription medications, such as cold medicines, appetite suppressants, birth control pills and certain migraine medications, can cause blood pressure to rise; likewise, excessive use of alcohol can also contribute to this condition. If your loved one shows any of these signs, be sure to take him/her promptly to the doctor to be clinically evaluated.

See the Doctor

During your loved one’s  appointment, the doctor will take his or her blood pressure.  If warranted, the doctor may also order additional diagnostic tests to determine if your loved one’s high blood pressure is related to another underlying condition or disease, such as diabetes, kidney disease, or arteriosclerosis or hardening of the arteries. 

Blood Pressure Reading

A blood pressure reading is done to assess the amount of pressure in the blood vessels when the heart is pumping and when it’s at rest. This comparative number indicates the pumping or “systolic” pressure (top number) and the resting rate or “diastolic” pressure (bottom number). Blood pressure varies by individual but in general, a resting blood pressure under 120/80 mmHg is considered normal; a reading between 120/80 mmHg and 140/90 mmHg is pre-hypertension—anyone at this stage should start limiting sodium in his/her diet; and consistent readings of 140/90 mmHg or higher indicate hypertension.

If the doctor determines your loved one has high blood pressure, there are a number of ways to lower it, including using medications and making relatively simple lifestyle changes. Here’s where you can help.

Support a Healthy Lifestyle

Making healthy lifestyle changes will help your loved one manage, and hopefully lower, his/her high blood pressure and reduce risk factors for heart attack, stroke, and heart disease, among others. You can be your loved one’s strongest ally by encouraging a healthy lifestyle that includes:

• Getting regular exercise—The American Heart Association recommends at least 30 minutes per day of moderate to vigorous physical exercise.  Just be sure you consult your loved one’s physician before starting any new physical activity program.  Consider accompanying, or better yet, participating in this program with your loved one.  You’ll both benefit!
• Losing weight—If your loved one is overweight, you can work with a dietitian or nutritionist to plan a healthy diet and exercise program that meets his/her needs. Weight loss often helps reduce high blood pressure to a healthier level. As a caregiver, you can provide ongoing encouragement to your loved one, particularly if a plateau is reached in his/her weight-loss program.
• Finding ways to reduce stress—Take some time each day to relax (good advice for your loved one andyou!).  Meditation, prayer, or just appreciating quiet time has been proven to lower blood pressure; likewise, enjoying a relaxing walk together or reading a favorite book to your loved one can help calm the stressors of your day.
• Reducing salt in the diet— A low salt or sodium diet may be part of the lifestyle changes recommended to help reduce blood pressure for your loved one. Because sodium is present in many foods, it ’s best to keep sodium to less than 200 mg per serving size if your loved one has high blood pressure. If any of his/her favorite foods have high salt content, such as canned soups, soy sauce, some processed foods and beverages, look for low salt alternatives. Get in the habit of checking the labels on food packages. You may also want to explore replacing salt with fresh herbs or spices to make foods tastier and healthier.
• Eating heart healthy—Your loved one will benefit from a diet of whole-grain, high fiber foods, and fruits and vegetables, as well as lean meats, fish, poultry, and low-fat or fat-free dairy products.  These heart-healthy foods are low in saturated and trans fats, salt and cholesterol. Furthermore, the Dietary Approaches to Stop Hypertension study, or DASH, shows diets rich in potassium can lower blood pressure. Make potassium-rich foods, such as bananas, kiwi, and oranges, an important part of your loved one’s diet.
• Limiting alcohol—Studies show a relationship between high alcohol consumption and high blood pressure. If your loved one is a male adult drinking more than three drinks daily he needs to limit his alcoholic beverages to two per day. Adult women should have only one drink per day. Reduced alcohol consumption can have a positive impact on your loved one’s blood pressure.
• Quitting smoking—A major risk factor for heart disease and stroke, smoking also raises blood pressure.  If your loved one struggles with quitting, seek a support group for him/her.  Alternative medicine is also a consideration, as well as a variety of over-the-counter and prescription cessation products that lower cravings for nicotine. Your doctor can provide counsel on resources and products to help your loved one quit.

If your loved one is prescribed blood pressure-lowering medications, be sure that he/she takes them. You can track his/her medication schedule, as well as diet and exercise program using a small notebook or journal. Additionally, you can monitor his/her blood pressure at home by recording the time, date, and number. Capturing this information is a useful resource for your loved one’s doctor to review at the next appointment. 

Remember high blood pressure is treatable and manageable. As a caregiver, you can provide the critical support your loved one needs to follow the doctor’s advice and treatment plan for lowering it.