You Shouldnt Ignore White Coat Hypertension
Some people experience white coat hypertension, when blood pressure is elevated in the doctors office but not in other settings. These patients need to monitor their blood pressure at home or wear an ambulatory blood pressure monitor that takes your blood pressure every 30 minutes for 24 hours.
While white coat hypertension was formerly considered simple nervousness, recent research suggests otherwise.
A study published in the journal Hypertension found that people with white coat hypertension are at a significantly greater risk for developing sustained high blood pressure than people who have normal blood pressure. One possible explanation is that people with white coat hypertension have a harder time managing stress and anxiety.
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About High Blood Pressure
High blood pressure, also known as hypertension, is usually defined as having a sustained blood pressure of 140/90mmHg or above.
The line between normal and raised blood pressure is not fixed and depends on your individual circumstances. However, most doctors agree that the ideal blood pressure for a physically healthy person is around 120/80mmHg.
A normal blood pressure reading is classed as less than 130/80mmHg.
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Regular Blood Pressure Checks If Diagnosed With High Blood Pressure
If you are diagnosed with high blood pressure, your blood pressure will need to be closely monitored until it is brought under control.
After your blood pressure has been controlled, your GP or practice nurse will measure your blood pressure at agreed regular intervals .
It is important you attend these appointments to ensure your blood pressure is being maintained within an acceptable range.
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Data Management And Monitoring
Patient data will be documented by dedicated trial personnel and managed in an eCRF using a trial management software. Data will be entered via an encrypted connection in web browser input masks. Each patient will be given an identification number to ensure pseudonymized data analysis. Each change in the data, e.g., due to resolved queries, will be documented by an automated audit trail. Pseudonymized data will be stored in accordance with local data protection laws.
Trial site monitoring will be conducted to ensure that the rights and well-being of patients are protected that the reported trial data are accurate, complete, and verifiable and that the conduct of the trial follows the currently approved protocol/amendment, with good clinical practice and with applicable regulatory requirements. The monitoring comprises the following tasks: training of the trial personnel prior to trial start , regular on-site monitoring visits, and a close-out visit at the end of the trial. Central elements of the monitoring are the verification of consent and inclusion criteria, along with trial conduct.
Is It Normal For Blood Pressure To Fluctuate
Its normal for blood pressure to vary somewhat throughout the day. Stress, exercise, and sleep can all make a difference. But if your blood pressure often changes significantly from one healthcare visit to another, there may a problem.
Studies have found that visit-to-visit changes in blood pressure are sometimes linked to a higher risk of heart disease and early death.
This article explains why your blood pressure numbers may be high sometimes and normal other times. It also offers advice about when to see a healthcare provider.
Verywell / Cindy Chung
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Treating High Blood Pressure
Treatment for high blood pressure will depend on your blood pressure levels and your associated risk of developing a cardiovascular disease, such as a heart attack or stroke.
There are seven main risk factors for developing a cardiovascular disease. These are:
- having a high level of cholesterol in your blood
- having a family history of cardiovascular disease .
How To Deal With Heart Racing At Night
Treatment options of heart racing at night depend on the underlying cause. In most cases, it is harmless and may go away without treatment. Your doctor may suggest you to avoid certain triggers and modify your lifestyle such as:
1. Medications
Treatments for palpitation include antiarrhythmic drugs, such as beta blockers or calcium channel blockers. If these medications do not effectively reduce your palpitations, stronger drugs that act directly on the heart may be necessary. Remember to follow the medical professionals advice on when taking medication.
2. Catheter Ablation
This procedure involves small wires being threaded from your leg veins into your heart to trigger arrhythmia, in order to identify and treat the problem areas. This is highly effective when the specific region causing the heart problem is identified, such as an SVT or supraventricular tachycardia.
3. Home Remedies
If you do not have any medical problem that needs specific treatment, certain remedies may be sufficient to relieve heart racing at night.Here are some effective home remedies:
- Taking grape juice several times a day can help with palpitation.
- Ripe guava may be eaten on an empty stomach also good for anemia and nervousness.
- Powdered anise seeds combined with dry coriander.
- Honey can be taken with a glass of water and lemon juice, before going to bed.
4. Avoid Triggers
7. Preventive Tips
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How Is Blood Pressure Measured
Blood pressure is measured using a machine called a blood pressure monitor.
A cuff is put over your arm. This cuff is attached to a machine which measures the pressure inside your arteries. When the machine is switched on the cuff tightens and then slowly loosens again. It is quick and painless. At the end, the machine will give a blood pressure reading.
Blood pressure is measured in millimetres of mercury .
A blood pressure reading contains two numbers and will be written as a figure like 120/75
The first number is the pressure when your heart beats . The second number is when your heart relaxes .
During a blood pressure test, a blood pressure cuff is wrapped around your arm so a blood pressure monitor can measure your systolic and diastolic blood pressure.
Maintain A Healthy Weight
Being overweight is a risk factor for having high blood pressure, and your risk increases further if you are obese.
There are two ways to check if you are overweight:
- Body Mass Index – This is your weight in kilograms divided by your height in metres squared. In the UK, people with a BMI of between 25 to 30 are overweight, and those with an index above 30 are classed as obese. People with a BMI of 40 or more are morbidly obese.
- Waist size – Using a measuring tape place the tape round your waist between the bottom of your ribs and the top of your hip bone. The table below indicates how much your health might be at risk, your ethnicity should also be taken into account.
| Sex | |
| Over 80 cm |
The best way to tackle obesity is by reducing the amount of calories that you eat, and taking regular exercise. Your GP can provide you with further information and advice on how you can do this.
More about having a healthy weight
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Special Subtypes Of Ah Patients
OBPM is an accessible, cheap and simple method to assess AH. However, as experts emphasized, the measurements were often not appropriately done, resulting in misdiagnosis of AH and the unnecessary treatment of patients. ABPM is the more expensive and difficult method to diagnose and assess AH. However, there are groups of patients with AH for whom OBPM is insufficient and ABPM is essential for objective assessment of BP control .
A special group are those with the WCH and AH patients with MH , AH in pregnancy or elderly patients. During antihypertensive therapy, assessing BP values based on ABPM is indispensable, particularly in the groups above . Perhaps this group should include patients with diabetes in whom achieving adequate BP control seems particularly difficult .
In the general group of treated AH patients, about 30% have MH . WCH is also common, observed in 3040% of AH patients . WCH is uncommon in patients with resistant AH . Based on data from the SPRINT , the incidence of WCH in treated AH patients was approximately 10% . In another study, the prevalence of WCH was 3135% in primary AH patients .
MH patients characterise with more frequent diabetes mellitus, chronic kidney disease and high CV risk . Few studies assessed hard endpoints in the MH group. Considering high CV risk profile, ESH/ESC guidelines recommends intensifying hypotensive treatment in these group .
High Blood Sugar At Night: Symptoms
There are various indications of high blood sugar at night that you can easily watch out for if you suspect you may have the condition. You should note that you can experience high blood sugar risk even if you undergo diabetes management.
Human errors can sometimes cause people to make several mistakes that lead to sugar rise at night. In such instances, knowing the symptoms to watch out for can help them adjust better. If you experience symptoms like the following, theres a high chance that you have high blood sugar at night:
- Increased urination
- Irritability and sudden mood swings
- Change in appetite
These symptoms become commonplace when you experience spikes at night. Also, when they become continuous, you may experience different health complications. The best way to prevent such is to tackle the cause of the high blood sugar rise at night, and this is what the next section focuses on.
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What About Low Blood Pressure At Night
Its typical for your blood pressure to be lower at night than when youre awake. The drop in both systolic and diastolic blood pressure can be up to 20% lower than your reading in the daytime.
Low blood pressure isnt usually seen as problematic unless its accompanied by other symptoms, such as dizziness or fainting. If you often feel lightheaded when getting up after sitting still or lying down for a long period, take care to sit up and get out of bed slowly in the morning. The NHS website advises that you could also try raising the head of your bed by about 15cm with bricks or heavy books.
Tips For Taking An Accurate Blood Pressure Reading
Follow these recommendations to get an accurate blood pressure reading:
Measure your blood pressure at the same time each day
A good first step is to check your blood pressure at the same time every day to help even out fluctuations. You should also try to arrange appointments with your doctor at the same time of day.
Sit in the best position
Sit upright with your feet flat on the floor and your arm supported at the level of your heart . Use the same arm each time you check your blood pressure. Resist the urge to talk or do other activities while your blood pressure is being taken.
Take a reading twice a day
Some experts suggest checking blood pressure twice a day: when you first get up and in the evening after work. This would be the opposite if you work night shifts. Taking a blood pressure reading twice a day will also help you detect any abnormal fluctuations.
Wait 30 minutes after eating, drinking, smoking, or exercising
Leaving some time before you take a blood pressure reading after eating, drinking , smoking or exercising can allow your blood pressure to stabilize.
Keep a record of your readings
Keeping a record of your blood pressure readings is a good way to get an accurate, average measurement and highlight any unusual patterns. High blood pressure is not diagnosed after one high reading your doctor will assess your average blood pressure, so being able to show them a blood pressure log will be helpful.
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Good Sleep Can Prevent And Manage High Blood Pressure
Most people experience a dip in blood pressure during the deepest stage of sleep , which is the bodys normal and healthy reaction to sleep. Not having that nighttime dip is a risk factor for heart disease and may increase daytime blood pressure.
Typically people spend 90 minutes to two hours in slow wave sleep per night. A recent study published in Hypertension found that men who got less slow wave sleep each night were a higher risk for hypertension than men who got more deep sleep.
While sleep disorders, like sleep apnea, and age can both affect the amount of deep sleep you get, there are steps you can take to ensure a good nights sleep. Getting seven to eight hours of sleep a night, maintaining a consistent sleep schedule and being more active during the day can help improve the quality of your sleep.
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Should I Take My Blood Pressure Medication At Night
If you are experiencing a medical emergency, please call 911 or seek care at an emergency room.
Doctors often suggest taking daily medication in the morning, as part of your start-the-day routine. A recent study, however, suggests that taking your blood pressure medicines at night may offer important cardiovascular protective benefits. Dr. Allen J. Taylor, chairman of cardiology at MedStar Heart and Vascular Institute, gives us his thoughts on the study and what patients should know.
This large study, recently published in the European Heart Journal, certainly caught my attention. The eye-opener: study patients who took their prescribed blood pressure medicines at bedtime had a dramatically lower risk for serious cardiovascular conditions and death than people taking their medicines in the morning. Besides better controlling their blood pressure overall, patients who dosed at night experienced:
- 56% lower risk of death due to heart or blood vessel conditions
- 49% lower risk of stroke
- 34% lower risk of heart attack
- 40% lower risk of needing surgery to open or widen a vessel supplying blood to the heart
These impressive results seem almost too good to be true and, like all studies, the benefits should be validated and confirmed with more studies. Still, its large size and long duration give this current study considerable credibility.
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Treatment Of High Blood Pressure
Treatment for HBP depends on its severity and associated risks of developing other diseases. Treatment options include:
Lifestyle changes
- Make and keep appointments to see your doctor for routine check-ups and follow-up tests.
Medications
- ACE inhibitors will help blood vessels relax and open up, leading to a lower blood pressure.
- Angiotensin II receptor blockers will help blood vessels open up, leading to a lower blood pressure.
- Beta blockers will help reduce your blood pressure.
- Alpha blockers will help reduce the arteries resistance, relaxing the muscle tone of the vascular walls.
- Alpha-2 receptor agonists will help reduce blood pressure by decreasing the activity of the sympathetic portion of the involuntary nervous system.
- Calcium channel blockers will help relax and open up narrowed blood vessels, reduce heart rate and lower blood pressure.
- Combined alpha and beta blockers are used as an IV drip for those patients experiencing a hypertensive crisis.
- Central agonists will help decrease the blood vessels ability to tense up or contract.
- Diuretics water pills will help reduce the amount of fluid retention in your body.
- Peripheral adrenergic inhibitors will help reduce blood pressure by blocking neurotransmitters in the brain.
- Vasodilators will help the muscle in the walls of the blood vessels to relax, allowing the vessel to dilate.
Why Taking Blood Pressure Meds At Bedtime May Be More Effective
- New research suggests that taking your blood pressure medication at bedtime may more effectively reduce your risk of illness or death due to heart and blood vessel disease.
- Timing of medication is important because blood pressure follows a daily rhythm. It rises higher during the day and falls at night when we sleep.
- Rather than taking a blanket approach, experts say any medication regimen should be personalized for you based on a discussion with your physician.
Should you be taking your blood pressure medication at bedtime rather than in the morning?
Research published in the October 22, 2019, issue of the European Heart Journal suggests that maybe you should.
In the study, the researchers followed 19,084 patients with high blood pressure for a median of 6 years.
The patients were randomly assigned to one of two groups: those who took their blood pressure medication in the morning and those who took it at bedtime.
The researchers found that bedtime medication seemed to make a difference for patients as they had better nighttime blood pressure.
They also had less risk of illness or death due to heart and blood vessel disease.
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High Blood Pressure Facts
What every adult should know about high blood pressure, or hypertension
Theres a good reason why every doctors appointment starts with a blood pressure check. While one in three American adults has high blood pressure, about 20% of people are unaware that they have it because it is largely symptomless.
In fact, most people find out they have high blood pressure during a routine office visit.
Blood pressure is the force of blood pushing against the walls of arteries as the heart pumps blood. High blood pressure, also referred to as hypertension, is when that force is too high and begins harming the body. If left untreated, it willl eventually cause damage to the heart and blood vessels.
Your blood pressure is measured in two numbers: The top systolic blood pressure measures the force pushing against artery walls when the heart is contracting. The bottom diastolic blood pressure measures pressure in the arteries when the heart is resting between beats.
Normal blood pressure levels are 120 mmHg/80 mmHg or lower. At risk levels are 120-139 mmHg/80-89 mmHg. Readings of 140 mmHg/90 mmHg or higher are defined as high blood pressure.
Here are six other things you should know about high blood pressure.