Blood Pressure Medication: Key Questions Answered

Blood pressure medication issues?

Hello, doctor.
About six months ago, during a health check, my blood pressure was 150/101.
Since then, at the hospital, my systolic blood pressure has been around 150 to 160, and my diastolic pressure has been in the 90s to low 100s.
I then bought an OMRON arm blood pressure monitor and measured my blood pressure continuously for a month, averaging 132/88 in the morning and 125/81 in the evening.
I brought this device to the hospital for comparison, and indeed, the hospital readings tend to be higher, so the device itself should be fine.
I considered the possibility of white coat hypertension, but due to concerns about high blood pressure, I started taking medication.
The hospital prescribed LOSARTAN, and after taking it, my readings at the hospital were around 120 to 130/80s.
However, strangely, my blood pressure at home hasn't changed much.
Q1: Do I really have high blood pressure?
Q2: Is LOSARTAN suitable for me considering my relatively high diastolic pressure?
Q3: Are there any specific lifestyle changes I should pay attention to regarding my diastolic pressure?

Chen Yu, 40~49 year old female. Ask Date: 2016/10/26

Dr. Li Han reply Cardiology

Hello, if your blood pressure is above 140/90 or requires medication to maintain it within that range, it can be considered hypertension.
Based on your blood pressure readings after taking losartan, it seems to be an appropriate medication for you.
For non-pharmacological management of blood pressure, remember to reduce salt and oil intake, increase physical activity, consume more fruits and vegetables, and limit meat consumption.
Life stress is everywhere, so try not to worry too much or get caught up in it.
The Changhua Hospital of the Ministry of Health and Welfare cares about you.

Reply Date: 2016/10/26

More Info

Understanding blood pressure and the appropriate use of medications is crucial for managing hypertension effectively. Based on your situation, let's address your questions and provide some insights into blood pressure management.

Q1: Do I really have high blood pressure?
Based on the readings you've provided, it appears that you may have hypertension, particularly if your blood pressure consistently measures above 130/80 mmHg. The American College of Cardiology (ACC) and the American Heart Association (AHA) define hypertension as a blood pressure reading of 130/80 mmHg or higher. Your initial readings of 150/101 indicate stage 2 hypertension, which requires medical intervention.
However, the phenomenon known as "white coat syndrome" can occur, where patients experience elevated blood pressure readings in a clinical setting due to anxiety. Your home monitoring shows lower readings, which is a positive sign. It’s essential to continue monitoring your blood pressure at home and share these readings with your healthcare provider for a comprehensive assessment.

Q2: Is Losartan suitable for my relatively high diastolic pressure?
Losartan is an angiotensin II receptor blocker (ARB) commonly prescribed for hypertension. It works by relaxing blood vessels, which helps lower blood pressure. Given that your systolic blood pressure readings have improved with Losartan, it suggests that the medication is effective for you.
Regarding your diastolic pressure, while it is essential to monitor both systolic and diastolic readings, the focus should be on overall cardiovascular health. A diastolic pressure in the 80s is still within the normal range, but if it consistently trends higher, it may warrant further discussion with your healthcare provider. Losartan can be effective in managing both systolic and diastolic pressures, but if your diastolic pressure remains elevated despite treatment, your doctor may consider adjusting your medication or adding another antihypertensive agent.

Q3: What lifestyle changes should I consider for managing diastolic pressure?
Lifestyle modifications play a significant role in managing blood pressure. Here are some recommendations:
1. Diet: Adopt a heart-healthy diet such as the DASH (Dietary Approaches to Stop Hypertension) diet, which emphasizes fruits, vegetables, whole grains, and low-fat dairy while reducing saturated fat and cholesterol. Limiting sodium intake to less than 2,300 mg per day (or ideally 1,500 mg) can significantly impact blood pressure.

2. Exercise: Regular physical activity can help lower blood pressure. Aim for at least 150 minutes of moderate aerobic exercise each week, such as brisk walking, cycling, or swimming. Incorporating strength training exercises at least twice a week can also be beneficial.

3. Weight Management: If you are overweight, losing even a small amount of weight can help reduce blood pressure. Focus on gradual weight loss through a combination of diet and exercise.

4. Limit Alcohol and Quit Smoking: Reducing alcohol intake and quitting smoking can improve overall cardiovascular health and lower blood pressure.

5. Stress Management: Chronic stress can contribute to high blood pressure. Techniques such as mindfulness, meditation, yoga, or deep-breathing exercises can help manage stress levels.

6. Regular Monitoring: Continue to monitor your blood pressure at home and keep a log to discuss with your healthcare provider. This will help in adjusting your treatment plan as necessary.

Conclusion
In summary, it seems you are managing your hypertension with Losartan, which is a suitable choice given your readings. However, it’s essential to continue monitoring your blood pressure at home and maintain regular follow-ups with your healthcare provider. Lifestyle changes can significantly enhance your blood pressure management and overall health. If you have further concerns or if your blood pressure readings do not improve, do not hesitate to reach out to your doctor for a more tailored approach to your treatment.

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