1. Racquel Wright, Natalya Cummings, Balraj Kaur, Michelle Jimenez NOT TOO HIGH, NOT TOO LOW, BUT JUST RIGHT! UNDERSTANDING YOUR BLOOD PRESSURE AND MANAGING HYPERTENSION

2. Today We’ll Talk about …  What does your heart do?  What is blood pressure?  What should your blood pressure numbers be?  What are the signs/symptoms of high and low blood pressure?  What do you do if your blood pressure numbers are too high or too low?

3. Your Heart  It looks like an ice- cream cone!  Pointed bottom  Rounded top  Hollow  Can fill up with blood

4. More about Your Heart – In middle of chest – Between your lungs – Size of fist – Tipped over More on left side – Is a muscle Acts like a pump

5. Your heart sends blood to the whole body  Oxygen  Nutrients  Carries away waste Heart Parts:  Arteries  Capillaries  Veins

6. Blood Pressure Measurement  Force of blood pushing against the walls of the arteries Force Amount of blood Size Flexibility of the arteries

7. Steps to follow before Taking your Blood Pressure  Don’t use 30 minutes prior to taking your blood pressure:  Caffeine,  Alcohol, or  Tobacco.  Go to the bathroom.  Rest 3-5 minutes before taking your blood pressure.  Sit comfortably.  Legs and ankles uncrossed  Back supported

8. Tips for Accurate Use  Same time of day  Use the same arm  Left  Don’t measure  immediately upon waking up, or  immediately after exercising. Wait an hour.

9. Remember Blood Pressure….  Varies throughout the day  Is often higher in the morning  Talk about your personal blood pressure goals with your doctor.

10. Risk Factors  Age  Race  Family history  Being overweight or obese.  Not being physically active.  Certain chronic conditions i.e high cholesterol, diabetes, kidney disease and sleep apnea.

11. Risk Factors  Using tobacco.  Too much salt (sodium) in your diet.  Too little potassium in your diet  Too little vitamin D in your diet.  Drinking too much alcohol.  Stress

12. Causes  Primary (essential) hypertension For most adults, there's no identifiable cause of high blood pressure.  Secondary hypertension Some people have high blood pressure caused by an underlying condition. Various conditions and medications can lead to secondary hypertension, including:  Kidney problems  Adrenal gland tumors  Certain defects in blood vessels you're born with (congenital)  Certain medications, such as birth control pills, cold remedies, decongestants, over-the-counter pain relievers and some prescription drugs  Illegal drugs, such as cocaine and amphetamines

13. What Does Your Blood Pressure Reading Mean? Normal Less than 120 Less than 80 Pre-hypertension 120-139 80-89 High Blood Pressure – Stage 1 140-159 90 – 99 High Blood Pressure – Stage 2 160 or higher 100 or higher

14. Why Worry about High Blood Pressure? Heart gets larger Leads to heart failure Heart can’t pump enough blood throughout the body. Small bulges in blood vessels “Aneurysms” Main artery from the heart Arteries in the brain, legs, and intestines Artery to the spleen Blood vessels in kidneys narrow Kidney failure Arteries in the body harden faster Heart attack Stroke Kidney failure Amputation of part of the leg Blood vessels in the eyes burst or bleed Vision changes Blindness

15. Signs/Symptoms Hypertension (high BP) Hypotension (low BP) Headache Dizziness Dizziness Fainting Shortness of breath Blurred vision Blurred vision Cold, clammy skin Nausea Rapid, shallow breathing Fatigue or confusion Nausea Pounding in your chest Thirst Irregular heartbeat Chest pain

16. Treatment  All patients with blood pressure readings greater than 120/80 should be encouraged to make lifestyle modifications, such as eating a healthier diet, quitting smoking, and getting more exercise. Treatment with medication is recommended to lower blood pressure to less than 140/90. For patients who have diabetes or chronic kidney disease the recommended blood pressure is less than 130/80. Thiazide diuretics.  Diuretics sometimes called water pills, are medications that act on your kidneys to help your body eliminate sodium and water, reducing blood volume. Ex: Aldoril, Diachlor, Diuril  Beta blockers. These medications reduce the workload on your heart and open your blood vessels, causing your heart to beat slower and with less force. Ex: atenolol, metoprolol

17. Treatment  Angiotensin-converting enzyme (ACE) inhibitors.  These medications help relax blood vessels by blocking the formation of a natural chemical that narrows blood vessels. Ex: vasotec, lisinopril  Angiotensin II receptor blockers (ARBs).  These medications help relax blood vessels by blocking the action of a natural chemical that narrows blood vessels. Ex losartan, valsartan  Calcium channel blockers.  These medications help relax the muscles of your blood vessels. Some slow your heart rate. Calcium channel blockers may work better for blacks and older adults than do ACE inhibitors or beta blockers alone. A word of caution for grapefruit lovers, though. Grapefruit juice interacts with some calcium channel blockers, increasing blood levels of the medication and putting you at higher risk of side effects. Ex: procardia  Renin inhibitors.  slows down the production of renin, an enzyme produced by your kidneys that starts a chain of chemical steps that increases blood pressure. Ex: tekturna

18. Lifestyle Changes  Eat healthy foods. Dietary Approaches to Stop Hypertension (DASH) diet: fruits, vegetables, whole grains and low-fat dairy foods.  Decrease the salt in your diet. A lower sodium level — 1,500 milligrams (mg) a day —  Maintain a healthy weight. If you're overweight, losing even 5 pounds (2.3 kilograms) can lower your blood pressure.

19. Alternative Medicine  Although diet and exercise are the best tactics to lower your blood pressure, some supplements also may help decrease it. These include:  Alpha-linolenic acid  Blond psyllium  Calcium  Cocoa  Cod-liver oil  Coenzyme Q10  Omega-3 fatty acids  Garlic  While it's best to include these supplements in your diet as foods, you can also take supplement pills or capsules  You can also practice relaxation techniques, such as yoga or deep breathing, to help you relax and reduce your stress level.

20. Alternative methods  Increase physical activity.  Limit alcohol  Don't smoke. Tobacco injures blood vessel walls and speeds up the process of hardening of the arteries.  Manage stress  Monitor your blood pressure at home  Practice relaxation or slow, deep breathing.

21. How Often Should You Check Your Blood Pressure? A few days every month if you…  have well controlled blood pressure  More often if you…  just started home monitoring of your blood pressure  changed medications  have health problems http://www.mayoclinic.com/health/high-blood-pressure/HI00016

22. Call Your Doctor When…  Your blood pressure is higher or lower than normal, and you have:  Severe headache, or  Chest pain, or  Numbness, or Tingling  Dizziness or fainting  Cold, clammy skin  Rapid, shallow breathing

23. Start Monitoring  Easy  Convenient  It betters your health.  Try it!

24. Questions?

25. References  Touhy, T. A., & Jett, K. F. (2010). Ebersole and Hess' Gerontological Nursing & Healthy Aging (3rd ed.). St. Louis, MO: Mosby Elsevier.  Centers for Disease Control and Prevention. (2010), High blood pressure. Retrieved from http://www.cdc.gov/bloodpressure/  Mayo Clinic. (2012, Aug. 10). Blood pressure charts. Retrieved from http://www.mayoclinic.com/health/blood- pressure/HI00043