High blood pressure problems

Dear Dr. Eva,

I’ve been on high blood pressure medication for several years. When I get a headache, since that is a sign of high blood pressure, I take an extra pill. I also take an extra dose when I eat pork, because I’ve heard it increases blood pressure (BP). Since I’ve noticed some problems with sex from my medicine, if I expect to be having sex I skip the dose that day. I know that’s probably bad, but sex is important to me. My doctor recommended a home BP cuff, but my insurance doesn’t cover it so I haven’t gotten one. What do you advise? – John R

Dear John,

I agree that sex is important! Have you discussed this problem with your health care provider? You could switch to a BP med that doesn’t have sexual side effects. It’s important for you to be on one that you are able to take every day.

Taking extra doses of your medication is a bad idea, especially if you take them without checking your blood pressure first. Even if a person does check their BP at home and it is elevated (meaning over 140/90), it’s not smart to take extra doses before discussing with doctor. In most cases the answer will be that if BP is elevated it would make more sense to increase the daily dose of medication, or add another medication. Since most BP medicines last all day, if you take an extra dose when your pressure is high, the extra dose may cause your blood pressure to be too low later in the day. Low blood pressure can cause light-headedness and even fainting.

Although it’s a common belief that high blood pressure (which is also called hypertension) causes headaches, it’s not true. Hypertension is called the silent killer because there are no symptoms except for the complications that happen after years of uncontrolled high BP – stroke, heart attack and kidney failure. Any kind of pain, including a severe headache, can raise a person’s BP, but it’s the pain that triggers the rise, not the rise in BP that causes the pain.

Besides pain, other common causes of worsening high blood pressure include:

* High intake of salt. Most fast foods and many snack foods contain unhealthy amounts of salt. Pork only increases BP if it is preserved or prepared with salt. For example, ham, bacon and cold cuts are preserved with salt and should be avoided. Fresh pork, like pork chops, does not cause a rise in BP as long as no salt is added.

*Smoking tobacco. Tobacco constricts blood vessels for 90 minutes after each cigarette. Narrowing of the blood vessels causes the blood pressure to rise.

*Overweight, especially recent weight gain. Every pound of fat includes many small blood vessels, and the heart must work harder to pump blood into them.

Lack of exercise. If your body is not used to being active, your blood pressure tends to be higher even at rest, and any exertion will raise your BP more.

*Emotional stress, especially if it is ongoing. The stress causes adrenaline (epinephrine) release, which constricts the blood vessels.

*Alcohol use: having more than two drinks a day doubles a person’s risk for high blood pressure. The risk gets worse as the number of drinks per day gets higher.

*Some medicines increase blood pressure, especially ibuprofen, naproxen, prescription arthritis medicines, and birth control pills.

You can find out for yourself whether your blood pressure goes up with headaches, and take more control over it by checking it at home. Reporting your home blood pressures to your health care provider will lead to better management of high blood pressure. BP cuffs are an important investment to make in your health. Good cuffs are available at most large drugstores or online for $40-$60. The ones worn around the upper arm are usually more accurate than those worn on the wrist. Also bring your cuff to your health care provider’s office to check its accuracy before relying on the results.

A long-term study recently proved that people with well controlled hypertension live an average of five years longer than people with hypertension that is uncontrolled. And that does not take into account the lower quality of life of those living after strokes or heart attacks. Despite this, only about half of people with high BP have it under good control. This is due to both patients and health care professionals not taking the problem seriously enough. It is hard for people to be consistent in taking medicine for a silent problem. But if you make the effort to keep your BP under control every day, your life will be healthier and longer. – Dr. Eva

Ask Dr. Eva is distributed by Healthy Living News. Email comments and questions to dreva AT healthylivingnews.org

More from Around NYC