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Tips to Control Blood Pressure

Home monitoring of BP

Measuring the blood pressure at home leads to better compliance and smoother control. Blood pressure in the clinic could be falsely high due to emotion (White coat hypertension). When in doubt, a 24 hours ambulatory blood pressure monitoring can be done to identify changes of BP throughout the day in different settings.

Salt Intake

The commonest reason for high blood pressure is the salt intake. Culturally our food, specially the Indian food, contains large quantities of salt ( pickles ). People working in farms and sweating in large quantities, compensated for the salt loss with dietary intake of salt to prevent exhaustion. However in the present age, we hardly sweat since we air condition our homes and working places. It is essential that we reduce the salt intake to control our Blood Pressure.

Physical activity

Exercise is very important in helping reduce Blood Pressure. All forms of isotonic exercises where the muscle tone does not change, but the length varies ( aerobic exercise, free hand exercise, walking etc) will lower 5 to 10 mm of blood pressure over a period of time. Isometric exercises (weight lifting, resistance training etc) lead to rise in blood pressure.

Bio feedback mechanisms

Yoga, meditation, music therapy and others can lower blood pressure by reducing the output of impulses from the nervous system.

Body weight ( BMI, Waist-Hip Ratio etc)

Obesity is associated with high blood pressure, weight reduction lowers blood pressure.

Drugs

All drug therapies require proper supervision by a physician.There are several groups of drugs available to control blood pressure.

  1. Diuretics (like Thiazide)
    These drugs remove salt through the kidneys leading to drop in Blood Pressure.Common side effects : Weakness, low potassium.

  2. Calcium channel blockers (like nifedipine, amlodipine etc)
    These drugs block the cellular passage of calcium in blood vessels and produce dilatation of blood vessels leading to drop in blood pressure. Common side effects : Swelling of legs

  3. Angiotensin Converting Enzyme (ACE) Inhibitors (like Captopril, Enalapril, Lisinopril etc)
    A harmone called Renin that is produced in the kidney acts on the substance called angiotensinogen and converts it to angiotensin I & II. Angiotensin-II is a powerful constrictor of blood vessels. These drugs - ACE inhibitors act on angiotensin converting enzyme and prevent angiotensin formation. Common side effects : Cough, High potassium

  4. Angiotensin - II blockers ( Losartan, valsartan, irbesartan etc)
    These drugs prevent the action of angiotensin-II on the blood vessels. Common side effects: Cough, High potassium

  5. Alpha blockers ( Prazosin etc)
    Alpha receptors are present in blood vessels. Stimulating them will produce constriction of blood vessels leading to high blood pressure. These drugs block the alpha receptors leading to drop in blood pressure. Common side effects : Swelling of the legs.

  6. Beta blockers (like Atenolol, Metoprolol etc)
    These drugs block beta receptors. Beta receptors are mainly present in the heart. Blocking them will result in drop in blood pressure and drop in heart rate.

  7. Centrally acting drugs (like Clonidine, Reserpine etc)
    These drugs act on the central nervous system resulting in reduced production of certain hormones leading to drop in blood pressure. Common side effects : Depression.

    Do not stop the drugs even if the blood pressure is under good control without the physicians advice

Further reading

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