The tools for managing hypertension

Hypertension is defined as elevated arterial blood pressure. While a few high readings here or there shouldn’t be terribly concerning, there are categories that indicate when a patient should be concerned:

120/80 = normal
121-129/80 = elevated but not high
Over 130/80 = high blood pressure

In order to help patients who are having a hard time managing their hypertension, Parkview opened the Hypertension Clinic. David Palmer, MD, Parkview Heart Institute, PPG – Cardiology, explains more about this beneficial, multidisciplinary service.

Symptoms

They call hypertension the silent killer, because there are often no symptoms until there’s already significant damage done. You don’t want to wait for symptoms to begin treatment. If your numbers are elevated, even if you aren’t experiencing any discomfort, you need to be getting treatment.

If the blood pressure is extremely elevated, typically a blood pressure of 180/120 or higher, you might notice headaches, shortness of breath, chest pain or other discomfort and you should consult your doctor immediately or go to the emergency room. But again, these are extreme cases.  

Risk factors

The risk factors for hypertension include:

  • Age – Before 65, men tend to have higher blood pressure, but after that, up to 70 percent of women will develop hypertension.
     
  • Ethnicity – African Americans are more likely to develop hypertension than other races.  
     
  • Diet – Those consuming a high salt diet are at a higher risk for hypertension.  
     
  • Smoking
     
  • Other medical conditions that can cause high blood pressure such as thyroid disease, adrenal gland problems, or kidney artery problems.
     
  • Chronic stress – Chronic, consistent stress can raise your blood pressure. I’ve had many patients say that after they retired their blood pressure came down and they could reduce their medication. Managing stress is an important reduction strategy for high blood pressure. When people say, “I can feel my blood pressure rising,” that is likely a sign that they are feeling the stress rather than their blood pressure. But if you are feeling symptoms that could be a sign of severe hypertension and you should check your blood pressure.
     
  • Family history of hypertension
     
  • Chronic kidney disease
     
  • Diabetes mellitus
     
  • Obstructive sleep apnea
     
  • Excessive alcohol consumption
     
  • Being significantly overweight or obese
The Parkview Hypertension Clinic

The Parkview Hypertension Clinic was specifically designed for patients who have difficult-to-control hypertension. Typically, they have been seen by their primary care provider and, either because of difficulty taking their medications as prescribed or various confounding factors, they are unable to manage the condition.

The clinic offers a multidisciplinary approach to treating hypertension, including a pharmacist, dietitian, nurse practitioner, and physician, all dedicated to educating the patient to empower them to take control of their health.

At the first visit, patients fill out questionnaires, watch educational videos, receive an educational binder with tips about their diet and managing blood pressure. We offer a range of non-pharmacological resources for improving their hypertension. After that, when they come in they will begin by watching educational videos and seeing the pharmacist. This way they can drill down into the medications and any compliance issues or interactions the patient might be experiencing. The pharmacist then gives the physician a download before they see the patient. The recommendations from the entire care team are incorporated into the patient’s care plan. Each appointment is thorough, educational and focused a different aspect of well-being.

For most patients, one of the biggest issue can be taking their medications as prescribed. Sometimes it’s difficult for people to admit that. This clinic is so helpful because it helps with strategies to remember medications (termed compliance) and reinforces that a high salt diet, anti-inflammatory drugs, stimulant medications for ADHD or narcolepsy, smoking, alcohol in excess of 2 drinks a day, will all raise blood pressure. We can screen for and discover these issues because our appointments are much more in-depth.

Measuring success

If a patient comes in and we can get their hypertension controlled in a few visits, they can graduate from the clinic and return to the care of their primary care physician who will then be able to manage their blood pressure effectively. Our biggest goal is to get any modifiable risk factors under control to prevent morbidity and mortality. People can have high blood pressure for so long they become desensitized and give up. Part of our mission is to show them we can get it under control. It’s not impossible. If you’re engaged in the process, our clinic is the best possible avenue for getting your hypertension under control and preventing heart attack, stroke, congestive heart failure, and kidney failure. Eliminating this risk has a huge impact on quality of life and life span.

The accolades are usually given to the people who come in when there’s an emergency and fix the problem, but it’s even more valuable to have the physician, pharmacist or nurse practitioner who can step in ahead of that and prevent the problem in the first place. It’s difficult to recognize the value of preventative care because by definition there’s nothing wrong yet. People wonder if they really need treatment. The team at our clinic can help patients understand why it’s important and the easiest ways to keep their blood pressure under control.

Patients who wish to utilize the Parkview Hypertension Clinic do need a referral from a physician.

 

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