FAQs
Professional Advice.
Patients often have similar questions when it comes to their experience with the London Hypertension Clinic, or about managing their condition. We've compiled a list of the most commonly posed questions — and our best answers — for your convenience.
Why do I have high blood pressure?
The most common type of high blood pressure is called primary hypertension. There is usually, but not always, a family history of high blood pressure. It is caused by inheriting genes that contribute to the blood pressure being high. This type of high blood pressure can start as early as the age of 20, and usually starts before the age of 50. Women with primary hypertension often are noted to have high blood pressure when they are pregnant, usually in 3rd trimester.
There are many things that can make primary hypertension worse, such as lifestyle choices and certain medications. Other common causes of high blood pressure include Obstructive Sleep Apnea (scoring system), and kidney or adrenal gland problems.
Why should I measure my blood pressure at home?
Hypertension is a disease in which a higher than ideal blood pressure causes damage to a patient’s brain, heart, kidneys, and blood vessels. In order to determine a patient’s risk of developing damage, we need to have a very accurate estimate of what the blood pressure is during the course of everyday life. Many things determine the blood pressure level at any given time in the day. In many patients (but not all), the stress of going to the hospital or a medical clinic can make the blood pressure go up. If we use these blood pressure measurements to estimate future risk of damage, we often end up estimating that the risk is higher than it really is.
How do you decide that I should take a blood pressure medication, instead of just trying to work on my healthy living?
It turns out that in patients that do an excellent job of measuring their blood pressure at home, these measurements provide a very accurate estimation of risk. In a future feature, I will cover how to do an excellent set of home blood pressures.
Blood pressure medications are recommended when healthy living alone isn't likely to make a big enough or fast enough decrease in blood pressure. If you take a step back, there is only one reason to ever take any medication: You believe that the benefit of that medication outweighs any potential risks.
How do we know what the risks and benefits of a medication are?
Any medication that is suggested has been studied in research projects projects that measure the effects, side-effects, and risks in patients. Based on this information, we learn what patients are most likely to benefit, and which patients may be at risk from side-effects. In many areas of the world, data is being continuously collected from patients using these medications, and this data is also used to refine our idea of what the benefits and risks are.
How do I do an excellent home blood pressure measurement, and how does the doctor use this information?
Blood pressure medications are among the most well studied medications in all areas of medicine (millions of patients have volunteered in these studies). When you take one of these medications, you are standing on the shoulders of these pioneers, who were willing to volunteer even though they didn’t know if the benefits truly exceeded the risks. Because of their sacrifice, you can be sure.
If your doctor offers you a medication, they should be able to tell you what they estimate the benefit to be in your specific situation, and what the side-effects and risks are. Make sure that you are convinced, because you are the one who has to swallow the pill!
For technique, please see our Measuring Your Blood Pressure page. Home BP measurements are more reflective of true blood pressure in most patients. Technique is very important. The most common problem with home measurements is that patients do not rest for 5 minutes before activating their BP monitor. If you follow the guidance on this website, you will be able to show your doctor blood pressure values that truly reflect what is going on. These numbers show us what your risk for future heart failure, stroke, and kidney damage are, and we can use these numbers to decide if we need to change your medications.
Last updated March 18, 2021
Page created by: Dr. George Dresser & Kush Joshi (Meds 2022)