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Blood Pressure - symptoms, risks, choices, management

Neuro Café 27th October 2021 by Linda S



Many LEGS participants have their own machine to monitor their blood pressure at home.

It is a good idea to check your device meets the standards of the blood pressure society. Monitor your blood pressure twice a day, morning and evening. The machine will indicate two numbers which show your systolic and diastolic scores.


  • Systolic (higher number) measures the force your heart exerts on the walls of your arteries each time it beats, or the force at which your heart pumps blood around your body.

  • Diastolic (lower number) measures the force your heart exerts on the walls of your arteries in between beats, or the resistance to blood flow in the blood vessels.


High blood pressure

  • 1 in 4 people have high blood pressure

  • In deprived areas, 30% more people are likely to have high blood pressure than in non-deprived areas

  • High blood pressure can lead to stroke, kidney disease, heart failure, dementia.


Symptoms of high blood pressure may include the following:

  • headache

  • palpitations

  • vertigo

  • fatigue

  • nosebleed

  • numbness

What are the risks related to high blood pressure?

  • stroke

  • heart disease

  • dementia

  • heart attacks

  • kidney disease

  • enlarged heart

Also high blood pressure may cause immune disorders, depression, anxiety, loss of vision

and sexual problems.


Modifiable factors which affect blood pressure

  • diet

  • alcohol

  • lack of physical activity

  • deprivation

  • mental health/stress



Non-modifiable factors which affect blood pressure

  • age

  • family history

  • ethnicity

  • existing medical conditions

NICE Suggestions: you have a choice!


You do have a choice when it comes to controlling your blood pressure, via lifestyle choices and medications. You can choose to:


- do nothing

- make lifestyle changes

- take medicines along with lifestyle changes


What can I do to lower blood pressure and lessen chances of stroke?


If you make lifestyle changes you might feel healthier and fitter and more positive. You might not need to take medication…but it is hard to change habits! Medication and lifestyle changes… you also might need to take more than one type of medication. Trial different medications to find the right ones for you


Medication can help change blood pressure, meaning you are less likely to have stroke or heart attack. You do have to remember to take medication. Some medication causes side effects, but not everyone gets side effects.


It is possible also for your blood pressure to get too low.



How to lower blood pressure

  • lose weight

  • change your diet

  • stop smoking and drugs

  • reduce stress

See slides in the Members’ Area for a 5-step guide and discover the top 9 foods to lower blood pressure. These include blueberries, tomatoes, garlic, celery, bananas, grapefruit and pak choi. Be careful when taking grapefruit and check first as it can interfere with medication.



Medication


  • Medication should be tailored to individual needs.

  • You may need to take 2 or more different types of medication.

  • If your blood pressure is more than 160/100 you will need to take medication and make lifestyle changes.

  • How long will you need to take medication? This differs case by case. It can be for rest of your life or you can stop or reduce medication after making lifestyle changes.



Never stop medication without talking to your healthcare provider first.


There are 4 groups of blood pressure medication. Please refer to the slides in the LEGS Members' Area for more information.

  1. ACE inhibtor stops production of hormone and relaxes arteries.

  2. Angiotension - 2 receptor blockers - work on the same hormone as above

  3. Calcium channel blockers - stop calcium from entering heart, widens arteries

  4. Thiazide-Like diuretics. Flush out the system.

There are also other types such as beta blockers.


Always ask GP or your healthcare provider before stopping medication. Ensure GP knows your medical history.


If you feel unwell or react badly to medication then talk to your GP or nurse or pharmacy as soon as possible.


How to combat high blood pressure?


There are various organisations who can help you to combat high blood pressure. These include:


Local authorities - lifestyle programmes, encouraging you to be more active

General Practice (GP): get your blood pressure monitored regularly

Pharmacists: offer opportunistic testing

Community settings: for opportunistic testing include gyms, supermarkets and the workplace.



Low blood pressure and Parkinson’s


It is common for people who have Parkinson’s to have low blood pressure, below 90/60. This is affected by the autonomic nervous system. A sensor in neck is affected - signals do not go to the brain, so changes are not made in reaction to sitting or standing, for example, you might feel dizzy or light-headed especially if you have remained in the same place for some time.


Symptoms include blurred vision; feeling weak, muddled, confused; fainting, blackouts.


There may be a large drop in blood pressure when standing or changing position.


Medications can contribute to postural hypertension including diuretics, antidepressants.


When we are likely to experience low blood pressure?


Low blood pressure is caused by an increased demand for blood:

  • when we stand up quickly or change position

  • after meals

  • dehydration

  • in hot environments

  • in the morning

  • when we have anxiety

Conditions such as diabetes can also cause low blood pressure, as can medication for prostate problems. If affected, discuss with your GP or Parkinson’s nurse.


Tips for managing low blood pressure


This article gives useful tips on how to manage low blood pressure with Parkinson's: https://www.parkinsons.org.uk/information-and-support/your-magazine/experts/managing-low-blood-pressure-and-parkinsons


  • change position

  • do activities slowly

  • gentle exercise - cross/uncross legs, foot pumps, calf squeezes

  • diet and hydration - drink water, eat small meals, ensure appropriate medication timing

  • monitor your blood pressure; keep a diary to figure out triggers

Which blood pressure monitor should I get?



This video can help you decide which is the best blood pressure monitor.

Monitors can vary, with different arm cuff sizes; they may take more than one person’s readings, have one-button operation, fit your wrist or arm (a wrist monitor may be less accurate). They may have an irregular heart beat detector and also may indicate if your blood pressure is in normal range which can be useful. There are suggestions of features to look out for. LEGS staff can point you to further resources.


Questions and Comments


What is "normal" for a blood pressure reading?

Between 80/120 systolic or top number. Between 60/80 diastolic or bottom number.

140/90 consistently is high.


High blood pressure can be genetic.


Why do hospitals take your blood pressure frequently?


Hospitals have a News Score - monitoring all your vitals eg heart rate, temperature, GCS if you are acutely unwell they want to ensure you are ok and not getting worse. A clip may be put on your finger or ear to measure oxygen levels in your blood. This monitoring can highlight to doctors if you are becoming more unwell. Blood pressure monitoring helps this.



What is normal?


One LEGS participant who does a daily blood pressure check felt confused by the GP saying blood pressure should be a certain number then the hospital saying something different.


Diet and exercise can bring blood pressure down. But not for everybody. For some people the only thing that brings it down is medication.


It was commented that the diastolic or lower number is critical. As long as the diastolic score is 80-85 you should be ok. Ranges within systolic and diastolic readings make things confusing. Do not be afraid to ask your doctor if you are confused and want clarification. Maybe medication will be the thing to bring blood pressure down. Do keep fit and active.


There are many different factors that may contribute to scores. For one participant, blood pressure went down following a pneumonia vaccine.


The top or systolic number can vary quite a lot. eg 180 or 190, but if you wait it can come down. If the bottom or diastolic number goes up it can be very dangerous.


Sometimes the time of day and a different situation will change the reading. Monitor both your systolic and diastolic scores, preferably at exactly same time every day. Rest a little bit and relax before you take it. Talk to your GP if you are unsure.


More details for suggestions and links to exercises for strength and balance can be found in resources in the Members’ Area of the LEGS website.




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