How to manage your blood pressure in isolation?

It is essential to make sure you’re accurately measuring and optimally managing your blood pressure at home, writes Dr Suresh Agrawal

Blood Pressure is the pressure at which blood flows in our body and all our organs receive blood as per their need and at desired pressure.

Blood Pressure is dependent on Cardiac Output, ie, blood pumped out by our heart during each cycle of its beat and resistance offered by different blood vessels in our body.

Blood Pressure levels, the rate of age-related changes, and prevalence of High BP vary among countries and its sub-populations within a country.

High BP is prevalent in all societies except a few primitive tribes, due to their lifestyle and negligible consumption of salt. Maintaining healthy blood pressure is important during (and after) the coronavirus pandemic. Blood pressure measurements taken at home are a better indication of your true blood pressure. They’re also a better indication of your risk of heart attack, stroke and kidney failure.

Unfortunately, a large number of people are not aware of that their BP is higher than desired levels and High BP is detected in them incidentally when they visit a medical practitioner for some other reasons say like toothache or inability to sleep.

Also, the blood pressure of for almost one-thirds of people who take medication for high BPis never at desired levels due to various reasons.Hence it is advisable to check BP at regular intervals as advised by your doctor.

Now with the pandemic of Covid-19, when most doctors have closed their clinics or curtailed their practice hours, not able to check BP should not be excuse, and it is advisable to check BP at home and send the readings to your doctors for interpretation rather than self-interpretation.

The ideal method while in isolation is to measure your blood pressure using your own device. Here are some guidelines recommended to confirm blood pressure using methods outside the clinic.

Measuring blood pressure at home

Your blood pressure can vary depending on whether you’re talking, exercising or under stress, or if there is a change in the temperature. It can also vary depending on your posture, whether you’ve just eaten, taken medication, drunk a coffee or smoked and time of the day.

During sleep, BP falls considerably.

Hence it is important to measure your blood pressure at home the correct way each time, otherwise your readings might be incorrect or misleading:

• Use a validated device

One that has been rigorously tested for accuracy. Most devices available in the market have not been validated. You can check if yours is by reading the back cover of the box.

• Use an upper arm device

Not a wrist cuff or one you wear on a wristband with a correct cuff size. If you don’t want to buy a device, you can hire or borrow one from some pharmacies and medical clinics – in the given circumstances, you should opt for a device of your own.

With Home BP measuring device, always take three to four readings at an interval of two to three minutes. The first measurement should be discarded, and take average of other three readings. Additionally, in seniors, BP should be checked not only lying but also in standing position, as BP on standing will be low.

• Take measures at around the same time

Morning and evening, over seven days (five days, minimum). Measure before taking medication, food or exercise, and as advised by your doctor (for instance, before visiting the doctor or after a medication change),

If BP has been measured at different times of the day, please mention the time.

• Don’t smoke or drink caffeine

Refrain from coffee or smoking 30 minutes before as it will affect your measurements.

• Don’t measure when stressed

If you’re uncomfortable, stressed or in pain, do not measure as that will only result in misleading measurements. Still, if you have to take BP, inform your doctor about the situation.

• Sit quietly for five minutes

Before measuring sit quietly for five minutes, without talking or any distractions from other people or television.

• Sit correctly

With feet flat on the floor, legs uncrossed, upper arm bare, arm supported with cuff at heart level, and back supported.

• Maintain a record

Take two measures, one minute apart. Record each measure in a diary or on the spreadsheet. Provide your doctor with your readings, by email or via telehealth – such as video calling.

What else can you can do to manage your blood pressure in lockdown?

While high blood pressure is mainly caused by unhealthy environment, lifestyle and behavior, you can modify some of these at home to lower your blood pressure, thus lowering the risk of heart disease.

About 30% of high blood pressure relates to eating too much salt, which can be hidden in many foods.

A balanced diet low in salt, high in fruit, vegetables and wholegrain, as well as healthy proteins, can help control blood pressure and improve your overall heart health.

Being at home means you can prepare food from the basic ingredients, avoiding the high salt, fats and sugars found in processed foods.

Maintaining a healthy weight and having an active life with regular physical activity and decreased sitting time is good for your blood pressure and overall health.

People who regularly walk for as little as 15 minutes a day are more likely to live longer than people who are inactive. That’s irrespective of age, sex or risk of heart disease.

To maintain ideal BP, sleep hygiene has to be maintained with good sleep for at least 8 hours.

Still check in with your doctor

If your doctor starts you on medication to lower your blood pressure, this will lower your risk of a heart attack, stroke, kidney failure and eyes. So, it’s important to stick with your treatment while in isolation, unless instructed to stop.

Don’t avoid a telehealth consultation. In fact it’s a great time to embrace it.

By maintaining a good lifestyle, one can be off anti-hypertension medicines or numbers of pills can be reduced significantly.