It is documented that about fifty percent of individuals diagnosed with hypertension do not have their blood pressure under control. 

Telehealth provides an excellent opportunity for maintaining blood pressure under control, and for prescription refills for blood pressure medications.

Blood Pressure by the Numbers 

Normal blood pressure is defined as < 120 / < 80

Elevated blood pressure is defined as 120-129 / < 80

Hypertension > 130 / > 80

Blood pressure monitoring may be conducted in the office as well as at home, but preparing properly is crucial. 

Home Blood Pressure Monitoring

To monitor blood pressure at home, a biceps, or upper arm cuff (such as the Omron brand, which is digital and works with the touch of a button) is preferred over a wrist cuff (wrist cuffs can render false high readings). 

Choosing the correct cuff size is imperative.

The bladder or inflatable area of the cuff should encircle 80% on the arm (biceps area)

To prepare for a blood pressure reading:

1. Empty the bladder
2. Sit upright in a chair in a relaxed state for at least 5 minutes with the legs uncrossed
3. Do not monitor the blood pressure in a stressful time, e.g., after learning your dog just knocked over the trash can! 
4. Expose the entire arm, removing any clothing 
5. Avoid caffeine and exercise 30 minutes prior to the reading
6. Outstretch the arm to be used onto a table for support, assure the arm is extended at the heart/chest level
7. Remain at rest and without talking while the automatic cuff is measuring the pressure
8. Record the pressure on a blood pressure log as often as a couple of times per week for your doctor 
9. Do not repeat the reading on the same arm within 10 minutes of the last reading

If you are taking blood pressure medications, the blood pressure is best checked at least 3 hours after taking your medication to determine the “treated” blood pressure reading. 

Logging the treated blood pressure reading will help your doctor to adjust your medication(s) as necessary.

High Cholesterol

It is important to note that lipid levels may vary depending on ethnicity and the testing laboratory. 

For reference:

Desirable total cholesterol < 200

Desirable low density lipoprotein cholesterol (LDL-C) < 100

Desirable high density lipoprotein cholesterol (HDL-C) > 50 for females & > 40 for males 

Desirable Triglycerides < 150

Of note: it is recommended to fast, only water & black coffee for 8 hours prior to having a lipid panel drawn. 

Treatment

Treatment of elevated cholesterol is based on overall risk of cardiovascular disease which takes several factors into consideration and is best discussed with your doctor.

Risk Factors for Hypertension & Hyperlipemia 

There are several known risk factors for cardiovascular disease which manifests as elevated blood pressure or elevated cholesterol, or both.

• Being Overweight & Obesity
• Increasing age
• Alcohol abuse
• Sedentary lifestyle
• Diet with too much sodium
• Poor diet
• Family history
• Stress
• Poor sleep
• Medication side effect
• Kidney disease
• Thyroid disease

In Summary

Live the best quality of life you can and discuss your cardiovascular health with your doctor, and partner with them to mitigate as many risk factors as possible.