We will check your blood pressure as often as necessary either during a surgery attendance or when you see the Practice Nurse/ Health Care Assistant. If hypertension (high blood pressure) is diagnosed then we might prescribe some routine blood pressure treatment. Before starting on treatment which may be lifelong, we take great care that treatment is indicated. It is very sensible when attending for a blood pressure measurement to sit quietly in the waiting room for ten minutes or so to allow the pressure to settle. This might help in reducing "white coat" hypertension which we all suffer from in a greater or lesser degree
We would always advise dietary means of reducing blood pressure along with regular exercise. Your doctor might give you a handout with suggestions to consider and follow. Needless to say, cessation of smoking, reduction of weight and a reduction in alcohol intake to the recommended limits are often all that is needed to reduce blood pressure successfully along with some regular exercise. Increasingly the role of salt in the diet is becoming a factor and pressure groups are encouraging supermarkets to add less salt to the processed food. All persons and especially hypertensives should be encouraged to stop all added salt with their food especially at the table. A salt substitute may be helpful in reducing the intake of salt although occasionally this has been known to be a cause of an excess of potassium in the blood.
Blood pressure monitors
To help with the diagnosis of hypertension, the practice has purchased several blood pressure monitors, which we will loan to patients for home monitoring- when suggested by one of the GPs or nurses (£20 deposit required-the Health Care Assistant will show you how to use it). We also have regular checks on the blood pressure machines that we use in the surgery. With new EU regulations regarding mercury in the surgery, we are experimenting with some new electronic blood pressure machines.
More and more people wish to monitor their BP at home, and we are happy to support you in this, as long as we agree on some basic "rules", so we know that this process is a fair representation of the situation.
Firstly, we do not recommend wrist-monitors, and we would ideally like you to use monitors validated by the British Hypertension Society. If not, we would like you to bring your monitor to surgery so we can test it alongside our readings.
Secondly, you must be able to fit the cuff appropriately, ensuring it is of the correct size for the arm, and to know that the cuff should be approximately level with the heart, with the arm supported and that you are seated with your legs uncrossed, having sat rested for at least 3 minutes.
Thirdly, we would like to see an average of 2 readings in the morning and 2 readings in the evening, over 7 days, with the 1st day's readings discarded from the calculation. There should ideally be a gap of 3 minutes between readings. The target (unless you are also diabetic or have kidney disease) would be for the AVERAGE to be less than 135/85. This means that both the systolic (top figure) has to be less than 135, AND the diastolic (bottom figure) has to be less than 85. Once BP is controlled to this level, with titration of medication and lifestyle change, then this process really only needs to be repeated every 6 months.
The Practice Nurse/ Health Care Assistant will also monitor blood pressures during the normal surgeries. The frequency of these checks depends upon many factors but we would wish all patients on medication to have at least an annual check of their blood pressure. Certain drugs will need a regular blood test to monitor any side effects.
British Hypertensive Society - This site has useful information including approved monitors.