Q1. Do we only need to take blood pressure on the left arm?
The conventional practice of taking blood pressure only on the left arm is incorrect. According to the latest research, blood pressure should be measured on both arms, then the side with higher readings should be used as the benchmark for monitoring and treatment. A 2021 meta-analysis of 24 studies comprising 53,827 patients with hypertension found that per 5 mmHg inter-arm difference in systolic blood pressure, there is a 6% increase in the mortality risk of cardiovascular and cerebrovascular diseases. If the systolic inter-arm difference is more than 10 mmHg, one needs to check whether there are atherosclerosis, blocked or narrowed blood vessels, or even aortic dissection.
Q2. What are the causes of pseudohypertension?
Factors like smoking, taking blood pressure after salty meals, stiff arms, tense up posture without back support, leg-crossing during measurement, may cause a falsely elevated blood pressure (pseudohypertension). Certain herbal medicines such as St John’s Wort, Yohimbine, liquorice, ephedra can also increase the readings. Other medications such as oral contraceptives, nasal decongestants like Pseudoephedrine, non-steroidal anti-inflammatory drugs may contribute to higher blood pressure.
Q3. What is the correct way to take blood pressure?
To measure your blood pressure correctly, relax and keep both feet on the ground. Sit at ease with your back supported, and rest your arm on a surface at heart level. Do not cover the arms with clothing and avoid talking during the measurement. Make sure the cuff arrow points to the brachial artery in your arm. Medium size cuffs are usually for adults with an arm size of 23 to 33cm. Readings may not be accurate if the wrong cuff is used, as pseudohypertension may occur if a small size cuff is used by someone with thick arms, or pseudohypotension if a large size cuff is put on a slim arm. Use a cuff size appropriate for your arm.
Q4. Do I need to take blood pressure medications forever?
Blood pressure medications will not lead to drug dependence nor deterioration of the condition. Stopping the medications will not cause your blood pressure to go up higher than original. Treating high blood pressure has many benefits. It can reduce the risks of stroke and acute myocardial infarction by 40% and 25% respectively. Patients on treatment are also 50% less likely to suffer from heart failure, and 48% less likely to have proteinuria.
Q5. Can diet control blood pressure? What is DASH Diet?
To prevent high blood pressure, DASH (Dietary Approaches to Stop Hypertension) diet is rich in fruits, vegetables, low-fat foods and high-fibre whole grains. Eat more deep-sea fish, poultry and legumes. Avoid red meat and saturated fats. A total of 412 patients with high blood pressure took part in a 2021 survey conducted by the American Heart Association. It showed that, compared with the American diet, DASH diet not only leads to lower blood pressure but also a 13% decrease in high sensitive C-reactive protein, a cardiac inflammatory indicator, and 14% reduction in high sensitive cardiac troponin, a heart damage indicator.
Q6. What is the benefit of reduction in high blood pressure?
Research showed that for every 5 mmHg reduction in diastolic blood pressure, the risk of heart diseases and stroke will be reduced by 21% and 34% respectively.
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