to a home monitor, record the readings and provide them to the practitioner when visiting the office, thereby allowing for the most effective treatment. Hypertension Canada only recommends wrist monitors for those who cannot fit into a blood pressure cuff. With upper arm devices, it is important to choose a monitor with the correct cuff size. Initial treatment of high blood pressure may include modifications to one’s lifestyle. For most, a reduction in the daily consumption of salt will be advised. As most of our salt ingestion is in processed foods, it is recommended that these foods be reduced, as well as limiting ingestion of table salt. In some cases, a salt substitute may be recommended. Those who are overweight are advised to reduce their calories and may need medical attention to achieve results. The use of semaglutide and related products has been shown to reduce blood pressure levels when prescribed for obese patients. Another recommended lifestyle factor is exercise. Many persons – especially seniors – do not get enough exercise. Increased activity has proven effective in lowering blood pressure. The World Health Organization recommends that we strive for 150-300 minutes of moderate aerobic activity per week. This may include home exercises, outside activities or regular walks. Alcohol reduction only has an effect on reducing blood pressure for heavy drinkers. Medication for hypertension is recommended for persons with office-recorded blood pressures that typically are higher than 140/90 and higher than 130 systolic for those who are at higher risk for a cardiovascular event such as heart attack or stroke. Initial therapy usually consists of a single tablet or pill once a day, although one or two drugs may be contained in the single dose. Medications may be added or changed until satisfactory readings are achieved. Patients should read the literature that comes with the prescriptions and become familiar with potential side-effects. Consulting with their pharmacist may be useful initially, with a subsequent visit to their practitioner. Patients who do not have insurance benefits for their prescriptions should advise their physician, as combination pills will be less expensive than two or more prescriptions. Regular visits every one to three months for BP readings are usually indicated until readings are most often lower than 130 systolic. Once controlled, visits may be extended to six months. Home measurements should be regularly recorded and provided to the practitioner. As symptoms rarely occur in persons with high blood pressure, it is important for all of us – especially seniors – to know what our blood pressure is from time to time. If levels higher than 130/90 are commonly noted, evaluation and possible treatment initiatives are indicated. If lifestyle modifications do not achieve satisfactory results, medication will be indicated followed by home and office monitoring indefinitely. Such action has been proven to allow blood pressure to return to normal levels and reduce the risk of heart conditions, stroke, kidney disease, blood vessel and other organ conditions. Health CSANews | WINTER 2025 | 39
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