Q: I am worried about my blood pressure because it’s been a little high ever since my family arrived for the holidays. Some of my relatives are really annoying, and we’ve all been eating and drinking too much all week. I have forgotten my blood pressure pills a couple times. Is it a big deal if it’s a little high for a few days?
A: First of all, regarding your blood pressure (BP)... have you been checking it? How do you know if it’s a little high?
The American Heart Association and the American College of Cardiology guidelines for 2018 define hypertension as 130/80 mmHg or higher. The American Board of Family Medicine is less stringent unless you are at high risk.
Unfortunately, high blood pressure does put you at risk for strokes, heart attacks, vascular disease, kidney failure, and other serious illnesses so you should be clear about what range your doctor recommends for you. In some cases, it’s possible for blood pressure to skyrocket and cause a stroke (with our without missing a dose of medication), so take having hypertension seriously.
How about creating some new holiday traditions that don’t involve eating and drinking?
Walking for just 30 minutes per day will cause significant improvements in your blood pressure and weight, and you can break it into three 10 minute increments. Walk the neighborhood with your family and enjoy the holiday lights. Or go for a walk to take a break from them!
Dance (or sing) to Christmas music together, anything to keep your bodies active. Regarding annoying families, going to AA or Alanon meetings has become a holiday tradition for many people so they can maintain their own serenity and well being under difficult circumstances.
In the meantime, yes, skipping your pills and drinking too much could obviously be a problem.
Binge drinking (even three drinks in one sitting) can transiently elevate your blood pressure. Chronically drinking excessive alcohol is one of the risk factors for causing hypertension.
If you have hypertension, you are advised to abstain, or to reduce alcohol to a maximum of two drinks per day (for men under 65) or to one drink per day for men over 65 and all women. Get in the habit of taking your blood pressure medicine at the same time every day. Consider using a pill minder.
It is very important to use proper technique when checking BP, and make sure that your doctor’s office is doing this as well.
For your baseline measurement, it is optimal to empty your bladder first, and to avoid caffeine, exercise, and stress for 30 minutes beforehand. Remove tight fitting clothing, then sit in a chair with your feet on the floor for 5 minutes and refrain from talking. Your arm should be supported, not hanging down.
A proper fitting cuff should be put around your upper arm (read instructions), and several readings should be done a couple minutes apart. Checking blood pressure cuff size and supporting the arm are important, yet often disregarded so ask your doctor about this. Check your blood pressure also at random times during the day so you can document the range.
Compare the readings when you are relaxing, stressed, morning, night, after exercise, etc... It is good to have an idea of what your average baseline blood pressure is, and what the maximum is. Blood pressure is constantly fluctuating. Maintaining a healthy average without extreme spikes under stress or with exertion is the goal.
Lastly, overeating can overload you with salt and raise your blood pressure acutely.
Gaining weight and increasing your BMI (body mass index) is also a risk factor for high blood pressure. Be sure to aim for a diet and lifestyle that keeps your BMI less than 25. This will reduce your risk of cardiovascular disease, diabetes, cancer and many other chronic diseases.
Now that’s a New Year’s resolution worth making, and keeping for life.