Blood pressure is one of the most important screenings because high blood pressure usually has no symptoms so it can’t be detected without being measured.
High blood pressure greatly increases your risk of heart disease and stroke.
If you can’t recall the last time you had your blood pressure checked, you may want to schedule a visit with your healthcare provider now.
Dr. Hafeza Shaikh, a Cardiologist at Lourdes Cardiology, is here to explain the importance of keeping your blood pressure under control.
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The Importance of Blood Pressure Control
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Born and raised in Flemington, New Jersey, Dr. Shaikh completed her undergraduate degree at Rutgers-New Brunswick in 2002 before graduating from New York College of Osteopathic Medicine with a degree in medicine in 2006. In 2009, she completed her residency in internal medicine at Lenox Hill Hospital, a major center for cardiac care in New York City. That same year, she entered the University of Medicine & Dentistry of New Jersey-School of Osteopathic Medicine (UMDNJ-SOM)/ South Jersey Heart Group Cardiology Fellowship Program, of which she graduated last month.
Learn more about Hafeza Shaikh, DO
Hafeza Shaikh, DO
Hafeza Shaikh, DO is the latest addition to the cardiology team at South Jersey Heart Group, an affiliate of Lourdes Cardiology Services-a leader in cardiac care for southern New Jersey and the Delaware Valley.Born and raised in Flemington, New Jersey, Dr. Shaikh completed her undergraduate degree at Rutgers-New Brunswick in 2002 before graduating from New York College of Osteopathic Medicine with a degree in medicine in 2006. In 2009, she completed her residency in internal medicine at Lenox Hill Hospital, a major center for cardiac care in New York City. That same year, she entered the University of Medicine & Dentistry of New Jersey-School of Osteopathic Medicine (UMDNJ-SOM)/ South Jersey Heart Group Cardiology Fellowship Program, of which she graduated last month.
Learn more about Hafeza Shaikh, DO
Transcription:
The Importance of Blood Pressure Control
Melanie Cole (Host): How important is blood pressure to our overall health and what's the best way to keep it under control? My guest today is Dr. Hafeza Shaikh. She's a cardiologist with Lourdes Health System. Welcome to the show, Dr. Shaikh. First, give the listeners a little physiology lesson. Tell them, what is blood pressure?
Dr. Hafeza Shaikh (Guest): Hi, Melanie, thank you so much for having me on the show today. To start with, blood pressure is usually defined by two numbers: by the systolic and by the diastolic. A lot of times people refer to this as either the "top number" or the "bottom number." Blood pressure is super important. It really reflects how your heart is able to circulate blood around your body to different organs. The other thing that we measure a lot of times, is the time between the heartbeats and that's the heart rate that you're familiar with, also. Now, blood pressure is so important just because it measures the pressure that is actually in your blood vessels when your heart first beats and then, also, when the heart is resting between the beats, that's the other amount of blood pressure that's left there. That's called the “diastolic blood pressure”. The reason we care so much is really blood pressure's implicated in so many important diseases that we see including heart disease and stroke, and often these are very life-altering diseases. Thanks so much for the opportunity to talk about this today.
Melanie: We hear about blood pressure, high blood pressure, low blood pressure. What are some of the causes of things that change our blood pressure?
Dr. Shaikh: Sure. Great question. One of the things that really changes our blood pressure and this can change during your lifetime, as well, is age. The reason that happens is that with age, sometimes the resistance and the amount of stiffness that your blood vessels and arteries have can change with time. Honestly, one of the easy reasons for why blood pressure changes over time is just with age and the change in your blood vessels. Another thing that can affect blood pressure is salt--sodium intake--and that has a lot to do with our diets. Unfortunately, the typical American diet sometimes is composed also of take-out and prepared foods that are pretty consistently high in sodium. That's another reason that people can gain hypertension, or high blood pressure, over time. Other reasons that you can get high blood pressure are also just a couple rare diseases that sometimes that may just be inherited or something you may be born with, as well. The other thing to keep in mind is blood pressure can also change just from acute issue such as stress levels, lack of sleep, even sleep apnea can cause things and these are important because these are potentially factors that are reversible and can change just with your modification.
Melanie: Dr. Shaikh, tell us the numbers. What are the numbers for optimum blood pressure, borderline, and then, what do you consider high?
Dr. Shaikh: Sure. Unfortunately, these numbers have been changing over time, too. Typically for the top number--that's what we refer to as the systolic blood pressure-- a number anywhere between 120-139 is a pretty good number for the top systolic number. Once you get in the range where that top systolic number is approaching 140-150, that usually is the first stage of hypertension that we need to be aware of. One exception in that situation has to do with age, meaning if you're above the age of 65, that top number can easily be just in the 140’s, meaning under 150 total, and that's considered within normal limits. Now, for the bottom number, anything above 90 when you're over the age of 65, would be considered hypertensive; but otherwise, between 85-90 would be considered the first stage of hypertension and ideally, you want that bottom number under 85.
Melanie: So, if people are told that they have high blood pressure, how often should people take their blood pressure or go to their local pharmacy and get their blood pressure taken? That's the first question.
Dr. Shaikh: Now, that kind of depends on a couple of factors. One thing is, sometimes, if you ordinarily don't have any other medical issues, then your blood pressure ideally should be checked at least once a year, every time that you see your primary care doctor because this is really the first spot where we are able to screen and pick up cases of high blood pressure. If, in fact, the blood pressure is high in that first screen, it does need to be confirmed, though, either with subsequent visits to the same doctor or at least on confirmatory readings at home. The other thing is, if otherwise you haven't seen a primary care doctor, sometimes people have not gotten a chance to get in, then, certainly, you can go ahead and have your first check done at the local pharmacy or wherever you are available to get a blood pressure machine from. Otherwise, if you're not feeling well, that's also a good time to get your blood pressure checked. Often, sometimes people can just be feeling that if they're getting headaches chronically, maybe around the same time every day, or going on for more than a couple days in a row without any other explanation, or even blurry vision or more progressive issues like shortness of breath when you're exerting yourself. All of those can also be signs of the blood pressure being high and that's a really good time to check the blood pressure, and, of course, if you can check it right at that time, then that's fantastic as opposed to checking it multiple hours later when you're home when it could have already recovered by then. Now, if somebody actually has an established diagnosis of having high blood pressure then, typically, their blood pressure should be checked, at least in a doctor's office, every few months and that can be done either with a primary care doctor or with a specialist. If the numbers are stable, then really the blood pressure can just be checked maybe even once or twice a year at that point. This is assuming that no changes have been made in the medicines. Certainly, any time there's been a change in the medicines that's treating the high blood pressure, then you want to, ideally, have it checked at least a few weeks after that change has been made, just to make sure that things are stable.
Melanie: Dr. Shaikh, we could talk about this topic for a very long time, but let's talk for a minute about medication, because there are so many people go on. They hear about diuretics and calcium channel blockers and beta-blockers and all these different things. What is the main intention when you put somebody on medication for high blood pressure?
Dr. Shaikh: I love these questions, Melanie, because honestly, these are questions that my patients do often have and I love that they feel comfortable enough with me in the office to raise them but I'm sure a lot of people may not always have the time or feel comfortable to discuss it with their doctors. To tell you the truth, that's one of my pet peeves; I figure if you're taking a medicine, I definitely feel that everybody should feel comfortable enough to discuss things with their doctors and make sure if they are having any side effects, if they feel the cost of the medicine is too much, or if they just feel like it's not the best choice for them, I do hope that they do discuss that with either their primary care doctor or their specialist. I just want to make sure that everyone is aware of that. Now, to actually answer your question, there are probably, I want to say, over 200 different choices for blood pressure treatment and they range from medicines that have been around for decades and also medicines that are, honestly, on the up-and-coming, and being invented every day. In general, different classifications can include: a diuretic, which are also called water pills; other pills such as calcium channel-blockers; beta-blockers; and then also a little bit more complex class of drugs called ACE inhibitors, or ARBs, which are angiotensin receptor blockers. Now, even outside of that, there's a whole other slew of medicines that are more of the miscellaneous or more advanced therapies for hypertension. Now, important things to keep in mind are that usually diuretics or calcium channel blockers or ACE inhibitors-- one of those three is usually the first-line medication. Diuretics are good because, as you know, sodium retains water and if you can kind of let go of a little bit of the sodium and water that's in your system with the diuretic pill, that's sometimes enough to get the blood pressure down just a couple points. Calcium channel blockers are great because they can help do a reduction of the blood pressure without also leaving any significant abnormalities in your electrolytes or in your fluid levels. That's another good first go-to choice. ACE inhibitors are great because they can help decrease the long-term effects of high blood pressure and these are effects that are seen in the kidneys, or in the heart, or in various different locations in the body. In terms of diuretics, those are commonly things like Hydrochlorothiazide or Lasix or Furosemide that you may have heard of. In terms of calcium channel blockers, these are things like Amlodipine, Nifedipine or Nicardipine. In terms of ACE inhibitors or angiotensin receptor blockers, these are medicines like Lisinopril, Losartan, and Ramipril, and I could go on and on; there are just so many different medications. The important thing is you definitely want a medicine that's going to treat not just your blood pressure, but if there are any other issues going on in your health such as diabetes, kidney problems, history of a stroke, or history of heart disease; that really helps to guide therapy. But, aside from that, if you don't have any of those other secondary conditions, then often, your doctor can choose from any of the three medications as their first choice. Again, as I said, communication is just so important; just making sure `that you understand the potential side effects of these medicines; making sure that you understand why your doctor chose one over the other; and then, just following along with your doctor making sure that the proper effects are seen in the medication that were intended when they first prescribed it for you.
Melanie: So, give us your best advice in the last few minutes here about lifestyle and how things like exercise, which can lower blood pressure after just one bout, what you want your patients to know about the things they can do to control their pressure aside from, and along with, the medications.
Dr. Shaikh: Definitely. Exercise, diet, screening for sleep apnea--these issues are just so important because as I tell patients, if they want to go ahead and continue taking in a high sodium diet, then, certainly, medications can be added on, but what's the point of that? If the underlying reason is that there's a high sodium diet being ingested, then that needs to be corrected right off the bat. A high sodium, if you just start taking a look at the labels around you, either from foods that are take-out, foods that you are may be cooking at home, using frozen or canned products to create; a lot of them just have so much hidden sodium, you would be appalled. A really important thing is I advise patients to go ahead and start taking a look at these labels and you'd be shocked. You know, the vegetable soup that you may think is healthy and benign may contain more than half of your days’ worth of sodium. It's really important to become a label reader from that aspect. Take a look at the sodium; take a look at the percentages listed on there. In terms of exercise, it's a hard-proven fact a few minutes a day of cardiovascular exercise added up in a week can really help drop the blood pressure a couple points and that can be critical, especially if you're someone running a borderline blood pressure that's maybe just a couple points higher than what it needs to be. The other thing is sleep apnea is often an underdiagnosed condition and by correcting sleep apnea, that also can bring the blood pressure down to a normal zone, sometimes. So, ask your doctor if that's something that you should be screened for. Finally, of course, excess amounts of caffeine, excess amounts of emotional or physical stresses also can raise the blood pressure, so that's something to be watchful of, as well.
Melanie: Dr. Shaikh, tell us about your team at Lourdes Health System.
Dr. Shaikh: Sure. We have a really great, really well-educated team with multiple locations all over South Jersey. Really, everyone's been doing a great job--everyone from our physicians, to nurses, to educators within the system, so I invite you to definitely take advantage of our expertise. Call us. We're more than willing to help. While we're particularly out of the Burlington location, we have offices all over in Cherry Hills, Stratford, Wuhl, and Berlin--multiple different locations. The best way to reach us is by going on for Lourdes Health Services and just reaching out to Lourdes Cardiology. We would be more than happy to help anybody.
Melanie: Thank you so much. What great information and so beautifully put. For more information on Lourdes Cardiology, you can go to LourdesNet.org. That's LourdesNet.org. You're listening to Lourdes Health Talk. This is Melanie Cole. Thank you so much for listening.
The Importance of Blood Pressure Control
Melanie Cole (Host): How important is blood pressure to our overall health and what's the best way to keep it under control? My guest today is Dr. Hafeza Shaikh. She's a cardiologist with Lourdes Health System. Welcome to the show, Dr. Shaikh. First, give the listeners a little physiology lesson. Tell them, what is blood pressure?
Dr. Hafeza Shaikh (Guest): Hi, Melanie, thank you so much for having me on the show today. To start with, blood pressure is usually defined by two numbers: by the systolic and by the diastolic. A lot of times people refer to this as either the "top number" or the "bottom number." Blood pressure is super important. It really reflects how your heart is able to circulate blood around your body to different organs. The other thing that we measure a lot of times, is the time between the heartbeats and that's the heart rate that you're familiar with, also. Now, blood pressure is so important just because it measures the pressure that is actually in your blood vessels when your heart first beats and then, also, when the heart is resting between the beats, that's the other amount of blood pressure that's left there. That's called the “diastolic blood pressure”. The reason we care so much is really blood pressure's implicated in so many important diseases that we see including heart disease and stroke, and often these are very life-altering diseases. Thanks so much for the opportunity to talk about this today.
Melanie: We hear about blood pressure, high blood pressure, low blood pressure. What are some of the causes of things that change our blood pressure?
Dr. Shaikh: Sure. Great question. One of the things that really changes our blood pressure and this can change during your lifetime, as well, is age. The reason that happens is that with age, sometimes the resistance and the amount of stiffness that your blood vessels and arteries have can change with time. Honestly, one of the easy reasons for why blood pressure changes over time is just with age and the change in your blood vessels. Another thing that can affect blood pressure is salt--sodium intake--and that has a lot to do with our diets. Unfortunately, the typical American diet sometimes is composed also of take-out and prepared foods that are pretty consistently high in sodium. That's another reason that people can gain hypertension, or high blood pressure, over time. Other reasons that you can get high blood pressure are also just a couple rare diseases that sometimes that may just be inherited or something you may be born with, as well. The other thing to keep in mind is blood pressure can also change just from acute issue such as stress levels, lack of sleep, even sleep apnea can cause things and these are important because these are potentially factors that are reversible and can change just with your modification.
Melanie: Dr. Shaikh, tell us the numbers. What are the numbers for optimum blood pressure, borderline, and then, what do you consider high?
Dr. Shaikh: Sure. Unfortunately, these numbers have been changing over time, too. Typically for the top number--that's what we refer to as the systolic blood pressure-- a number anywhere between 120-139 is a pretty good number for the top systolic number. Once you get in the range where that top systolic number is approaching 140-150, that usually is the first stage of hypertension that we need to be aware of. One exception in that situation has to do with age, meaning if you're above the age of 65, that top number can easily be just in the 140’s, meaning under 150 total, and that's considered within normal limits. Now, for the bottom number, anything above 90 when you're over the age of 65, would be considered hypertensive; but otherwise, between 85-90 would be considered the first stage of hypertension and ideally, you want that bottom number under 85.
Melanie: So, if people are told that they have high blood pressure, how often should people take their blood pressure or go to their local pharmacy and get their blood pressure taken? That's the first question.
Dr. Shaikh: Now, that kind of depends on a couple of factors. One thing is, sometimes, if you ordinarily don't have any other medical issues, then your blood pressure ideally should be checked at least once a year, every time that you see your primary care doctor because this is really the first spot where we are able to screen and pick up cases of high blood pressure. If, in fact, the blood pressure is high in that first screen, it does need to be confirmed, though, either with subsequent visits to the same doctor or at least on confirmatory readings at home. The other thing is, if otherwise you haven't seen a primary care doctor, sometimes people have not gotten a chance to get in, then, certainly, you can go ahead and have your first check done at the local pharmacy or wherever you are available to get a blood pressure machine from. Otherwise, if you're not feeling well, that's also a good time to get your blood pressure checked. Often, sometimes people can just be feeling that if they're getting headaches chronically, maybe around the same time every day, or going on for more than a couple days in a row without any other explanation, or even blurry vision or more progressive issues like shortness of breath when you're exerting yourself. All of those can also be signs of the blood pressure being high and that's a really good time to check the blood pressure, and, of course, if you can check it right at that time, then that's fantastic as opposed to checking it multiple hours later when you're home when it could have already recovered by then. Now, if somebody actually has an established diagnosis of having high blood pressure then, typically, their blood pressure should be checked, at least in a doctor's office, every few months and that can be done either with a primary care doctor or with a specialist. If the numbers are stable, then really the blood pressure can just be checked maybe even once or twice a year at that point. This is assuming that no changes have been made in the medicines. Certainly, any time there's been a change in the medicines that's treating the high blood pressure, then you want to, ideally, have it checked at least a few weeks after that change has been made, just to make sure that things are stable.
Melanie: Dr. Shaikh, we could talk about this topic for a very long time, but let's talk for a minute about medication, because there are so many people go on. They hear about diuretics and calcium channel blockers and beta-blockers and all these different things. What is the main intention when you put somebody on medication for high blood pressure?
Dr. Shaikh: I love these questions, Melanie, because honestly, these are questions that my patients do often have and I love that they feel comfortable enough with me in the office to raise them but I'm sure a lot of people may not always have the time or feel comfortable to discuss it with their doctors. To tell you the truth, that's one of my pet peeves; I figure if you're taking a medicine, I definitely feel that everybody should feel comfortable enough to discuss things with their doctors and make sure if they are having any side effects, if they feel the cost of the medicine is too much, or if they just feel like it's not the best choice for them, I do hope that they do discuss that with either their primary care doctor or their specialist. I just want to make sure that everyone is aware of that. Now, to actually answer your question, there are probably, I want to say, over 200 different choices for blood pressure treatment and they range from medicines that have been around for decades and also medicines that are, honestly, on the up-and-coming, and being invented every day. In general, different classifications can include: a diuretic, which are also called water pills; other pills such as calcium channel-blockers; beta-blockers; and then also a little bit more complex class of drugs called ACE inhibitors, or ARBs, which are angiotensin receptor blockers. Now, even outside of that, there's a whole other slew of medicines that are more of the miscellaneous or more advanced therapies for hypertension. Now, important things to keep in mind are that usually diuretics or calcium channel blockers or ACE inhibitors-- one of those three is usually the first-line medication. Diuretics are good because, as you know, sodium retains water and if you can kind of let go of a little bit of the sodium and water that's in your system with the diuretic pill, that's sometimes enough to get the blood pressure down just a couple points. Calcium channel blockers are great because they can help do a reduction of the blood pressure without also leaving any significant abnormalities in your electrolytes or in your fluid levels. That's another good first go-to choice. ACE inhibitors are great because they can help decrease the long-term effects of high blood pressure and these are effects that are seen in the kidneys, or in the heart, or in various different locations in the body. In terms of diuretics, those are commonly things like Hydrochlorothiazide or Lasix or Furosemide that you may have heard of. In terms of calcium channel blockers, these are things like Amlodipine, Nifedipine or Nicardipine. In terms of ACE inhibitors or angiotensin receptor blockers, these are medicines like Lisinopril, Losartan, and Ramipril, and I could go on and on; there are just so many different medications. The important thing is you definitely want a medicine that's going to treat not just your blood pressure, but if there are any other issues going on in your health such as diabetes, kidney problems, history of a stroke, or history of heart disease; that really helps to guide therapy. But, aside from that, if you don't have any of those other secondary conditions, then often, your doctor can choose from any of the three medications as their first choice. Again, as I said, communication is just so important; just making sure `that you understand the potential side effects of these medicines; making sure that you understand why your doctor chose one over the other; and then, just following along with your doctor making sure that the proper effects are seen in the medication that were intended when they first prescribed it for you.
Melanie: So, give us your best advice in the last few minutes here about lifestyle and how things like exercise, which can lower blood pressure after just one bout, what you want your patients to know about the things they can do to control their pressure aside from, and along with, the medications.
Dr. Shaikh: Definitely. Exercise, diet, screening for sleep apnea--these issues are just so important because as I tell patients, if they want to go ahead and continue taking in a high sodium diet, then, certainly, medications can be added on, but what's the point of that? If the underlying reason is that there's a high sodium diet being ingested, then that needs to be corrected right off the bat. A high sodium, if you just start taking a look at the labels around you, either from foods that are take-out, foods that you are may be cooking at home, using frozen or canned products to create; a lot of them just have so much hidden sodium, you would be appalled. A really important thing is I advise patients to go ahead and start taking a look at these labels and you'd be shocked. You know, the vegetable soup that you may think is healthy and benign may contain more than half of your days’ worth of sodium. It's really important to become a label reader from that aspect. Take a look at the sodium; take a look at the percentages listed on there. In terms of exercise, it's a hard-proven fact a few minutes a day of cardiovascular exercise added up in a week can really help drop the blood pressure a couple points and that can be critical, especially if you're someone running a borderline blood pressure that's maybe just a couple points higher than what it needs to be. The other thing is sleep apnea is often an underdiagnosed condition and by correcting sleep apnea, that also can bring the blood pressure down to a normal zone, sometimes. So, ask your doctor if that's something that you should be screened for. Finally, of course, excess amounts of caffeine, excess amounts of emotional or physical stresses also can raise the blood pressure, so that's something to be watchful of, as well.
Melanie: Dr. Shaikh, tell us about your team at Lourdes Health System.
Dr. Shaikh: Sure. We have a really great, really well-educated team with multiple locations all over South Jersey. Really, everyone's been doing a great job--everyone from our physicians, to nurses, to educators within the system, so I invite you to definitely take advantage of our expertise. Call us. We're more than willing to help. While we're particularly out of the Burlington location, we have offices all over in Cherry Hills, Stratford, Wuhl, and Berlin--multiple different locations. The best way to reach us is by going on for Lourdes Health Services and just reaching out to Lourdes Cardiology. We would be more than happy to help anybody.
Melanie: Thank you so much. What great information and so beautifully put. For more information on Lourdes Cardiology, you can go to LourdesNet.org. That's LourdesNet.org. You're listening to Lourdes Health Talk. This is Melanie Cole. Thank you so much for listening.