Controlling Your Blood Pressure Archive

Q. I just got diagnosed with diabetes and my doctor said I am at risk for heart disease. Why?

A. Diabetes is considered to be an extremely strong risk factor for heart disease. One reason is that people with diabetes are also more likely to have other conditions that raise their odds of heart disease, such as obesity, high blood pressure, or elevated LDL cholesterol. Also, those factors seem to have more of a detrimental effect on people who have diabetes compared with those who don't.

The dangers of hypertension are well documented, but low blood pressure levels can cause problems, too.

It may boost the effect of your current medication.

It appears that people with high blood pressure who take folate along with the blood pressure medicine enalapril (Vasotec) may be less likely to have a stroke than people who take enalapril alone.

High blood pressure is one of the many health risks associated with not getting enough sleep, which is often caused by insomnia, or difficulty falling or staying asleep. Although often considered a nighttime problem, some people with insomnia may be in a state of "hyperarousal" that also makes it hard for them to nod off during the day. Now, new research suggests that people with chronic insomnia who also have trouble napping face a higher risk of high blood pressure.

The study, in the March 2015 issue of Hypertension, included more than 200 people with chronic insomnia (defined as insomnia that lasts more than six months) and almost 100 normal sleepers. All underwent daytime nap tests, which measures how quickly a person falls asleep in a quiet environment during the day. People with chronic insomnia who took longer than 14 minutes to fall asleep during the nap studies had three times the risk of high blood pressure compared with normal sleepers, the researchers found. Treatments such as medications and biofeedback to help dampen hyperarousal may be best for people with this type of insomnia, they suggest, although more research is needed.

You can't see your blood pressure or feel it, so you may wonder why this simple reading is so important. The answer is that when blood pressure is high, your heart is working overtime to pump blood through your body. This extra work can result in a weaker heart muscle and potential organ damage down the road. Your arteries also suffer when your blood pressure is high. The relentless pounding of the blood against the arterial walls causes them to become hard and narrow, potentially setting you up for stroke, kidney failure, and cardiovascular disease.

A healthy lifestyle — not smoking, losing excess weight, eating nutritious foods, and exercising regularly — is the cornerstone for preventing and treating hypertension.

Q. I take several medicines to get my blood pressure under control, and they seem to do the job. However, I get dizzy at times. Is there anything I can do, other than stopping my medications?

A. Many people occasionally feel dizzy if they stand up too quickly, and the older you get, the more likely this will happen. When you're lying down or sitting, less blood pressure is needed to send sufficient blood to the brain. But as you stand, the pressure must rise to deliver adequate amounts. If that doesn't happen fast enough, your brain can't function as well as it should, and you feel dizzy. Moving from a lying or seated position to a standing position more slowly usually helps if this is the underlying reason.

Apps that track and chart your blood pressure may be useful. But for now, avoid those that use the phone as a measuring tool.

Job strain—defined as having a demanding job in which you have little control—may slightly increase the risk of a stroke. The findings, in the February 2015 Stroke, echo earlier results that show a similar link between heart disease and job strain.

Researchers gleaned the results from 14 different studies that included more than 190,000 men and women from six European countries. Their average age was 42, and the follow-up lasted just over nine years, on average. Job strain was associated with a roughly 20% higher risk of ischemic stroke (the type that occurs when a clot blocks a blood vessel supplying the brain).

The telltale sign is leg pain and fatigue that comes on with activity and goes away with rest.