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 Your blood pressure plays a vital role in your overall health. However, it can become pretty complicated, leading to a lot of questions. Listed below are some frequently asked questions about blood pressure!
I had a high blood pressure reading. Do I have hypertension now? When we look at your blood pressure, we are looking for a trend over time. One reading may be an outlier or an anomaly. We want to see what your home readings look like on a daily basis, rather than just once in the doctor’s office. Many patients experience “White Coat Syndrome” or higher blood pressure and/or pulse due to being at the doctor’s office or in a medical setting. However, if this high reading is accompanied by symptoms like headache, irregular/fast heart rate, or nosebleeds, please seek medical attention. I only have high blood pressure. What do my kidneys have to do with that? The kidneys play an integral role in the balance of sodium and fluids in the body. If the kidneys begin to not work properly and these levels become unbalanced, then we can see changes in the blood pressure. They also manage and balance the other electrolytes and some hormones that can contribute to blood pressure. What is a “normal” blood pressure reading? “Normal” can look different for everyone based on their unique circumstances. Generally, a systolic blood pressure of 120-140 and a diastolic of ½ to ⅔ of that reading is considered normal. However, there are cases where a patient may not be able to get a reading like that without feeling ill. Why do I have to take my blood pressure multiple times? Blood pressure is constantly changing from minute to minute and there are a variety of factors that can contribute to those changes. We always recommend taking a moment to breathe and relax before taking a reading. If your reading comes back high, take a few minutes to take deep breaths and think happy thoughts. Take the reading again. It will most likely be lower than the first. If it is not, then we can assess and that’s when an emergency hypertension medication could be taken. The original reading could be affected by things like recent activity before sitting down to take your blood pressure or stress. We will generally go by the second reading rather than the first. When is the best time to take my blood pressure? The best time to take your blood pressure is 1-2 hours after taking your medication, when you are calm, relaxed, and comfortable. The time of day may vary for each person based on your personal schedule. When possible, take your blood pressure around the same time of day. This practice gives the most accurate results and lets us see how well your medications are working. What are the symptoms of high or low blood pressure? High Blood Pressure: headache, irregular or fast heart rate, nose bleeds, nausea (with or without vomiting), anxiety, chest pain, vision changes Low Blood Pressure: dizziness, lightheadedness, vision changes, fainting, weakness, nausea (with or without vomiting), confusion Why is my bottom number (diastolic) high? Your diastolic blood pressure is the number on the bottom of the reading. It is the pressure inside your arteries when the heart is filling, between the heartbeats.Your diastolic blood pressure will generally follow the systolic blood pressure. Your diastolic should be about ½ to ⅔ of the systolic number. Munjal’s Musings: “Think of your blood pressure like a car. When you steer the front, the back end tends to follow. The same goes for blood pressure. When you focus on and adjust the systolic (top number), the diastolic (bottom number) tends to follow. This can be said for most people but is not applicable to all.” If you are concerned about your blood pressure, track your readings on a regular basis and call to make an appointment today! As always, stay safe and healthy!  Did you know that 1 in 5 adults with Hypertension have Chronic Kidney Disease? More often than not, patients are surprised to learn about the relationship between blood pressure and the kidneys and how closely they are intertwined with one another. Let’s learn more about the two-way relationship between blood pressure and the kidneys to understand this concept a little better.
What is blood pressure? Blood pressure measures the pressure of the circulating blood against the walls of the blood vessels. This is the measurement of the amount of force the body is using to get the blood through the arteries. What happens when you have high blood pressure? High blood pressure, or hypertension, can put a strain on the body over a long period of time. Overtime, uncontrolled or chronic hypertension can cause the arteries around the kidneys to weaken, narrow, or harden. Hypertension can also lead to other complications, like heart diseases or stroke. How does this affect my kidneys? Your kidneys are located in the back, just below the ribcage. The kidneys filter blood to remove toxins, keep in good nutrients, and balance fluids.When the blood vessels that supply the kidneys with blood are compromised, the kidneys cannot function properly and become damaged. This damage further hinders the kidney’s ability to filter and function properly, which leads to this vicious cycle. High blood pressure causes kidney damage and kidney damage causes high blood pressure. What can be done to stop it? Bodily functions are all connected, so it is important to remember to maintain your overall health and manage other chronic conditions. There are a number of things that can reduce the progression or risk of hypertension and Chronic Kidney Disease.
Munjal’s Musings: “What came first: the chicken or the egg? Generally, Chronic Kidney Disease causes hypertension. Hypertension is also liable to come back and worsen the kidney disease. When you help the blood pressure, you help the kidney disease. When you help the kidney disease, you also help the blood pressure. It’s a two way-relationship.” If you have any questions or concerns regarding your kidney function or blood pressure, call our office to schedule an appointment with Dr. Munjal. As always, stay safe and healthy!  Taking your blood pressure and keeping track of the readings is vital to your health if you have hypertension or Chronic Kidney Disease (CKD). However, this task can get daunting or become overwhelming for some. For current patients, we have a few tools that may help alleviate the stress around tracking your blood pressure.
Blood Pressure Logs: We provide blood pressure log sheets that assist with keeping your blood pressure information neat and organized. Additionally, there is a reference sheet with instructions and tips for taking the most accurate readings. Be sure to bring this sheet back in at your appointments so we can see your trends! Trackers: Our patient portal has a feature that allows patients to link a blood pressure monitor to their account to track readings so it is more readily available to your care team. This information is not regularly monitored, so be sure to call in when you notice a change or have concerns that need to be addressed by your care team. By using the trackers feature in the patient portal, you can show your other healthcare providers your history of readings by simply logging into your portal on your phone or other smart device. Remote Patient Monitoring (RPM): Our remote patient monitoring program allows you and your healthcare provider to manage your health from the comfort of your own home via bluetooth or 4G enabled health tracking devices. You will be assigned a Care Coordinator that will reach out on a monthly basis and will work with you to maintain consistent communication regarding your vital readings. You will receive additional communication for readings that are out of the designated range to ensure you are doing well. This program comes with an app that stores all of your readings for you with a wide range of other features that can help your overall health. Putting these tools to use is only as helpful and effective as the habits associated with them. Staying on top of taking your blood pressure on a regular basis is the most important part of tracking it. You can find more information on habits and blood pressure on our blog as well. As always, stay safe and healthy! Helpful Links: Habits Blog Post: The Dynamic Duo: Setting Goals and Building Habits Connect a Health Tracker: https://www.jaxnephrology.com/connect-health-tracker.html Blood Pressure Blog Posts: How to take Your Blood Pressure, Understanding Your Blood Pressure Readings  In 2021, Dr. Munjal seized the opportunity to incorporate a Remote Patient Monitoring (RPM) program into his practice when it became available to Medicare patients. Dr. Munjal’s passion for this type of program has only grown since its implementation. “For twenty years, I have said that if I ran an insurance company, I would give all patients a blood pressure monitor and scale as they are two of the most effective tools to take care of one’s health. I have always asked patients to log all readings to review at appointments rather than relying on the one reading taken in-office. This may be wrong or an outlier (which happens more often than not) which can greatly affect decision making. If we can see a trend of regular readings in a consistent environment, then we are making better decisions for the patient. These devices are capable of transmitting readings in real time so patients no longer have to maintain a log themselves. Because of this, the care team and I are able to monitor and make decisions as we go along, thus fine-tuning the care plan.”
Our RPM program allows our patients’ blood pressure and weight readings to be monitored remotely by their care team. Patients are able to remain in the comfort of their own home and receive personalized and comprehensive care. By identifying trends and out-of-range readings, we are able to alter a patient’s care plan with more precision in a timely manner to help improve overall health and wellbeing without frequent office visits. Our office provides all of the necessities to get started. This includes:
Remote Patient Monitoring has become an important part of how we care for our patients. We have seen a wide range of benefits from this program for our patients since we began in early 2021. We have been able to identify trends and intervene faster by altering care plans when we have noticed a change in health status. This has reduced potential hospitalizations, prolonged in-office follow-up appointments, and helped to improve care plans for other providers within the patient’s care team. If you are interested in the RPM program, call our office at (904) 260-9898 to get more information. As always, stay safe and healthy!  Is White Coat Syndrome real? Yes! Let’s set the scene: You are at your appointment and the Medical Assistant calls you back. They take your vitals and your blood pressure comes back high. The first thought you may have is “Oh no! My readings at home are normally lower than this. Do I have high blood pressure now?” Not necessarily. This is a prime example of what White Coat Syndrome looks like! Let’s investigate this reading and what it may mean.
White Coat Syndrome is used to describe when a patient has elevated blood pressure when in a medical setting, like a doctor’s office or hospital. One high blood pressure reading does not mean that a patient has hypertension. Additionally, there are other factors that can affect your blood pressure at an appointment like stress, anxiety, traffic, paying a bill upon arrival, missing work for the appointment, and more. It is important to note that these temporary spikes in blood pressure could lead to hypertension or other cardiovascular issues down the road. At Jacksonville Nephrology, Dr. Munjal does not make decisions based on a single reading. He looks for trends in blood pressure readings and will make changes based on the patient’s normal range. If we were to make medical decisions and changes based on a single reading, the patient may end up taking too much medication and have a number of side effects, leaving them feeling ill or even hospitalized. By looking at trends over time, Dr. Munjal is able to make more informed decisions. Dr. Munjal encourages his patients to take their blood pressure regularly at home 1-2 hours after medications have been taken when calm, relaxed, and comfortable. This practice gives the most accurate results and lets us see how well your medications are working. Munjal’s Musings: “Most people have White Coat Syndrome and it looks different for everyone. It is most important to be aware of it. Take your readings at home regularly so you know your normal range.” If you see a high reading at your next doctor’s appointment, take a deep breath and remember that it’s okay. Remind yourself of your normal range and discuss it with your doctor. If you have concerns about your blood pressure, call to make an appointment with Dr. Munjal today! As always, stay safe and healthy! |
