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diagnosed with high blood pressure (hypertension): managing support, resources and lifestyle

here’s how you can manage a diagnosis of high blood pressure (hypertension).

by karen hawthorne

dec 18 2023
read time 9 minute read
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high blood pressure (hypertension): support, resources and lifestyle
lifestyle changes like an increase in regular exercise can have a big impact on managing high blood pressure. getty images
early on, patrice lindsay decided she would become a nurse like her mom. she had an interest in science and medicine, and a family history of heart disease. she went on to specialize as a cardiac nurse. then the unexpected happened. she had a stroke when she was just 38 – a strong and capable working professional and mom to two little children.
“it came totally out of the blue,” says lindsay, adding it took a while for her to get a proper diagnosis. “sometimes being a young female, you don’t have the emergency doctor who will put two and two together. so i did experience some of that bias that most women do experience.”

as time magazine reports , women are less likely to be referred for further diagnostic testing than men are. and women’s pain is more likely to be viewed as having an emotional or psychological cause, rather than a biological one.

she says she was fortunate that her stroke was mild compared to what many people go through, although it took six months to a year for her to fully recover. she still has difficulty with her leg coordination and slow cognition, especially when she’s tired or overworked. “emotionally, it took a long time to come to terms with being that young with two young kids and having to face that.”

heart disease and stroke have a lasting effect on physical and mental health. for lindsay, it also influenced her career path, sparking her outreach and advocacy work with the canadian stroke network and more than 10 years with the heart and stroke foundation where she currently leads engagement and stroke strategies.

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while her personal experience with stroke was related to a heart condition, she says that high blood pressure, also known as hypertension, is the “silent killer” that can lead to a similar acute event or even death. lack of awareness is a huge concern.
“the problem with high blood pressure is you don’t often have signs and symptoms in the way that you would if you’re having a flu or a cold or heart attack or heart chest pain,” she says. “most of the time, you just don’t know you have it until somebody puts a blood pressure cuff machine on you.”
here’s how you can manage a diagnosis of high blood pressure (hypertension).

understand your diagnosis of high blood pressure (hypertension)

what is high blood pressure (hypertension)? it’s a chronic condition that happens when the blood pressure in your arteries rises and your heart has to work much harder than normal to pump blood through the blood vessels. why? your arteries become thick and stiff for a number of reasons, like genetic predisposition, aging and the inflammation that comes with risk factors like obesity or being overweight, not being physically active, smoking, alcohol intake, insomnia, diabetes, and other chronic health issues.
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over time, these all add up to poor heart health.
the numbers show you’re not alone. estimates suggest one in four adults – almost eight million canadians – have high blood pressure and many more may not be aware of it. heart disease is the second leading cause of death after cancer and a leading cause of hospitalization. with the aging population and increasingly more young people being diagnosed because of family history and lifestyle, those numbers are expected to grow.

while it’s historically been thought of as a men’s issue, heart disease is just as much a concern for women. estrogen offers a protective benefit, but hormonal changes that happen with pregnancy, diabetes and menopause put women at higher risk . high blood pressure can happen to anyone at just about any point.

a 2022 heart and stroke survey found that right on the frontlines of the issue, seven in 10 health professionals across the country identified a lack of high blood pressure screening practices, and six in 10 noted inadequate treatment and control as areas they’re concerned about. so, getting a diagnosis is a solid step to take control of your health before it’s too late.

get all the information you can to understand high blood pressure and how to manage it from resources like heart and stroke, says lindsay. the organization can be a starting point for people who are newly diagnosed and their families. “we often get phone calls from people saying, ‘this is what’s happened. i’m so surprised’ and ‘what do i do next?’ they start to realize how vulnerable they are.”

connect regularly with your care provider

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part of living with a chronic disease is seeing your healthcare provider for expert monitoring. typically, antihypertensive medication is prescribed and then patients are followed to see if adjustments in dosages or different medications will be more effective.
the challenge is the rising number of people without access to a family doctor and consistent care. as lindsay notes, this also leads to less screening for high blood pressure and poor management of the disease.
“i’ll hear from people who say they were prescribed medication for a month. ‘i took it for a month, my blood pressure came down, so i’m all good now.’ of course, when they stop the medication, their blood pressure goes back up again.”
access to medication is also an issue, she adds. “in rural, remote communities where even if people have the diagnosis, they may not have access to medications or may not be able to afford the medications. i often hear people tell me, ‘it was prescribed for three times a day, but i can’t really afford it, so i’m only taking it once a day.’ that is not uncommon, but the medication is not going to do its job.”
dr. dylan blacquiere, stroke neurologist at the ottawa hospital and assistant professor of medicine at the university of ottawa, acknowledges the gap in public knowledge about hypertension and healthcare providers’ ability to diagnose, treat and help people manage the disease. he sees patients with acute stroke or bleeding in the brain whose blood pressure may have been uncontrolled for years.

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“this might be the very first time they’ve ever been told that their blood pressure is high. and some of that is they don’t have access to reliable ways to check it. or nobody’s ever sat down and discussed with them ways to reduce their blood pressure. i think a lot of it lately is because of the difficulties in being able to access reliable primary care.”
without consistent care, blood pressure that isn’t adequately managed can also lead to vascular cognitive impairment where subtle changes occur over time, like ongoing memory issues and difficulties with function that may look similar to alzheimer’s disease, says blacquiere.
“high blood pressure is damaging the pathways that the brain needs to be able to communicate so it’s harder to think, it’s harder to remember, it’s harder to process things. these changes mean that it’s difficult for people to live independently if it’s left untreated long enough.”

monitor your blood pressure numbers

checking your blood pressure regularly is highly recommended to give you a better reading and peace of mind that you’re doing well. some people have spikes in blood pressure because of nervousness during a visit at a medical clinic, known as “white coat hypertension,” the mayo clinic notes .

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as a general rule in blood pressure categories, low risk is 120/80, medium risk is 121-134/80-84 and high risk is 135+/85+.
“we’re trying to really encourage people, especially adults, to know their numbers,” lindsay explains. “there are those blood pressure machines in the grocery store and the drug store where you sit down for two minutes, pop your arm in and get a sense of a baseline.”

she also directs people to hypertension canada’s list of recommended devices for self-monitoring at home that has advantages for ease and convenience for regular checks and keeping a log of results. the organization has tested each unit, and also offers tips on when and how to take your measurements , including before taking blood pressure medication, at least two hours after a meal and one hour after drinking coffee. another important point is your body’s position, seated with your back supported and legs uncrossed with feet flat on the floor. your arm should be supported with the middle of the cuff at heart level.

these devices can be expensive, so cost may be prohibitive. some extended health plans may cover a portion of the purchase.
studies on home blood pressure monitoring have shown that it has the potential to cut costs to healthcare and address health disparities facing racial and ethnic minorities and rural residents by reducing cardiovascular events.

investigators in georgia, new york and shanghai looked at the health and economic impact of home monitoring for a 2023 study published in the american journal of preventive medicine , concluding the self-monitoring at home “facilitates early detection, timely intervention, and prevention of complications, leading to improved control and better health outcomes.”

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adopt healthy lifestyle habits to manage high blood pressure

easier said than done, lifestyle changes can have a big impact on managing high blood pressure, with potential to reduce medication dosages and even control blood pressure without medication. but there are many roadblocks to eating more nutritious whole foods, making time for regular exercise and getting good sleep (all three help prevent obesity and other metabolic disorders). lindsay points to rising food prices and the effects of the global pandemic sabotaging health habits.
“fresh foods are incredibly expensive for people,” she says. “the workforce is very competitive and young people feel like they have to work more and do more to get ahead. they’re spending longer hours at the office, they’re picking up fast food on the way home. they’re exhausted when they get home. sleep patterns aren’t great. with work at home, we’re even losing the dash to the office and people are less mobile.”

but being committed to making healthy changes has been proven to help control high blood pressure even in cases where people are resistant to medication. research  by duke university medical center demonstrated that combined dietary counselling, behavioural weight management and exercise in a cardiac rehab facility reduced blood pressure and improved cardiovascular disease biomarkers.

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reach out for support

finding the kind of support that works for you will help you cope with the lifelong vigilance required. lindsay recommends heart and stroke online resources, like a comprehensive guide to helping you manage high blood pressure, webinars to hear from heart specialists, and peer groups to discuss personal challenges. facebook communities, for example, can be transformative for people.

“sharing people’s lived experience, like ‘i was prescribed these medications, anybody else on it?’ so they look to each other for validation and for input and guidance. that’s usually a very strong motivator to hear from other people living the same situation you are.” peer support research has shown its positive impact on sticking with the hypertension treatment regimen and the result of better blood pressure control.

awareness and education are a significant part of managing hypertension as case numbers grow. as blacquiere sees it, there’s more to be done so people understand the health risks and take action. outcomes in the long-term can lead to permanent disability, so it’s nothing to shrug off simply because it’s a common problem.
“people get the idea that high blood pressure can be bad for your health. and i think people get the idea that it can cause this subtle damage over time, so it can lead to heart damage, it can lead to kidney damage, all these other things. people get that it’s not a good thing to have, and people get that it’s not a good thing to continue to leave untreated, but i don’t think people necessarily get the idea that some of these changes might in fact be irreversible if it’s not taken seriously enough.”
karen hawthorne
karen hawthorne

karen hawthorne worked for six years as a digital editor for the national post, contributing articles on health, business, culture and travel for affiliated newspapers across canada. she now writes from her home office in toronto as a freelancer, and takes breaks to bounce with her son on the backyard trampoline and walk bingo, her bull terrier.

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