Internal medicine service providing long-term monitoring of high blood pressure (hypertension) through accurate measurement, medication adjustment, and lifestyle recommendations.
Indication
- Office blood pressure readings of 140/90 mmHg or higher
- Persistently elevated home readings above 135/85 mmHg
- Possible hypertension symptoms such as headache, dizziness, palpitations, or nosebleeds
- Blood pressure management in individuals with concomitant cardiac, renal, or vascular disease
- Increased cardiovascular risk due to diabetes, chronic kidney disease, or high cholesterol
- Pre-pregnancy or pregnancy-related blood pressure assessment
- Efficacy and side-effect review of currently used antihypertensive medications
Preparation
- Avoid tea, coffee, smoking, and strenuous exercise for 30 minutes before the visit
- If you monitor blood pressure at home, bring records from the past 1-2 weeks
- List all current medications with doses and timing
- Bring previous blood test, ECG, and kidney function reports
- Resting quietly for 5 minutes before measurement improves accuracy
How it's performed
- The physician measures blood pressure on both arms with an appropriate cuff after rest
- Symptoms, family history, smoking and alcohol use, and comorbid conditions are reviewed
- Cardiac, pulmonary, abdominal, and pulse examinations are performed to assess target organ involvement
- Blood tests, urinalysis, ECG, and fundus examination are arranged when needed
- Lifestyle recommendations and appropriate medication are initiated based on risk level
- Follow-up intervals and home monitoring methods (upper-arm device, daily readings) are explained
Post-procedure
- Follow-up within 2-4 weeks after starting or adjusting medication
- Once target is reached, regular monitoring every 3-6 months
- Annual evaluation of kidney function, electrolytes, lipid profile, and ECG
- Keeping a morning-evening home reading log and sharing it at visits
- Support for salt restriction, weight management, regular exercise, and smoking cessation
Risks
- Untreated high blood pressure increases risk of heart attack, stroke, and kidney failure
- Medication side effects: dizziness, ankle swelling, cough, fatigue
- Excessively low blood pressure (hypotension) may cause dizziness on standing
- Abruptly stopping medication can lead to uncontrolled rises in blood pressure
- Some medications may affect kidney function and potassium levels
FAQ
Do I need to take blood pressure medication for life?
Long-term use is needed for most patients; however, with weight loss, salt restriction, and regular exercise, doses can be reduced in some individuals. Decisions are made through individual assessment under physician supervision.
How should I measure my blood pressure at home?
Use a validated upper-arm digital device. Measure morning and evening while seated, after 5 minutes of rest, taking two consecutive readings. Note each reading with date and time.
My blood pressure looks normal — can I stop the medication?
No. Normal readings indicate the treatment is working; stopping medication often causes values to rise again. Dose changes should only be made on physician advice.
Which foods should I avoid?
Salt, pickled foods, instant soups and chips, processed meats, and excessive caffeine adversely affect blood pressure. Vegetables, fruits, whole grains, and low-fat dairy form the basis of the recommended DASH diet.
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