Public Education Slide Kit

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Public Education Slide Kit
High Blood Pressure
The Silent Killer
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Overview

• What is high blood pressure?
• Why should I care?
• What causes it?
• How will I know if I have it?
• Can I measure my own blood pressure?
• How can I lower my blood pressure?
• Are there medications?

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What is blood pressure?

• The force or pressure on the inside of our
  arteries (blood vessels) as the blood circulates.
• You cannot feel changes in blood pressure.

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What is hypertension?

• A condition when blood pressure is always too
  high.
• Also called High Blood Pressure (HBP).
• Hypertension is a blood pressure of 140/90 mm Hg
  or greater.

140
90
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Why should I care?
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Leading risks for premature death
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HYPERTENSION
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Tobacco Use
Alcohol
3
4
Cholesterol
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Overweight
(World Health Organization 2002)
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Hypertension can cause

• Stroke (brain attack)
• Heart attack heart failure
• Kidney failure
• Sexual dysfunction
• Dementia
• Eye damage
• Early death

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Death due to atherosclerosis (infarction)
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Stroke due to broken blood vessel (hemorrhage)
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Eye blood vessels
Severe hypertension
Normal
Eye blood vessels leak and break due to high
blood pressure
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Do you know how many Canadians have hypertension
?
Question
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Answer

• 1 in 4 Canadians have hypertension.
  

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What causes hypertension ?

• Lifestyle 60
• Genetics 35
• Underlying disease 5
• kidney disease, excessive use of aspirin-like
  drugs (NSAIDs)

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Your lifestyle can raise your blood pressure

• Physical inactivity
• Unhealthy diet
• Not enough fruit, vegetables,
• and low- fat dairy
  
• Too much salt (sodium).
• Being overweight

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Your lifestyle can raise your blood pressure

• Excess alcohol
• Smoking or exposure to cigarette smoke
• Stress

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Hypertension is more common in older people
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How is blood pressure measured?
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What do the numbers mean?

• The upper number is when the heart beats
• The lower number is when the heart relaxes
• Measured in mm Hg (millimeters of mercury)
• e.g. 124/84 mm Hg

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What are the numbers called?
Systolic Blood Pressure (SBP)
Diastolic Blood Pressure (DBP)
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What should your blood pressure be?
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Do I have hypertension ?
One high reading may not mean you have
hypertension
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How do you know if you have hypertension?
Question
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Answer

• Many people have hypertension and dont know it.
  
• The only way to know if you have hypertension is
  to have your blood pressure measured.

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The silent killer

• Most people cannot feel if their blood pressure
  is high.
• Usually, there are no symptoms.

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How can I check to see if I have hypertension ?

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How can I check to see if I have hypertension ?

• Have your blood pressure measured
• Regularly
• Lifelong
• Note Family members may also be at risk and
  should have their blood pressure checked.

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Who can measure my blood pressure?
Your Family Doctor
You
Local Pharmacist
A Nurse
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How often should I check my blood pressure?

• If your blood pressure is
• Less than 130/85 - every 2 years
• 130-139/85-89 - every year
• Above 139/89 - check often

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Can I measure my own blood
pressure ?
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Selfmeasurement of blood pressure

• You can measure your own blood pressure at home.
• Home blood pressure measurement devices are
  available at most pharmacies.
• Purchase a device endorsed by the Canadian
  Hypertension Society (CHS) with the logo
• Make sure your device has the right cuff size for
  your arm - ask if unsure.

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Selfmeasurement of blood pressure

• Carefully follow the instructions for proper
  measurement that come with the device.
• For most people, normal BP at home is lt 138/85
  mmHg
• More instructions can be found at
  www.hypertension.ca
• Another helpful website is at www.heartandstroke.c
  a/BP

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Self-measurement
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World Hypertension Day
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Why treat hypertension?
A decrease of 10/5mm Hg (typical with one
medication or a change in lifestyle) reduces your
risk of developing serious complications.
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Who can help me lower my blood pressure ?
Your Family Doctor
You
A Dietitian
A Nurse
A Psychologist
Your Pharmacist
A Hypertension Specialist
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How can I lower my blood pressure ?

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What you can do

• Measure your blood pressure regularly.
• Increase your physical activity.
• Control your weight.
• Eat a healthy diet.
• Cut back on sodium and processed foods.

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What you can do

• Limit alcohol.
• Become smoke-free.
• Reduce stress.
• See your doctor/health care provider.
• Take medications as prescribed.

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Lifestyle changes make a difference

• Small changes in eating habits and activity can
  lower blood pressure.
• Set weekly goals for change.

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Healthy lifestyles really make a difference
Applying the 2005 Canadian Hypertension Education
Program recommendations 3. Lifestyle
modifications to prevent and treat hypertension
Padwal R. et al. CMAJ ? SEPT. 27, 2005 173 (7)
749-751
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Reducing systolic BP, stroke and heart attack
Stroke
Heart Attack
Decrease in systolic blood pressure
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Why treat hypertension?
A decrease of 10/5mm Hg (one medication or a
change in lifestyle) reduces your risk of
developing serious complications.
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Lifestyle changes make a difference
Is this your familys idea of a fitness centre?
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Physical activity

• Physical activity can
• Decrease risk of heart disease and stroke.
• Lower blood pressure almost as much as taking one
  medication.
• Help to reduce weight.
• Help to reduce stress.

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Physical activity
30 to 60 minutes per day!

• Make exercise a priority make it part of your
  daily schedule.
• Do activities that you enjoy.
• Do a variety of activities.
• Exercise with a friend.
• Join a fitness class or get a personal trainer.
• Set small realistic attainable goals.

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Walking weight loss

• Walk 1 mile (1.6 Km) 100 calories
• Walk 4 miles (6.4 Km) 4 times a week and burn off
  up to ¼ Kg/week (½ lb / week) extra
• These are just estimates based on the
  literature for an averaged size person

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Walking weight loss
30 to 60 minutes per day!

• The BP lowering effect of walking vigorously for
  40 minutes per day, 4x a week is as effective as
  greater amounts of exercise.
• The positive effects of exercise may last up to
  72 hours.
• Therefore, build this into your weekly schedule.
  

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Control your weight

• Lower your blood pressure by losing as little as
  10 pounds (4.5 kg).

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Waist management
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Portion control!

• Calories - Just enough to keep a normal weight.
• Eat less if you are overweight.
• Eat more vegetables fruit. (7-10 servings a
  day).
• Avoid excessive fat and carbohydrate intake.

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Eat a healthy diet

• Follow Canadas Food Guide
• Adequate fruit, vegetables, whole grains
  low-fat dairy products.
• Foods low in saturated and trans fat, sugar
  salt, and high in fiber.
• Visit www.healthcanada.gc.ca/foodguide for more
  information.

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Shake the salt habit

• Limit foods with added sodium.
• Limit fast and pre-prepared or processed foods
  (canned soups, pickles, chips, processed meats)
• Choose foods with the least added sodium.
• Limit salt/sodium used at the table and in
  cooking.

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Check food labels for sodium
Look for foods that provide 10 or less of your
daily value for sodium.
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Limit alcohol

• No more than 2 drinks per day
• 9 drinks weekly for women
• 14 drinks weekly for men
• No Binging

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Smoking increases

• .. your blood pressure
• .. your risk for heart disease and stroke
• .. your risk for many lung diseases
• .. your risk for many types of cancer

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Become smoke-free

• Quit on your own (works for many).
• Join a smoking cessation program.
• Try gum, patch, pills.
• Avoid temptation.
• Discuss with your doctor or pharmacist.
• Choose smoke-free environments.

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Reduce stress

• Take time to relax.

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What about medications for hypertension ?
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Hypertension medications

• Lower your blood pressure.
• In the long-term reduce your risk for
• stroke (by 40),
• heart attack (by 20), and
• heart failure (by 50).
• Usually do not change how you feel.

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Question

• Do all people on medications for hypertension
  have their blood pressure under control?

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Answer

• Many people with hypertension require both
  lifestyle changes and more than one medication to
  control their blood pressure.

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Hypertension medications

• It may take up to 6 weeks for pills to lower your
  blood pressure.
• Pills need to be continued, even when your blood
  pressure is controlled.
• Pills are usually taken for life
• (unless your doctor stops the medication).

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Medications need to be taken as directed or
Hypertension medications

• Blood pressure may not be controlled.
• Side effects may be more troublesome.
• An adverse reaction or event may result.
• Your doctor may think they are not working and
  prescribe a higher dose or add another medication.

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High blood pressure

• Is a silent and common cause of disability and
  death.
• Can be prevented and treated by changes in
  lifestyle.
• Can cause problems that may be prevented by
  lifestyle changes and medication.
• Get your blood pressure measured today!

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What you can do

• Know your numbers.
• Know your targets.
• Measure your blood pressure at home.
• Make healthy lifestyle choices.
• Take pills as prescribed.

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Resources

• Heart and Stroke Foundation
• www.heartandstroke.ca/bp

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Can be ordered at www.hypertension.qc.ca
Resources
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Can be ordered at www.hypertension.qc.ca
Resources
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Resources
Available at www.hypertension.ca/bpc
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Other resources

• Smokers Help Line
• www.aadac.com
• 1-866-332-2322
• Canadas Food Guide www.healthcanada.gc.ca
• Canadas Exercise Guide www.hc-sc.gc.ca

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Question

• Blood pressure measures the amount of pressure in
  your arteries.
• TRUE
• FALSE
• Dont know

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Question

• 2. A blood pressure greater than 140 over 90
  (140/90 mmHg) is considered too high.
• TRUE
• FALSE
• Dont Know

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Question

• 3. You can usually tell if your blood pressure is
  too high by the way you feel.
• TRUE
• FALSE
• Dont know

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Question

• 4. Having one elevated blood pressure reading
  means that you have high blood pressure.
• TRUE
• FALSE
• Dont know

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Question

• 5. Hypertension is a major risk factor for stroke
  and dementia.
• TRUE
• FALSE
• Dont know

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Question

• 6. The following lifestyle factors can help to
  treat and control high blood pressure
• Having a healthy weight
• Regular exercise
• Eating a healthy diet
• Restricting alcohol intake
• Reducing sodium/salt intake
• TRUE
• FALSE
• Dont know

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Question

• 7. Smoking increases blood pressure.
• TRUE
• FALSE
• Dont know

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Question

• 8. Generally, people who do not have high blood
  pressure should have their blood pressure checked
  every 3 to 4 years.
• TRUE
• FALSE
• Dont know

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Question

• 9. If you are taking pills for high blood
  pressure you will need to stay on them the rest
  of your life.
• TRUE
• FALSE
• Dont know

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Question

• 10. If you are older than 65 and your blood
  pressure is elevated above your target despite
  your healthy lifestyle, should you be considered
  for medication?
• TRUE
• FALSE
• Dont know

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How can you do all that?

• The 5 Steps to Change
• Take control
• Keep it simple
• Take it slow
• When you fall, get up
• Change your mind
  

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The 1st of the 5 steps to change

• To take control two things need to happen
• The need to change something must be very
  important to you.
• You must have confidence in yourself that you can
  actually succeed at doing it.
  
  

Importance Confidence Motivation
The Sixty Second Motivator Jim Johnson, PT
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How motivated are you ?

• Ask yourself
• How important is it for me to make this change ?
• (0 not important, 10 very important)
• How confident am I that I can make this change?
• (0 not confident, 10 very confident)
  
  

Importance Confidence Motivation
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If you scored low on importance..

• Find reasons to change that are meaningful to
  you and give you something you really want.
• What would it be like if you reached your goal?
• How would you feel?
• What would the benefits be ?
• What would happen if you never reached your goal?
• What would it take to make reaching your goal
  more important to you?
  

Importance Confidence Motivation
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If you scored low on confidence..

• Make sure you have the tools, skills and
  knowledge that will allow you to reach your goal.
• Do you know how you will achieve your goal?
• Is there more than one way to do it?
• What skills and tools are needed?
• What knowledge is needed?
• If you know people who achieved similar goals,
  ask how they did it.
• Who should I ask for help or advice?
  

Importance Confidence Motivation
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Acknowledgements

• Sponsored by
• Blood Pressure Canada
• The Canadian Hypertension Society
• The Canadian Hypertension Education Program
  (CHEP)
• Heart and Stroke Foundation of Canada
• Updated in 2008 by a multi-disciplinary team
• Nurse Donna McLean
• Physicians Charlotte Jones (Chair), Ross
  Feldman
• Dietitians - Wendy Shah, Marla Richardson
• Downloadable at
• www.hypertension.ca/bpc