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Posted: November 30, 2006

Spousal Caregiving

Are You Concerned About Your Blood Pressure?

Bill Andrew

As a caregiver, I am sure that you are concerned about your blood pressure as a result of the various stresses and strains of your caregiver activities and responsibilities. I recently came across an article published by Harvard Medical School entitled "10 Steps to Lower Your Blood Pressure" that I wanted to share with you.

High blood pressure (hypertension) typically has no symptoms or warning signs. In fact, some 30% of people who have it do not realize it. That lack of knowledge can be deadly -- it’s even been called a "silent killer."

Over the years, untreated high blood pressure can damage various internal organs and set you up for several life-threatening diseases, including stroke and heart disease. Therefore, obtaining crucial information can help you to identify a blood pressure problem and get it under control sooner than later.

High blood pressure is not something that can be easily lowered to acceptable levels. In many cases, people just have to learn to live with. Medications can offer an easy fix but often come with unwanted side effects. It is much harder to make healthful lifestyle changes, but the resulting benefits go far beyond lower blood pressure. That’s why it makes sense to start with these habit changes and add medications only if needed.

Here are 10 steps that can help you to lower your blood pressure and keep it under control.

1. Check it. Unless you know what it is, you can’t really do much about lowering your blood pressure. While your doctor usually checks it every visit, you can also do so at home with relatively inexpensive home blood pressure monitors. I try to check mine weekly since spousal caregiving can be the source of stress and tension that may increase blood pressure.

2. Get moving. Regular exercise improves blood vessel flexibility and heart function and can take the form of something as simple as taking a brisk walk daily or even 3-4 times a week. This has been shown to lower blood pressure by 10 points, prevent the onset of high blood pressure, or allow you to lower the blood pressure medication dosage.

3. Eat right. Did you know you can lower your blood pressure with a proper diet? A landmark study called Dietary Approaches to Stop Hypertension (DASH) found this to be the case. The DASH diet focuses on fruits, vegetables, low-fat dairy products, whole grains, poultry, fish, and nuts -- much like the so-called Mediterranean diet. You should avoid red meats, sweets, sugar-containing beverages, and saturated fats and cholesterol.

4. Control your weight. If you tend to be on the heavy side for the size of your body frame, losing weight can often lower your blood pressure. Losing 10% of your current weight, or even 10 pounds, can often make a big difference in your blood pressure.

5. Do not smoke. Nicotine constricts small blood vessels. Did you know that smoking a single cigarette can cause a 20-point spike in your systolic blood pressure (the first and larger number -- the "120" of 120/80, for example). While stopping smoking is difficult, there are many aides available to assist in this effort.

6. Drink alcohol in moderation. According to recent research, one drink a day for women, or two per day for men, is good for the heart and blood vessels. Going beyond that can contribute to higher blood pressure as well as other serious problems.

7. Shake up your salts. Too much sodium and too little potassium can boost blood pressure in people who are sensitive to salt. The imbalance is so great that the American Medical Association is calling for food manufacturers and restaurants to cut the sodium content of food by 50% by 2016. You should aim for less than 1.5 grams of sodium and at least 4.7 grams of potassium a day.

8. Sleep is good. Burning the candle at both ends, so it interferes with your sleep, can contribute to high blood pressure. It also can increase the chances of developing heart disease or a sudden cardiac arrest. As a caregiver, you need your sleep, especially if you are a 24/7 caregiver as I am. A minimum of six hours a night may be enough for some people; however, eight hours is more like it for most people.

9. Reduce stress. While mental and emotional stress will definitely increase your blood pressure, meditation, deep breathing, and other stress-busting techniques can lower it.

10. Stick with your prescribed medications. If you are taking prescribed medications to lower and maintain your blood pressure, keep doing so -- religiously. While taking these medications may not make you feel better outwardly, they may keep you from having a stroke, heart attack, or other related problem.

High blood pressure, like most everything else in medicine, is a highly personal condition. Preventing high blood pressure, and keeping it from doing harm, requires careful, individualized evaluation byyour doctor. It also takes a highly focused commitment on your part.

If the Harvard suggestions don’t work for you in lowering and maintaining healthy blood pressure, there are dozens of medications available by prescription from your doctor. They come in a range of regimens and costs. They also come with a range of potential effects on other medical conditions, may have interactions with other medications, and may have potential side effects.

Which medication is best for you is one decision only you and your doctor can make. In fact, deciding which medication is best for treating high blood pressure is one of the major controversies in medicine today. Current guidelines indicate that the first choice should be an inexpensive diuretic (water pill). Some experts claim that an ACE inhibitor or calcium-channel blocker might be a better place to start.

In reality, what is best for you is not necessarily what is best for someone else. Most people may need more than one medication to get their blood pressure under control, and one of those should probably be a diuretic.

None of what I’m writing today should be construed as medical advice. Work with your doctor to determine what is best for you.

Personally, my blood pressure, measured as I write this, is 120/80 -- and it is often lower than that. I subscribe to the first nine suggestions above; I do not take any prescription medication for high blood pressure despite the stresses, strains, trials, and tribulations incurred from being a 24/7 spousal caregiver.

I would like to hear your reaction to the above suggestions -- what works for you and what does not. You can e-mail me at and let me know if I can use your comments in a future column. Thank you.


"Health is not valued until sickness comes."

Dr. Thomas Fuller (1654-1734)

Bill Andrew identifies himself as a former “nutritionally-empowered Alzheimer’s caregiver” who attributes the slow-down in progression of Alzheimer’s disease in his wife, Carol – and the growth of his own personal emotional, mental, physical, and spiritual capability and strength to provide quality 24/7 care for her in their own home – to the targeted nutritional supplements they both took on a daily basis. Carol went to her Heavenly reward on June 9, 2008 – Bill continues on to advocate for family caregivers. Contact Bill with your caregiving questions and comments via email at

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