Treating High Blood Pressure Can Be a Bargain

Sometimes, the simplest things can make all the difference.

In an effort to cut back on my family's monthly expenses, I discovered I could save $24.95 a month simply by reducing the speed of my computer downloads. I was nervous at first that my impatience would get the upper hand, but was assured by my cable provider that if I wasn't happy with the slower service, I could immediately have it upgraded again.

After a few weeks, I must confess, I can barely notice the difference. This is but one of many steps I have taken to save money each month that have made me feel more in control of my life and happier as a result.

This reminds me that when it comes to our health choices and medications, we can save much more than we think. There really are many ways we can reduce our "monthly" health costs and feel more in control -- and healthier, to boot. Sadly, all too often people don't have the confidence or even know they can take these steps. I thought I would use my new blog, "Ask Dr. Marie: Straight Talk and Reassuring Answers to Your Most Private Questions," to occasionally talk about some of these steps.

Let's start with high blood pressure, or hypertension. Treating high blood pressure is considered one of the most (if not the most) cost-effective activities we can take. More than 50 million people have hypertension in the United States, with one-third of them unaware of it and another one-third on treatment, but with blood pressure that is not well controlled. That leaves only about one-third of people with their blood pressures well-controlled with lifestyle changes and/or medications. And even for these patients, the chances are pretty good that they are not on the most effective and least costly medications.

How do you know if you or someone you love has high blood pressure? We used to say a blood pressure over 140/90 when checked on three or more occasions meant high blood pressure. We now know that the ideal blood pressure is more like 115/70, and any blood pressure over 130/80 is considered high for most individuals!

Yet, relying solely on your doctor's visit to measure your blood pressure is not good enough. Many individuals have high blood pressure when they see that "white coat" -- perhaps because they waited so long in the waiting room, they fear the news their doctor may bring, or they simply get anxious when they step on the dreaded scale or undress and bare all.

However, it is your blood pressure recorded while at home -- especially at night while you are resting, free of stress and especially while sleeping -- that tells the most about your risk for heart, kidney and brain damage from high blood pressure. A study in this week's Journal of the American Medical Association looking at patients with resistant hypertension reminds us of this fact.

So, step one to finding the most cost-effective treatment for high blood pressure is to find out if you have it in the first place -- and if you have it -- is it under optimal control?

Purchasing a simple home blood pressure monitoring device is a great deal. I use the Omron brand and recommend this brand to my patients, although any good digital device will do.

It is important that the cuff wraps comfortably around your arm. Many patients who are obese will need to order an extra large cuff, often called a thigh cuff.

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