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You looked at 135 and relaxed.

But the 90 changes the reading.

Blood pressure is not calculated by averaging the two numbers. Each number matters, and the one that falls into the higher category determines how the reading is interpreted.

The upper number is the pressure created when your heart pumps blood out.

The lower number is the pressure in your blood vessels while your heart rests between beats.

With a reading of 135/90, the lower number is already at the hypertension threshold under WHO and International Society of Hypertension guidance. Under AHA/ACC guidance, a lower number of 90 falls within Stage 2 hypertension.

Does one reading confirm that you have hypertension? Usually, no.

Sit quietly for five minutes and repeat the measurement correctly. Keep a record of readings taken on different days and discuss them with your clinician.

Your clinician will also consider other factors that affect your chances of developing heart disease or having a stroke. These include diabetes, kidney disease, high cholesterol, smoking and any previous heart or stroke problem.

Do not dismiss 135/90 as “not too bad.”

Save this poster. The number you almost ignored may be the one that matters most.

#HeartAndStrokeMonth

#HealthyLivingWithDrKetch

Whatever happened to pre-hypertension?

For years, people were told, “Your blood pressure is not high yet. It is only pre-hypertension.”

Then the term seemed to disappear.

It did not disappear because those readings became harmless. Newer guidelines divided the old category into more specific groups.

Depending on the exact reading and the guideline your clinic uses, you may now hear elevated blood pressure, high-normal blood pressure or stage 1 hypertension.

One unexpected reading is not a reason to panic. But please do not dismiss it as “only borderline.”

Repeat the measurement correctly on different days. Keep a record and discuss persistent readings with your clinician.

The name may have changed. The opportunity to act early remains.

Tomorrow, we will look at the actual numbers and explain what the upper and lower readings mean.

#HeartAndStrokeMonth

#HealthyLivingWithDrKetch

“My blood pressure is normal now. I have stopped the tablets.”

But what if the tablets are the reason it is normal?

A normal reading does not necessarily mean the hypertension has disappeared. It may mean your treatment is working.

Blood-pressure medicine is not a painkiller. You do not wait until you have a headache or feel unwell before taking it.

If you stop the medicine, your blood pressure may rise again without warning. Some blood-pressure medicines can also cause problems when stopped suddenly.

Keep taking your medicine as prescribed and continue recording your readings.

If the readings become unusually low, you feel dizzy or the medicine is causing side effects, speak with your prescriber. The dose may need to be reduced or the medicine changed.

Some people may eventually need less medicine. A few may be able to stop after a proper medical review.

The important thing is not to make that decision alone.

Please share this with someone who takes blood-pressure medicine only when the number is high or a headache begins.

#HeartAndStrokeMonth

#HealthyLivingWithDrKetch

The clinic says 126/78.

At home, your monitor keeps showing readings around 150/94.

Please do not let one normal clinic reading silence what appears to be happening during the rest of your day.

This pattern may be masked hypertension. Your blood pressure looks normal during the appointment but is repeatedly high at home.

First, make sure you are checking correctly. Use a validated upper-arm monitor with the correct cuff. Sit quietly before checking. Take two readings, one minute apart, and record both numbers.

Keep a record of the date and time. Take that record and your monitor to your healthcare professional. A 24-hour blood-pressure monitor may be recommended to confirm the pattern.

White-coat hypertension is the reverse. That is when blood pressure is high at the clinic but normal at home.

Do not change your medicine because of one reading.

And do not dismiss repeated high home readings because one clinic reading was normal.

Please share this with someone who has been told, “Your blood pressure was fine at the hospital, so there is nothing to worry about.”

You check your blood pressure once and see 168/104

Your mind races straight to stroke.

Take the reading seriously, but do not diagnose yourself from one number.

Blood pressure can rise temporarily because you just exercised, drank coffee, felt anxious or talked while it was being measured. An incorrectly sized cuff can also give a misleading result.

Sit quietly for five minutes, keep your back supported, your feet flat and your bare arm resting at heart level. Do not talk.

Take two readings, one minute apart, and write down both numbers.

If repeated readings remain high, arrange a medical assessment. Your healthcare professional may ask you to monitor at home or use a device that records your blood pressure over 24 hours.

If your blood pressure is 180/120 or higher, wait one minute and check again. If it remains that high, contact a healthcare professional immediately.

If that reading comes with chest pain, difficulty breathing, weakness, numbness, vision changes or difficulty speaking, seek emergency care now.

One high reading is not usually a diagnosis.

It is also not a reading to ignore.

#HeartAndStrokeMonth

#HealthyLivingWithDrKetch

“But I feel fine.”

That is exactly why high blood pressure is often missed.

You may have no headache or other warning while persistently high blood pressure makes your heart work harder and gradually damages blood vessels.

Over time, that damage can affect your brain, kidneys and sight.

The good news is that much of this damage can be prevented.

Check your blood pressure regularly. Reduce salt and salty packaged foods. Stay physically active. Do not smoke.

If you have been prescribed blood-pressure medicine, take it consistently. Feeling well may mean the treatment is working. It does not mean you should stop it.

Keep your follow-up appointments even when nothing feels wrong.

Please send this to someone who believes blood pressure only matters when a headache begins.

#HeartAndStrokeMonth
#HealthyLivingWithDrKetch

You remind everyone else to take their medicine and keep their clinic appointments.

But when last did you sit down and check your own blood pressure?

Many people with high blood pressure feel completely well. That is why waiting for a headache or another warning sign can be dangerous.

Today begins Heart and Stroke Month on Healthy Living with Dr Ketch.

Let us start with the number you cannot guess by how you feel.

Sit quietly for five minutes before checking. Keep your back supported, your feet flat and your arm resting at heart level. Take two readings, one minute apart, and write them down.

One high reading is not a diagnosis. Check again after resting. If your readings remain high, speak with a healthcare professional.

Before today ends, check your blood pressure.

Then send this to the person who is always looking after everyone except herself.

#HeartAndStrokeMonth

#HealthyLivingWithDrKetch

One small stain after two years without a period.

It stops. You may be tempted to ignore it.

Please do not wait for it to happen again.

Any vaginal bleeding that occurs after 12 months without a natural period is called bleeding after menopause. It should be assessed even when it is only spotting, pink or brown discharge, or a single episode after sex.

The cause may be dryness and thinning of the vaginal tissues after menopause. It may also be a polyp, a reaction to hormone treatment or a change in the lining of the womb. Less commonly, it may be cancer.

Most women assessed for bleeding after menopause do not have cancer. But there is no safe way to know the cause without being checked.

Your assessment may include an examination, an internal ultrasound or a small sample from the lining of the womb. What happens next will depend on what is found.

Today brings our Women’s Health Month series to an end. My hope is that this month has made it easier to listen to your body and seek care without shame or delay.

Thank you for reading and sharing these posts with the women you care about.

#WomensHealth

#HealthyLivingWithDrKetch

After six months without a period, you assume menopause has arrived and stop family planning.

Then the pregnancy test shows two lines.

How can that happen?

During perimenopause, your periods may disappear for several months and then return. Your ovaries can still release an egg during this time.

Ovulation happens before menstruation. This means pregnancy can occur before you ever see another period.

If your periods stopped naturally, the general guidance is:

If you are under 50, continue contraception for two years after your last period.

If you are 50 or older, continue for one year after your last period.

By age 55, contraception can usually be stopped because natural pregnancy is exceptionally rare.

These rules are harder to apply when you use hormonal contraception. The pill, injection, implant or hormonal IUD may change or completely stop your bleeding. The absence of a period does not necessarily confirm menopause.

And remember, hormone replacement therapy can relieve menopause symptoms, but it does not prevent pregnancy.

Before stopping family planning, speak with a clinician about your age, the method you use and when your natural periods stopped.

One final warning: bleeding that starts after 12 months without a natural period should be assessed.

Save this before assuming that no period automatically means no pregnancy.

#WomensHealth
#HealthyLivingWithDrKetch