• Dr Francisco

Dr Francisco and All against hypertension!

General recommendations for patients with high blood pressure (the more recommendations you follow the better your health and the lesser the complications you can have). But discuss with your doctor if all of them apply to you or if there is any contraindication.

It is not simple to follow all the recommendations and it takes time, effort and perseverance, but you can do it, you just need to believe it is important and good for you and your life as a whole, including your family. But at the end of the day, it depends mainly on you and on the effort you put on it. The effort is worth it as you could reduce complications and likely live longer and better for you to enjoy a healthier life with your family and friends.

Consult your doctor for specific advice and clarifications.


Dr Francisco's recommendations:

1.Buy a blood pressure machine to monitor your blood pressure at home and ask your doctor to teach you how to use it. It is an extra cost, but it is an important investment in your health. By monitoring the blood pressure at home you can, for example, identify increments in your blood pressure early and seek medical advice promptly rather than waiting for the next appointment to discover your blood pressure was high for the last months, whilst causing some damage to your organs, and 2) to rule out “white coat” hypertension, where your blood pressure is high in the clinic and normal at home, as your doctor might not need to increase your medications based on high readings in his clinic if the readings at home are normal.

2.Take your medications as prescribed by your doctor

3.Aim to have a blood pressure of at least <140/90 mmHg (a higher blood pressure can be allowed in the elderly and patients at risk of falling, or might need to be lower in patients with other medical conditions…again talk to your doctor to see what is the correct target for you.

4.Avoid very salty food and reduce the amount of salt added to your food. This can improve the blood pressure in many patients

5.If overweight or heavier, aim to lose weight through diet improvements and exercise. Losing weight can improve blood pressure in many patients, and even reduce the need of anti-hypertensives medications in some patients.

6.If you smoke…sincerely, stop smoking. It is not easy, ask for help if having difficulties, there are many methods to help you to quit smoking

7.Have your heart checked. For many patients a trace of the heart (ECG/EKG) is a good initial test: consult your doctor first to see if this is necessary

8.Do at least light to moderate exercise several days a week if no heart problems (consult first your doctor)

9.Patients with heart problems might benefit for the use of aspirin, but consult your doctor if this is suitable for you

10.Reduce fried, fatty, oily food (reduce saturated fats, especially) if you have high blood cholesterol

11.If you have high blood cholesterol, you might also need anti-cholesterol medications and to be more strict with your diet

12.Reduce sugary food and sugary drinks, especially if overweight, to help you reducing your weight and possibly to reduce the risk of developing diabetes if you have any predisposition

13.Get your kidney function checked and test for leakage of protein in the urine, as high blood pressure can affect your kidneys without you noticing it

14.If leakage of protein detected in your urine, ask your doctor if you should/could be on anti-proteinuric medications, as they can protect your kidneys, but some patients might have contraindications to them

15.See an eye doctor to examine the back of your eye yearly or earlier if changes in your eyesight occur

16.Regarding alcohol, if possible avoid it, otherwise, do not binge-drink and avoid drinking in excess

17.Inform your doctor immediately after becoming pregnant as you might need to discontinue medications like anti-cholesterol and anti-proteinuric medications

18.Go back to consult your doctor if you have queries or worries about your health or side effects of therapies or recommendations or you do not respond as both you and the doctor expected to the strategy proposed by your doctor. A minority of patients with high blood pressure do not have essential hypertension and they should have further tests performed.

If you would like more specific advice, Dr Francisco will be happy to advise you.

Wishing you the best possible health,

Dr Francisco Salcido-Ochoa Nephrologist and Transplant Immunologist.

Active promoter of healthy living and a provider of approachable, flexible and empathic care in Singapore for Singaporeans, Expats and International patients.