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Steroids and Monitoring your Blood Pressure

What blood pressure reading is too high?

High blood pressure (Hypertension) is a medical condition where the force of your blood pushing against the walls of your blood vessels is too high.

Drugs and PEIDs can increase your blood pressure, which in turn increases your risk of heart disease and stroke. Get to know your normal blood pressure so you can monitor how it changes over time, and don’t just ignore it if it is high. If you get on top of it early enough, it is an easily managed risk.

What does a blood pressure reading mean?

There are two different forces that you’ll hear about:

  1. Systolic pressure – the pressure in your blood vessels when your heart is contracting/pumping
  2. Diastolic pressure – the pressure in your blood vessels when your heart is resting

Blood Pressure Chart

https://www.heart.org/-/media/Files/Health-Topics/High-Blood-Pressure/HBP-rainbow-chart-English.pdf

When these pressures are too high, your heart and blood vessels must endure a higher workload and work less efficiently. The increased force of the blood causes friction damage to the inside of the arteries over time and encourages cholesterol to form plaques along this damage.

The more damage and plaques form, the narrower the inside of the arteries become, causing the blood pressure to go higher again – a nasty cycle that can get out of control – resulting in stroke, heart attack, vision loss, sexual dysfunction and kidney disease.

Blood Pressure on artery Walls

https://library.teladochealth.com/hc/en-us/articles/360038889034-What-Is-High-Blood-Pressure

Symptoms of High Blood Pressure

Usually there are no symptoms until it leads to a major event like a heart attack or stoke – that’s why it is called the ‘Silent Killer’. You may be completely unaware that you have had high blood pressure for years. This is why it is important to check your blood pressure regularly, so if there is a problem, you can get it handled before the cycle causes permanent damage.

People think they will know if they have high blood pressure because they think they will get headaches and nosebleeds. This is rare. Most people with high BP won’t.

If you are getting blood spots in your eyes, this may be a sign of optic nerve damage caused by high blood pressure and/or diabetes – if you have this symptom, you need to have your eyes checked to see how much damage may be present, as well as going to a doctor to get your blood pressure controlled.

What are your risk factors for high blood pressure (high BP)?

Certain things will increase your risk of developing high blood pressure. Do you have any of the following?

Risk factors you can’t control:

  • Family history of high BP.
  • Age – the older you are, the more likely you are to have high BP.
  • Race – people of African and Aboriginal descent are more likely to have high BP
  • Type 1 Diabetes – most people with diabetes also develop high BP.
  • Kidney Disease – kidney disease can cause high BP, which in turn causes more damage to the kidneys.

Risk factors you can control:

  • Lack of physical activity – more physical activity is one of the easiest ways to manage blood pressure.
  • Unhealthy/high sodium diet – the more salt you consume, the more fluid you retain, increasing your blood pressure. A high-fat diet also increases the risk of plaques forming in blood vessels, pushing blood pressure up.
  • Being overweight or obese – carrying too much weight puts extra strain on your heart, and increases your chances of diabetes which worsens your risk of high BP.
  • Type 2 diabetes – as with Type 1, most people with diabetes will also develop high BP, but this can be managed with a good diet and healthy weight.
  • Alcohol – regular drinking has a big effect on BP.
  • Sleep apnoea – this is when you stop breathing when you sleep which increases the risk of high BP and is common in people with resistant hypertension (hard to treat high BP).
  • High Cholesterol – more than half of people with high BP also have high cholesterol.
  • Smoking – nicotine increases your blood pressure temporarily each time you smoke and contributes to artery damage, adding to the cycle. Smoking also makes the blood sticky, increasing the risk of blood clots in your body, including the heart, lungs and brain.
  • Stress – too much stress can encourage behaviours that increase BP, such as poor diet, inactivity, drinking, etc.

If you are a steroid user, you might recognise that some of the risk factors listed above are also side effects of steroid use. PEDs not only increase your blood pressure themselves, but they can also cause sleep apnoea, increased fluid retention, increased cholesterol, increased anxiety/stress/mental health issues, etc. So steroid use is a BIG contributor to high BP.

How often should I check my blood pressure?

For people under 45 with normal blood pressure (less than 120/80), you should get it checked at least once every two years. If you are over 45, you should get it checked yearly.

If your blood pressure is elevated (above 120/80) you should be monitoring it more often, and if it is high (>140/>90) then it is recommended by the American Heart Foundation that it is checked at least once a month.

If you are using PEDs, you should be checking your blood pressure at least once a month, even if it is normal.

You can get it checked by your doctor, at needle exchange clinics with a health nurse, at most chemists, or buy your own BP monitor and check it at home yourself.

This video here shows you how to take your blood pressure yourself at home:

https://www.heart.org/en/health-topics/high-blood-pressure/understanding-blood-pressure-readings/monitoring-your-blood-pressure-at-home

You can find a guide to taking your blood pressure and diary for recording it here:
https://www.heartfoundation.org.au/getmedia/18380f2a-56d1-449a-adb5-27f52f24011b/Home-blood-pressure-measuring-guide-diary-infographic.pdf

I’ve been monitoring my blood pressure and it is high, what do I do now?

Firstly, go to your doctor to have it properly diagnosed. They will tell you if it’s bad enough to warrant medication or if changing your lifestyle may be enough to get it under control.

If you start taking medication and it goes down, DO NOT STOP TAKING IT unless you have been told by your doctor. Most likely, it will just go back up if you stop. You may have gone too far down the high BP cycle ever to be able to come off the medication, but your doctor will decide this.

Once your arteries are damaged and narrow, they can’t return to normal. Managing your blood pressure to prevent further damage will be something you will have to do for the rest of your life.

References

https://www.heart.org/en/health-topics/high-blood-pressure

https://www.heartfoundation.org.au/Bundles/Your-heart/Blood-pressure-and-your-heart

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