The Blood Pressure Basics

The Blood Pressure Basics

Hello everyone!! I hope you are having a great week!!  Today I would like to address a very common problem in Internal Medicine, Hypertension a.k.a., High Blood Pressure. 

What is Hypertension?

Hypertension puts a  strain on your arteries and heart, and can restrict blood flow to and from other body organs. This can lead to heart disease, stroke, kidney disease, and other problems. 

When your heart beats or contracts, it pushes blood through the arteries. This force creates pressure on the arteries. This is called systolic blood pressure ( The top number).  When your heart relaxes, between beats, the pressure in the arteries is called the diastolic blood pressure (The bottom number). 

What Do the Numbers Mean?

The answer here depends on which society guidelines you reference as there are some slight variations in terminology used.  For our purposes today we will call normal blood pressure 130/89 or less on average.  High blood pressure is 140/90 or higher.  There is some gray area about whether 130-140 is normal or pre-hypertension but suffice it to say that under 140/90 is generally safe.

Which is Better? Office Or Home Readings

Here at Bianco Primary Care, we rely heavily on what you get at home.  In the office, we check your blood pressure as a screening and if we find it to be high here, we will ask our patients to begin a home monitoring regimen.  There is a medical condition called “white coat hypertension” and home monitoring helps us know if the number in our office is real or just nerves.

Blood Pressure Machines Vs Manual Readings

Although we use the manual technique here in the office, most automated machines work very well.  If there is any doubt we have our patients bring their machine to the office and cross check them with a manual reading.  You can pick up a home monitoring device at almost any pharmacy or online.

Will I feel it when I have High Blood Pressure? 

There is a common misconception if you have high blood pressure you will experience symptoms such as nervousness, sweating, difficulty sleeping or feel flush. The truth is that high blood pressure is largely a symptomless condition. If you ignore your blood pressure because you think symptoms will alert you to the problem, you are taking a dangerous chance with your life. It’s always better to have it checked by your doctor at regular visits.   

How Is High Blood Pressure Treated?

Like with most things we treat we usually start with a thorough look at your lifestyle habits and work to make improvements in your nutrition and get you on a sensible exercise regimen. Medicines also play a role and are determined based on each individual’s specific circumstances.

I hope this helps clear a few things up about high blood pressure.  We are happy to talk with you about this topic in more detail.  We also have a Nutrition and Fitness expert on staff to help with the lifestyle changes that can help you achieve optimal blood pressure. 

Is it time for an affordable Primary Care Doctor who knows you and you can reach when you need them? In-office, text, phone, email – No insurance required.

What Do Cholesterol Numbers Mean?

What Do Cholesterol Numbers Mean?

Having your cholesterol checked is part of the standard annual labs that we all get every year. It gives important insight into your health. But what does it really mean?  What should my numbers be? Do I need to take cholesterol medicine?  I want to take a few minutes to talk about this lab test and dispel a few misconceptions about how to interpret it and what “good numbers” look like.

Total Cholesterol, HDL, LDL and Triglycerides

To start, let’s talk about the main markers used in a standard “lipid panel”.  Lipids are the fats or fatty substances in your blood. Lipids are measured and categorized as Total Cholesterol, HDL, LDL, and Triglycerides.  As the name implies, your Total Cholesterol is the combination of all your cholesterol both good and bad (HDL + LDL + 20% of Triglycerides).  HDL is your “good” cholesterol (think H for Healthy) and helps to clean your arteries.  LDL is your “bad” cholesterol (think L for Lousy) and is the primary lipid implicated in vascular disease (heart attacks and stroke).  Triglycerides are a measure of free fatty acids and are not as directly correlated to vascular disease but are affected by the amount of fried foods, processed foods, and alcohol we take into our bodies.

Undertsanding the Numbers

When you get your lab report in front of you, there are normal reference ranges listed, which vary slightly from lab to lab, but generally indicate the Total Cholesterol should be less than 200, HDL to be more than 40, LDL to be less than 130 (some labs list as low as 100) and Triglycerides less than 150.

The clinical application of the results, however, is not as simple as just looking at lab reference ranges.  One simple example is to say that your LDL is nice and low at 115 but your HDL is super high (a good thing) at 85.  Once you add in the 20% of Triglycerides you will easily be over 200, but only because your good cholesterol is so high.  In this case, a Total Cholesterol of over 200 is not a bad thing at all.

This becomes even more nuanced when discussing your LDL or bad cholesterol.  As long as your LDL is less than 190 (as the vast majority of us) then we have to look at your potential other risk factors for heart attack and stroke to guide whether you need medicine to lower your numbers.

Most of the other risk factors we control, at least to some extent, and include smoking, high blood pressure, and diabetes.  The one risk factor we cannot control is age.  The extent of your risk factors determines how aggressive we need to be in lowering your LDL or in deciding to leave it alone.  As we do here at Bianco Primary Care, your doctor may run a few advanced labs to assess cardiovascular disease risk.

This basic understanding of the numbers of a lipid panel will let you know how much and what kinds of fat you have in your blood. The good news is getting and keeping these numbers in the healthy range is often a matter of diet and exercise. But can also be controlled through a variety of low-cost medications.

Is it time for an affordable Primary Care Doctor who knows you and you can reach when you need them? In-office, text, phone, email – No insurance required.

What You Need To Know About Inflammation

What You Need To Know About Inflammation

Inflammation is a hot topic today and seems to show up everywhere when discussing health.  We are bombarded by advertisements that tell us to eat certain foods or take certain supplements to “reduce inflammation”, and all this information can be overwhelming.  In this post I want to share what you need to know about inflammation:  1) define what inflammation is, 2) explain where it comes from and 3) discuss why you should care about it in regard to having good health.

What Is Inflammation

Inflammation is the result of the body’s immune response or defense against injury, infection or allergy.  The first point to make here is that inflammation is a natural response.  The immune system causes increased blood flow to a certain area of the body or to the whole body depending on the offending agent.  This increased blood flow brings white blood cells and chemical toxins.  This is, of course, a good thing if you are sick and trying to fight off infection or if your body encounters are allergen. Thankfully, this type of circumstance is infrequent for the vast majority of us. 

Where Does Inflammation Come From 

Inflammation is a problem when it becomes a chronic condition outside of an infection or an allergic response.  This happens when our bodies are not healthy and is a reaction to the stress on our organs from being overweight, eating the wrong foods, having uncontrolled blood pressure or blood sugar, smoking, etc.  Notice I said overweight and not obese above.  You do not have to be “obese” (defined as BMI >30) to be inflamed.  If you have belly fat then you more than likely have inflammation.  This unnatural amount of inflammation can lead to more severe health problems.

Why You Should Care about Inflammation

As part of our patients’ annual screening labs we check a marker of inflammation called CRP-HS.  This test tells us the amount of inflammation you have in your body. If you have elevated levels then you are at risk for a host of diseases including heart attack and stroke and even a severe case of COVID-19. Yes CRP has been found to be a risk factor for more severe cases of the novel coronavirus.  This makes sense because we now know that COVID-19 causes damage and death through an overreaction of the immune system (inflammation) and not necessarily only the virus itself.

Knowing your level of inflammation through testing is an integral part of routine health maintenance and can help you know your risk of systemic disease.   This can then be used to assess what needs to be done to reduce your level of inflammation.  Particularly at this time, this is the best way to assess your possibility of having a more severe case of COVID versus a more mild case. 

Drs. Shelley & Michael Bianco

Get your inflammation assessed and strategies to reduce it today! We work with you to get and keep you healthy. Were here when you need us,  personalized care, and affordable plans