High Blood Pressure: The Role of the Family

When someone in your family has high blood pressure, or any chronic illness, it can be stressful for the whole family. Your family member with high blood pressure may need to take medicines and make some changes to a healthier lifestyle. You may feel upset because you do not know what to do to help. Knowing about high blood pressure and how it affects your family member will prepare you to help your loved one.

What is high blood pressure?

High blood pressure occurs when blood vessels become narrow or stiff, forcing the heart to pump harder to push blood through the body.

Blood pressure is measured as two numbers an upper number (called the systolic pressure) and a bottom number (called the diastolic pressure). For adults, 18 and over, blood pressures that stay at 140/90 or higher are considered high.

How often should blood pressure be checked?

Blood pressure should be checked at least once a year unless it is too high or too low. In that case, blood pressure should be checked as often as the doctor advises.

What causes high blood pressure?

High blood pressure affects an estimated 50 million Americans. In most cases, the causes of high blood pressure are not known, but some things may increase the risk of developing high blood pressure. These include:

  • Heredity: High blood pressure tends to run in families.
  • Race: African Americans have high blood pressure more often and more severely than whites.
  • Age: The tendency to develop high blood pressure increases as you age.
  • Obesity: People who are overweight have a greater chance of developing high blood pressure.
  • Lack of exercise: An inactive lifestyle may contribute to being overweight, which is a risk factor for high blood pressure.
  • Alcohol use: Drinking excessive amounts of alcohol can increase blood pressure.
  • Too much dietary salt: Heavy use of salt can increase blood pressure.
  • Oral contraceptives: Women who take the pill have an increased chance of developing high blood pressure especially if they are also smokers.
  • Gender: Until age 45, high blood pressure is more common in men than women. Between ages 45 and 54 the risk is similar. After age 54, more women than men will have high blood pressure.
  • Other Diseases: Having chronic kidney disease makes you more likely to develop high blood pressure.

How do you know if you or someone in your family has high blood pressure?

High blood pressure often causes no symptoms, even if severe. It is possible to have high blood pressure for years without knowing it. That is why it is called a silent killer. The only way to find out if blood pressure is too high is to have it measured.

Is high blood pressure a serious problem?

Uncontrolled high blood pressure is a serious problem because it can damage many organs in the body. It adds to the workload of the heart, which over time can cause the heart to enlarge and become weaker. Uncontrolled high blood pressure increases the risk of strokes, and it can also damage the kidneys. Careful control of high blood pressure lowers the risk of developing these complications. That is why it is so important for your family member to follow the doctor's advice concerning treatment and to take all the medicines prescribed.

Can lifestyle changes help to control high blood pressure?

If mild, high blood pressure may sometimes be brought under control by losing weight if your family member is overweight, cutting down on fat and salt in the diet, starting a regular exercise program approved by the doctor, and limiting alcohol intake to no more than two drinks a day for men and one drink a day for woman. Medicines may also be needed to get high blood pressure under control. Many effective medicines are available for the treatment of high blood pressure. Sometimes, a combination of different medicines may be needed. These medicines should be taken as ordered by the doctor, even if your family member is feeling fine, because high blood pressure is just as damaging even when it causes no symptoms.

What treatment is best for high blood pressure?

The doctor will talk to you about the best treatment for your family member who has high blood pressure. This treatment will be based on the results of the patient's tests, physical examination and individual needs.

Should the whole family make lifestyle changes because one person has high blood pressure?

Many of the lifestyle changes advised for people with high blood pressure, such as following a healthier diet and starting an exercise program, are things we all should do as part of a healthy lifestyle. These changes can benefit the whole family.

Can diet help to control high blood pressure?

Reducing the amount of fat and salt can lower the risk of many diseases and also be an important part of the treatment for high blood pressure. Fixing healthful meals for the whole family will save wear and tear on the cook who will not have to make separate foods for your family member with high blood pressure. It will also make it easier for him or her to follow the diet by eliminating some of the temptation to return to old habits.

The family member who does the meal planning and cooking should visit the dietitian along with the patient. Both can learn about the best foods to use and other helpful ideas to make following the diet easier. The doctor can provide a referral to a registered dietitian, who will offer suggestions about eating the right foods in the right amounts to help control high blood pressure. The services of a registered dietitian may be covered by some health insurance policies.

Can exercise help to control high blood pressure?

The benefits of exercise include feeling and looking better, reducing stress and having better overall health. Families can exercise together and enjoy these activities as part of their free time together. They can walk, swim, or ride a bicycle regardless of age or differing abilities. Joining a gym, bowling league or a softball team are other good ideas.

How does stopping smoking help?

People who have high blood pressure, and smoke increase their risk of having complications such as heart attacks and strokes. Stopping smoking can be hard to do, especially if others in the family continue to smoke. Family members should consider stopping smoking together and using the money usually spent on cigarettes to buy something they can enjoy together. At today's high cigarette prices, it would not take long to save enough money for a bicycle, for example.

What if our family member who has high blood pressure does not take the prescribed medicines?

Families can be supportive, but the responsibility for taking medicines rests with the patient. Sometimes, patients may have difficulty remembering whether they took the medicines or not. Special pill boxes are available that have small compartments labeled with the days of the week, as well as times of the day. These allow your family member to check to make sure the pill was taken. Watches with alarms and beepers are also helpful.

Some of the main reasons patients give for not taking their medicines are:

  • "I don't feel sick, so I really don't need these pills."
  • "These pills don't really help. I don't feel any different now than I did before."
  • "I feel worse when I take these pills. They cause headaches, make me feel tired, cause problems with my sex life. I'm not going to take them anymore."
  • "I can't pay for these pills. They cost too much."

Regardless of the reason, failing to follow the doctor's orders about taking medicines is dangerous. Blood pressure medicines should never be stopped abruptly. You should encourage your family member who has high blood pressure to discuss any questions or concerns about medicines with the doctor. If there are problems with side effects, the doctor may be able to prescribe a different medicine that works better for the patient.

Should we avoid anything that might upset our family member who has high blood pressure?

Usually, continuing with normal family life is an important part of what the family can do to help the person who has high blood pressure. Trying to shield the person only robs them of their usual place in the family. It may be useful to talk openly as a family about what kind of help the patient finds "helpful" and what kind of help seems more like "nagging." If there are frequent disagreements or constant stress in the family, counseling may be useful. The family's religious leader, a family service agency in the community, or a private counselor (psychiatrist, psychologist or social worker) can help family members talk about their concerns and find new ways to make family life more positive and less stressful.

How should family members care for themselves?

Sometimes, family members themselves have many worries about whether they are doing the right thing when they try to help. They may be angry and frustrated when the patient refuses to make lifestyle changes or take the prescribed medicines. They may worry about the future and the chance the patient may get sicker. Talking about these worries is important. Sometimes, just getting out of the house and talking it over with a friend is all that is needed to feel better. If these worries continue or have a negative effect on other parts of life (a job or school, for example), it may be important to talk with a professional counselor. Remember, it is natural to be worried about a family member who has a health problem. By talking about these worries and concerns, family members may be more able to be supportive and helpful to the person who has high blood pressure.

Is high blood pressure hereditary? Are other family members likely to get it?

The exact causes of high blood pressure are usually not known. However, there is evidence that high blood pressure tends to run in families. Therefore, other family members should have their blood pressure checked at least once a year

Is high blood pressure likely to cause other problems?

If high blood pressure is not well controlled, other problems may develop such as heart attacks, strokes or kidney disease. It is important to encourage the person who has high blood pressure to see the doctor regularly so these problems can be prevented. Family members should be aware of the following warning signs:

  • Heart attack: pain and/or pressure in the chest, which may spread to shoulders, arms or neck; feeling faint; shortness of breath; feeling sick to the stomach and sweating
  • Stroke: sudden weakness or numbness of the face, arm or leg on one side of the body; sudden loss of vision especially in one eye; difficulty talking or understanding speech; sudden severe headaches; dizziness, unsteadiness or sudden falls
  • Kidney disease: pain in the lower back, swelling of hands and feet, increased need to urinate, burning or discomfort when urinating and blood in the urine

See also in this A-Z guide:

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©2013 National Kidney Foundation. All rights reserved. This material does not constitute medical advice. It is intended for informational purposes only. No one associated with the National Kidney Foundation will answer medical questions via e-mail. Please consult a physician for specific treatment recommendations.