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1 Hypertension Management WHAT IS HYPERTENSION (HIGH BLOOD PRESSURE)? Blood pressure is a measure of how hard the blood pushes against the walls of your arteries as it moves through your body. It is normal for blood pressure to go up and down throughout the day but if it stays up, you have hypertension (high blood pressure). When blood pressure is high, it starts to damage the blood vessels, heart, and kidneys. This can lead to heart attack, stroke and other problems. High blood pressure is called a silent killer because it doesn t usually cause symptoms while it is causing damage. SYSTOLIC & DIASTOLIC CONTRIBUTING FACTORS Aging Drinking Alcohol Eating a lot of Salt Obesity High Cholesterol No Exercise Stress Poor Diet Diabetes Sleep Apnea Your blood pressure consists of two numbers: Systolic and Diastolic. Systolic pressure/diastolic pressure 120/80 The Systolic number shows how hard the blood pushes when the heart is pumping The Diastolic number shows how hard the blood pushes between heartbeats, when the heart is relaxed and filling with blood Adults should have a blood pressure of 120/80 or less. High Blood pressure is 130/81 or higher. Many people fall into the category in between, called elevated blood pressure, or Stage 1. People with elevated blood pressure, or Stage 1, need to make lifestyle changes to bring the blood pressure down and help prevent or delay high blood pressure.

2 SIGNS & SYMPTOMS People with primary (essential) high blood pressure usually do not have any symptoms. Most people with high blood pressure feel fine. It is during a routine exam or a doctor visit for another problem that high blood pressure is found. Severe high blood pressure (180/120 or higher) may lead to malignant high blood pressure. This is also called hypertensive emergency or hypertensive crisis. Very severe high blood pressure is a medical emergency. Symptoms of severe high blood pressure include: Headaches, especially pulsating headaches behind the eyes that occur early in the morning Visual disturbances Nausea and vomiting Over time, untreated high blood pressure can damage organs such as the heart, kidneys or eyes. This may lead to: Chest pain (angina), heart attack, heart failure, or irregular heartbeat Stroke Kidney (renal) failure Peripheral artery disease Eye Damage (Retinopathy) 2 HM Copyright 2018 Trilogy Health Insurance, Inc.

3 WHO TO CALL & WHEN WHEN SHOULD I CALL MY DOCTOR? Your blood pressure is 130/81 or higher on two or more occasions You are unable to take your medications Feeling lightheaded or dizzy You are feeling fatigue which keeps you from doing daily activities You are experiencing shortness of breath that is worse, or shortness of breath at rest WHEN SHOULD I CALL 911? Your blood pressure is 180/120 or higher Your blood pressure is causing you headaches You have chest pain or discomfort that lasts more than 15 minutes and is NOT relieved by rest or Nitroglycerin You are unable to catch your breath You feel faint or lightheaded You experience a fast or irregular heartbeat CONTACT INFORMATION My doctor: Phone #: Cardiologist: Phone #: Emergency Contact: Please keep this along with your medication list on your refrigerator where it is easily accessible by emergency personnel. 3 HM Copyright 2018 Trilogy Health Insurance, Inc.

4 TREATING HYPERTENSION YOU CAN TREAT HYPERTENSION WITH LIFESTYLE CHANGES: Lose weight Become more active Stop smoking Limit alcohol Limit your salt intake MEDICATION Deciding whether to treat high blood pressure with medicine and choosing the best medicine are based mainly on: How high your blood pressure is Whether you have signs that have caused organ damage, such as an enlarged heart or early damage to your arteries, kidneys or eyes. Whether you think you can succeed at making lifestyle changes. Doctors may have different opinions about when to start medications. A single, low-dose medicine is prescribed at first. If blood pressure is not controlled, your doctor may change the dosage or try a different medication or a combination of medications. It is common to try several medications before your blood pressure is successfully controlled. 4 HM Copyright 2018 Trilogy Health Insurance, Inc.

5 MEDICATION MANAGEMENT The following are types of medications that may be used to treat your hypertension: NAME OF MEDICATION : Diuretics: furosemide, Bumex, Lasix, hydrochlorothiazide ACE lnbitors: Lisinopril, Captopril FUNCTION: Increase urination to help remove extra fluid and salt Reduces tension of blood vessels Angiotension II Receptor blockers (ARBs): Atacand, Diovan, Cozaar Beta Blockers: atenolot, labetalol, Coreg Reduces tension of blood vessels Widens blood vessels and decreases the work load on your heart Calcium Channel Blockers: Norvasc, Nifedipine Reduces tension of blood vessels Vasodilators: Minoxidil, Hydralazine, Nitroglycerin Widens blood vessels and decreases the work load on your heart THERE ARE MANY OTHER MEDICATIONS YOUR DOCTOR MAY CHOOSE FOR YOU. 5 HM Copyright 2018 Trilogy Health Insurance, Inc.

6 MEDICATION MANAGEMENT IMPORTANT FACTS ABOUT YOUR MEDICATION The medications your doctor prescribed cannot make your hypertension go away, but they can make you feel better and help you manage your disease. Below are some helpful tips regarding your medicine. HELPFUL TIPS Always take your medicine as prescribed. Keep all your medications in the original container (filling a weekly pill box is okay, however, do not put the rest of your medications in a different container). Try to learn your medications. What does it look like? What is the dose? Remember that from time to time the manufacturer changes. Please clarify any changes with your pharmacist. Do not run out of your medicine. Tell your pharmacist and doctor all of the medications you are taking, this includes all prescribed and non-prescribed medications such as vitamins and home remedies. Do not skip or increase your dose unless you are told to do so by your doctor. If you miss a dose, do NOT double up on your medications; instead, take your next dose when it is due. If you are unable to take your medications for any reasons, call your doctor or nurse immediately. Do NOT take any over-the-counter medications until you check with your doctor. Some of these medications may interfere with your prescribed medications and could worsen your hypertension. Try to get all of your medications from one pharmacy. This will decrease confusion for both you and the doctor when new medication is prescribed. 6 HM Copyright 2018 Trilogy Health Insurance, Inc.

7 DON T FORGET THINGS TO DO TO HELP ME LIVE WITH HYPERTENSION Monitor your blood pressure daily if able Eat a low sodium (salt) diet Avoid tobacco and alcohol Always take your medications as ordered Know when to call your doctor and always inform him/her if you are unable to take your medications for any reason Stay active 7 HM Copyright 2018 Trilogy Health Insurance, Inc.

8 MY CARE TEAM My doctor is: Phone #: Cardiologist: Phone #: Pharmacy: Phone #: Hospital: Dietician: Phone #: Care Manager: Phone #: HM Copyright 2018 Trilogy Health Insurance, Inc.

9 BLOOD PRESSURE/PULSE RECORD NAME: DATE TIME BLOOD PRESSURE PULSE DATE TIME BLOOD PRESSURE PULSE 9 HM Copyright 2018 Trilogy Health Insurance, Inc.

10 MY MEDICATION RECORD NAME: PRESCRIPTION MEDICATION DOSE FREQUENCY LAST DOSE TAKEN 10 HM Copyright 2018 Trilogy Health Insurance, Inc.

11 QUESTIONS FOR YOUR DOCTOR Going to your doctor can be overwhelming at times and can make you nervous. You may forget what you want to ask and/or forget what your doctor tells you. Use this sheet to write down your questions. YOUR QUESTION 1. THE ANSWER YOUR QUESTION 2. THE ANSWER YOUR QUESTION 3. THE ANSWER 11 HM Copyright 2018 Trilogy Health Insurance, Inc.