Recent research shows that lowering your blood pressure below these levels decreases your risk of heart attacks and all-cause mortality. That’s right—lowering your blood pressure has a direct impact on your life expectancy. In fact, a person with a systolic pressure of 135 has double the risk of heart disease as someone with a systolic pressure of 115. Same goes for a diastolic pressure of 85 instead of 75. 10 points might not seem like much, but every blood pressure increase has a big impact on your health.
Metformin doesn't typically cause blood pressure to plummet and lead to hypoglycemia, but it can—and that can cause headaches. "Metformin alone should not cause hypoglycemia,” Rodriguez explains. But “when we see headaches, it’s usually in a patient on a combination of medications that can drop blood sugars too low.” If you’re experiencing an abnormal amount of headaches or an abnormal type of headache, talk to your doctor about adjusting your medications.
There have been a significant number of studies on metformin’s risk of inducing lactic acidosis — a state in which lactic acid builds up in the body, which can be fatal. But the greater majority of studies concluded without any cases of lactic acidosis according to “The Phantom of Lactic Acidosis due to Metformin in Patients With Diabetes” in the American Diabetes Association’s (ADA) Diabetes Care journal.
Metformin has acid dissociation constant values (pKa) of 2.8 and 11.5, so exists very largely as the hydrophilic cationic species at physiological pH values. The metformin pKa values make metformin a stronger base than most other basic medications with less than 0.01% nonionized in blood. Furthermore, the lipid solubility of the nonionized species is slight as shown by its low logP value (log(10) of the distribution coefficient of the nonionized form between octanol and water) of -1.43. These chemical parameters indicate low lipophilicity and, consequently, rapid passive diffusion of metformin through cell membranes is unlikely. As a result of its low lipid solubility it requires the transporter SLC22A1 in order for it to enter cells.[113][114] The logP of metformin is less than that of phenformin (-0.84) because two methyl substituents on metformin impart lesser lipophilicity than the larger phenylethyl side chain in phenformin. More lipophilic derivatives of metformin are presently under investigation with the aim of producing prodrugs with superior oral absorption than metformin.[115]
It is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location – one that is up and away and out of their sight and reach. http://www.upandaway.org
While high blood pressure doesn’t have any distinctive symptoms in itself, there can be many associated conditions and signs that high blood pressure may be affecting your body and causing damage. When left untreated, high blood pressure can cause the following symptoms in the body, which may worsen over time. If you are experiencing any of the following symptoms chances are your high blood pressure may be placing you at risk of developing further conditions and should be addressed immediately.
For how confusing hypertension can be, learning how to maintain a healthy blood pressure is surprisingly simple. As with other types of circulatory health, like cholesterol, the first step to lowering blood pressure is lifestyle change. “Whenever you’re dealing with hypertension, the first thing you need to deal with is lifestyle change,” Watnick explains. “Exercise is essential, weight control is essential. Eating a low-salt diet is quite important.” National guidelines recommend at least 30 minutes of exercise each day. For seniors, exercise can involve simple changes to everyday routine, like walking more often and engaging in household chores. In addition to improving overall cardiovascular health and cholesterol, the presence of which can increase blood pressure by narrowing arteries, exercise can also help with weight loss.
Some people may ask why doctors are lowering the threshold for high blood pressure, when it was already difficult for many patients to achieve the previous blood pressure targets of below 140 mm Hg/90 mm Hg, said Dr. Pamela B. Morris, a preventive cardiologist and chairwoman of the ACC's Prevention of Cardiovascular Disease Leadership Council. However, Morris said that the guidelines were changed because "we now have more precise estimates of the risk of [high] blood pressures," and these new guidelines really communicate that risk to patients. So, just because it's going to be difficult for people to achieve, "I don't think it's a reason not to communicate the risk to patients, and to empower them to make appropriate lifestyle modifications," Morris told Live Science.
The World Health Organization has identified hypertension, or high blood pressure, as the leading cause of cardiovascular mortality.[162] The World Hypertension League (WHL), an umbrella organization of 85 national hypertension societies and leagues, recognized that more than 50% of the hypertensive population worldwide are unaware of their condition.[162] To address this problem, the WHL initiated a global awareness campaign on hypertension in 2005 and dedicated May 17 of each year as World Hypertension Day (WHD). Over the past three years, more national societies have been engaging in WHD and have been innovative in their activities to get the message to the public. In 2007, there was record participation from 47 member countries of the WHL. During the week of WHD, all these countries – in partnership with their local governments, professional societies, nongovernmental organizations and private industries – promoted hypertension awareness among the public through several media and public rallies. Using mass media such as Internet and television, the message reached more than 250 million people. As the momentum picks up year after year, the WHL is confident that almost all the estimated 1.5 billion people affected by elevated blood pressure can be reached.[163]
When your heart contracts and squeezes blood out into your network of arteries, the pressure inside those blood vessels is at its highest. This is called systolic pressure and it’s the top number on your blood pressure reading. In between beats, the heart relaxes and the pressure drops. This is your diastolic blood pressure, and it’s the reading’s bottom number.
Everybody’s blood pressure goes up and down throughout the day. Walking to work, meditating, stressing about your Facebook feed, taking that sweet afternoon nap, and pounding a triple shot espresso all influence your blood pressure. There’s even a thing called “White Coat Hypertension” where people report higher than normal blood pressure readings due to the stress of just being in a doctor’s office with a cuff strapped to your arm. Blood pressure is a moving target. It’s not the end of the world if it spikes every now and then.

Pulse pressure (the difference between systolic and diastolic blood pressure) is frequently increased in older people with hypertension. This can mean that systolic pressure is abnormally high, but diastolic pressure may be normal or low a condition termed isolated systolic hypertension.[59] The high pulse pressure in elderly people with hypertension or isolated systolic hypertension is explained by increased arterial stiffness, which typically accompanies aging and may be exacerbated by high blood pressure.[60]


Half of American adults have this life-threatening condition, yet many are unaware or simply don’t take it seriously. But it doesn’t have to be that way. Hypertension is manageable and even preventable, but you have to know your risk factors and get your blood pressure checked (regularly!) to see if you’re at risk. Let’s take a closer look at what blood pressure actually is, how hypertension works, and how you can prevent the effects of high blood pressure to stave off heart disease.
Other medical organizations have issued new numbers recently. I believe that one must consider the source. Do the members of the group have an interest in seeing increased drug sales? Individuals with pharmaceutical connections often want people to start taking blood pressure medications, who really don't need them at all. For some, it is all about drug sales, not about your health.
Lactic acidosis almost never occurs with metformin exposure during routine medical care.[70] Rates of metformin-associated lactic acidosis is about nine per 100,000 person-years, which is similar to the background rate of lactic acidosis in the general population.[71] A systematic review concluded no data exists to definitively link metformin to lactic acidosis.[72]
Dietary changes can help control blood pressure. One diet designed to promote lower blood pressure is known as the DASH diet. This stands for Dietary Approaches to Stop Hypertension. The DASH diet recommends eating more vegetables, fruits, whole grains, low-fat dairy products, poultry, nuts, and fish. Red meat, saturated fats, and sweets should be avoided. The DASH diet can lower blood pressure within 2 weeks. It can also help to reduce your intake of sodium. The following is the DASH diet suggested daily intake:
5. Be aware of the "Circadian Rhythm" cycle. Your Blood Pressure is highly influenced by the time of day. For normal people, the highest BP occurs about midday, and the lowest at about 3-4 AM in the morning. For some people, described as "non-dippers", this early morning BP dip does not occur. For these people, highest blood pressure usually occurs around 6 AM to 9 AM in the morning. Some doctors are not aware of this, and make erroneous assumptions. A non-dipper may see 150/95 in the morning, and 130/85 in the evening. Non-dipping is usually associated with abnormal sleep conditions, such as sleep apnea, heavy snoring, drug and alcohol abuse, etc.
Blood pressure: The blood pressure is the pressure of the blood within the arteries. It is produced primarily by the contraction of the heart muscle. It's measurement is recorded by two numbers. The first (systolic pressure) is measured after the heart contracts and is highest. The second (diastolic pressure) is measured before the heart contracts and lowest. A blood pressure cuff is used to measure the pressure. Elevation of blood pressure is called "hypertension".

Elevated blood pressures in the medical setting may not necessarily reflect the individuals real status. "White coat hypertension" describes a patient whose blood pressure is elevated because of the stress of the visit to the doctor or other healthcare professional, and the worry that their blood pressure might be elevated. Repeated blood pressure checks at the doctor's office or the use of a home blood pressure monitoring device may be used to confirm that you have high blood pressure.
As for when to check your blood pressure, the most important thing is to do it consistently the same time of the day (ask the doctor which time he prefers and also what time in relation to taking your medication). The following article has a lot of good information for someone just starting to monitor their blood pressure: https://www.drugs.com/cg/how-to-take-a-blood-pressure.html

Hypertension results from a complex interaction of genes and environmental factors. Numerous common genetic variants with small effects on blood pressure have been identified[34] as well as some rare genetic variants with large effects on blood pressure.[35] Also, genome-wide association studies (GWAS) have identified 35 genetic loci related to blood pressure; 12 of these genetic loci influencing blood pressure were newly found.[36] Sentinel SNP for each new genetic locus identified has shown an association with DNA methylation at multiple nearby CpG sites. These sentinel SNP are located within genes related to vascular smooth muscle and renal function. DNA methylation might affect in some way linking common genetic variation to multiple phenotypes even though mechanisms underlying these associations are not understood. Single variant test performed in this study for the 35 sentinel SNP (known and new) showed that genetic variants singly or in aggregate contribute to risk of clinical phenotypes related to high blood pressure.[36]

^ Bennett WL, Maruthur NM, Singh S, Segal JB, Wilson LM, Chatterjee R, Marinopoulos SS, Puhan MA, Ranasinghe P, Block L, Nicholson WK, Hutfless S, Bass EB, Bolen S (May 2011). "Comparative effectiveness and safety of medications for type 2 diabetes: an update including new drugs and 2-drug combinations". Annals of Internal Medicine. 154 (9): 602–13. doi:10.7326/0003-4819-154-9-201105030-00336. PMC 3733115. PMID 21403054.
Lastly, we conduct statewide outreach to health care organizations. We make and distribute a suite of materials available to encourage accurate and consistent blood pressure self-management in English, Spanish, Russian, Chinese and Vietnamese. We also work closely with Washington Information Network 211 so people can call or search online for places to get their blood pressure checked nearby.
^ Jump up to: a b Brown S, Atkins C, Bagley R, Carr A, Cowgill L, Davidson M, Egner B, Elliott J, Henik R, Labato M, Littman M, Polzin D, Ross L, Snyder P, Stepien R (2007). "Guidelines for the identification, evaluation, and management of systemic hypertension in dogs and cats". Journal of Veterinary Internal Medicine. 21 (3): 542–58. PMID 17552466.
If you are having surgery, including dental surgery, or any major medical procedure, tell the doctor that you are taking metformin. Also, tell your doctor if you plan to have any x-ray procedure in which dye is injected, especially if you drink or have ever drunk large amounts of alcohol or have or have had liver disease or heart failure. You may need to stop taking metformin before the procedure and wait 48 hours to restart treatment. Your doctor will tell you exactly when you should stop taking metformin and when you should start taking it again.
You may be directed to seek medical care if blood pressure readings are elevated if done as part of a community health screening. Isolated elevated blood pressure readings do not necessarily make the diagnosis of hypertension. Blood pressure readings vary throughout the day, and your primary care provider may record a different reading than the one that was measured in a screening that sent you in for care.
The UK Prospective Diabetes Study (UKPDS) revealed that taking metformin reduces the risk of heart attack by 39 percent compared with other blood-glucose-lowering drugs. For this reason, metformin is often continued even after it no longer adequately controls blood glucose by itself. Another drug or drugs are then “layered” on top of metformin to achieve blood glucose control.
Serum creatinine is measured to assess for the presence of kidney disease, which can be either the cause or the result of hypertension. Serum creatinine alone may overestimate glomerular filtration rate and recent guidelines advocate the use of predictive equations such as the Modification of Diet in Renal Disease (MDRD) formula to estimate glomerular filtration rate (eGFR).[27] eGFR can also provide a baseline measurement of kidney function that can be used to monitor for side effects of certain anti-hypertensive drugs on kidney function. Additionally, testing of urine samples for protein is used as a secondary indicator of kidney disease. Electrocardiogram (EKG/ECG) testing is done to check for evidence that the heart is under strain from high blood pressure. It may also show whether there is thickening of the heart muscle (left ventricular hypertrophy) or whether the heart has experienced a prior minor disturbance such as a silent heart attack. A chest X-ray or an echocardiogram may also be performed to look for signs of heart enlargement or damage to the heart.[23]
^ Qaseem, A; Wilt, TJ; Rich, R; Humphrey, LL; Frost, J; Forciea, MA; Clinical Guidelines Committee of the American College of Physicians and the Commission on Health of the Public and Science of the American Academy of Family, Physicians. (21 March 2017). "Pharmacologic Treatment of Hypertension in Adults Aged 60 Years or Older to Higher Versus Lower Blood Pressure Targets: A Clinical Practice Guideline From the American College of Physicians and the American Academy of Family Physicians". Annals of Internal Medicine. 166 (6): 430–437. doi:10.7326/m16-1785. PMID 28135725.
It is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location – one that is up and away and out of their sight and reach. http://www.upandaway.org
Medicines are available if these changes do not help control your blood pressure within 3 to 6 months. Diuretics help rid your body of water and sodium. ACE inhibitors block the enzyme that raises your blood pressure. Other types of medicines— beta blockers, calcium channel blockers, and other vasodilators—work in different ways, but their overall effect is to help relax and widen your blood vessels and reduce the pressure inside the vessel. [See also the free government publication “Medicines to Help You: High Blood Pressure” (PDF) from the US Food and Drug Administration.]
All things considered, metformin can cause a modest reduction in weight, most likely due to side effects, like a decreased appetite and an upset stomach. But although effective for weight loss, the drug doesn’t replace traditional dieting methods. So if you’re looking to lose more and keep the weight off longer, you have to get active and eat right.
Various expert groups have produced guidelines regarding how low the blood pressure target should be when a person is treated for hypertension. These groups recommend a target below the range 140–160 / 90–100 mmHg for the general population.[13][99][100][101][102] Cochrane reviews recommend similar targets for subgroups such as people with diabetes[103] and people with prior cardiovascular disease.[104]

In people aged 18 years or older hypertension is defined as either a systolic or a diastolic blood pressure measurement consistently higher than an accepted normal value (this is above 129 or 139 mmHg systolic, 89 mmHg diastolic depending on the guideline).[5][7] Other thresholds are used (135 mmHg systolic or 85 mmHg diastolic) if measurements are derived from 24-hour ambulatory or home monitoring.[79] Recent international hypertension guidelines have also created categories below the hypertensive range to indicate a continuum of risk with higher blood pressures in the normal range. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure (JNC7) published in 2003[27] uses the term prehypertension for blood pressure in the range 120–139 mmHg systolic or 80–89 mmHg diastolic, while European Society of Hypertension Guidelines (2007)[86] and British Hypertension Society (BHS) IV (2004)[87] use optimal, normal and high normal categories to subdivide pressures below 140 mmHg systolic and 90 mmHg diastolic. Hypertension is also sub-classified: JNC7 distinguishes hypertension stage I, hypertension stage II, and isolated systolic hypertension. Isolated systolic hypertension refers to elevated systolic pressure with normal diastolic pressure and is common in the elderly.[27] The ESH-ESC Guidelines (2007)[86] and BHS IV (2004)[87] additionally define a third stage (stage III hypertension) for people with systolic blood pressure exceeding 179 mmHg or a diastolic pressure over 109 mmHg. Hypertension is classified as "resistant" if medications do not reduce blood pressure to normal levels.[27] In November 2017, the American Heart Association and American College of Cardiology published a joint guideline which updates the recommendations of the JNC7 report.[88]


3. Fairly recently, the difference between Systolic and Diastolic pressure, named "Pulse Pressure", has been gaining interest in the research community. This Pulse Pressure has been found to correlate linearly with heart attack risk - the higher the number, the higher the risk. According to this theory, a BP of 140/ 90 (PP=50) is more desirable than a BP of 140/ 80 (PP=60).
^ Jump up to: a b Burt VL, Cutler JA, Higgins M, et al. (July 1995). "Trends in the prevalence, awareness, treatment, and control of hypertension in the adult US population. Data from the health examination surveys, 1960 to 1991". Hypertension. 26 (1): 60–69. doi:10.1161/01.HYP.26.1.60. PMID 7607734. Archived from the original on 2012-12-20. Retrieved 5 June 2009.

^ Jump up to: a b Semlitsch, T; Jeitler, K; Berghold, A; Horvath, K; Posch, N; Poggenburg, S; Siebenhofer, A (2 March 2016). "Long-term effects of weight-reducing diets in people with hypertension". The Cochrane Database of Systematic Reviews. 3: CD008274. doi:10.1002/14651858.CD008274.pub3. PMID 26934541. Archived from the original on 23 March 2016. Retrieved 9 March 2016.

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