What general health maintenance strategies should a patient with hypertension or diabetes implement at home to manage their condition?

Home Health Maintenance for Hypertension and Diabetes

Blood Pressure Monitoring at Home

All patients with hypertension and diabetes must monitor their blood pressure at home. 1

Proper Measurement Technique

• Sit with feet flat on the floor, back supported, arm at heart level 1
• Rest for 5 minutes before measuring 1
• Use appropriate cuff size for your upper arm circumference 1
• Take readings at the same time each day 1
• Record all readings in a log to share with your healthcare provider 1

Target Blood Pressure Goals

• Your target is less than 130/80 mmHg 1
• If readings consistently fall below 90/60 mmHg, contact your provider immediately as therapy may need adjustment 1
• Home readings correlate better with cardiovascular risk than office measurements, making home monitoring essential 1

When to Seek Immediate Care

• Blood pressure ≥180/110 mmHg with cardiovascular disease requires same-day medical evaluation 1
• Symptoms of low blood pressure (dizziness, lightheadedness, fainting) require urgent contact with your provider 1

Lifestyle Modifications

Weight Management

• Reduce excess body weight through caloric restriction 1
• Weight loss enhances effectiveness of blood pressure medications and improves glycemic control 1, 2

Dietary Modifications

Follow a DASH-style eating pattern: 1

• Limit sodium to less than 2,300 mg per day 1, 3
• Consume 8-10 servings of fruits and vegetables daily 1, 3
• Include 2-3 servings of low-fat dairy products daily 1
• Increase dietary potassium through 4-5 servings of fruits and vegetables (if no kidney disease) 3

Alcohol Consumption

• Men: limit to 2 drinks per day maximum 3
• Women: limit to 1 drink per day maximum 3
• If you have a history of alcohol abuse or dependence, complete abstention is advised 3
• Excessive alcohol (≥3 drinks/day) worsens blood sugar control 3

Physical Activity

• Increase physical activity levels as tolerated 1
• Regular exercise lowers blood pressure and improves insulin sensitivity 2

Medication Adherence

• Home blood pressure monitoring improves medication-taking behavior and reduces cardiovascular risk 1
• Take all prescribed medications as directed, even when feeling well 1
• Never stop or adjust medications without consulting your healthcare provider 1
• If taking ACE inhibitors, ARBs, or diuretics, monitor for dizziness when standing 1

Monitoring for Complications

Check for Orthostatic Hypotension

• Measure blood pressure while sitting, then immediately after standing 1
• A drop in blood pressure upon standing may indicate autonomic neuropathy requiring blood pressure target adjustment 1
• Report persistent dizziness or lightheadedness when standing to your provider 1

Blood Glucose Monitoring

• During acute illness or infection, check blood glucose every 4-6 hours 4
• Dehydration and infection can independently worsen blood sugar control 4
• Monitor at least twice daily, more frequently if symptomatic 4

Regular Healthcare Visits

• Blood pressure should be measured at every routine clinical visit 1
• Bring your home blood pressure log to all appointments 1
• Discuss any medication side effects or concerns 1
• If on ACE inhibitors, ARBs, or diuretics, kidney function and potassium levels should be monitored at least annually 1

Common Pitfalls to Avoid

• Do not use magnesium supplements for blood pressure or diabetes control - there is insufficient evidence and potential harm in kidney disease 3
• Do not combine ACE inhibitors with ARBs - this combination should not be used 1
• Do not target blood pressure below 120/80 mmHg - this is associated with adverse events 1
• Do not use wrist or finger blood pressure monitors - upper arm monitors are most reliable 1