By Beth O’Keefe RN Care Coordinator with VNSNY CHOICE Health Plans, from the not-for-profit Visiting Nurse Service of New York

Asian Chinese mid-adult female medical practitioner checking blood pressure of African American middle-aged female patient.

Fall is in the air and whenever the seasons change it makes sense to perform a basic health check—especially for older adults, the elderly and those with functional disabilities who may be homebound, or slowing down, and not getting out and about as much as they used to. As a Registered Nurse with VNSNY CHOICE Health Plans in the Hudson Valley and upstate New York, I provide care management for members of our health plan who often live alone, have functional deficits, and/or have various  health ailments that frequently include high blood pressure.

High blood pressure, also known as hypertension, has symptoms that are often subtle—and can be missed by a person who has elevated blood pressure. Having high blood pressure boosts the risk of death due to a heart attack or a stroke, suffering an aneurysm, and having cognitive decline or kidney failure.While high blood pressure cannot be cured, it is critical that it be controlled and managed. Along with medical management and medication therapy as indicated, healthy lifestyle changes like weight loss, a healthy diet and exercise are very important means to addressing high blood pressure.

Management in the home setting is an important way to minimize the risks associated with a diagnosis of hypertension. Registered Nurse Care Coordinators in our health plan, work to ensure that our members with hypertension learn to manage their medications, maintain healthy lifestyles, be aware of the importance of regular follow-up with their health care provider; and be knowledgeable of signs and symptoms to report to their health care provider or that may require emergency interventions.

The following reminders are important for all adults to review with their physician or health care provider, but are especially so for anyone over the age of 65:

Review and Update Medications

Once a year all medications taken should be reviewed with your health care provider for necessity, regimen, dosage needed, effectiveness, side effects and interactions.  It is also important to keep an up-to-date list of all the medications you are taking, including over-the-counter medications and any supplements you take. For many people, including people who are forgetful, a medication pre-pour box can help to ensure that medications are being taken correctly. Finally, it is important to use only one pharmacy for all of your medication needs, in order to decrease the risk of medication errors and interactions.

Dietary Guidelines

Dietary changes are often needed when managing blood pressure. Gradually changing your diet will result in better long-term success. The goal is to decrease your daily sodium intake to 2mg a day unless otherwise instructed by your health care provider, increase your intake of healthy fats, decrease your intake of unhealthy fats, increase your intake of lean proteins, legumes and whole grains, and increase your intake of vegetables and fruit.

Incorporate Exercise into a Daily Routine

Exercise is an important aid in controlling high blood pressure and preventing its complications. What forms of physical activities and exercises are incorporated into a person’s daily and weekly routines, depend on the individual’s health and wellness status. For example, someone who has balance or ambulation impairments might do a seated or recumbent exercise program. Others might begin a progressive walking program, and still others might swim, run or go biking. A person who has health issues, health limitations, or who has not exercised in a long time, should discuss their options—and the program they want to initiate—with their health care provider before beginning. The important thing is to move your body and increase your heart rate safely.

Monitoring Your Blood Pressure at Home

Some people choose to monitor their blood pressure at home, while others may be advised by their health care provider to do this; others may only have their blood pressure monitored by their health care providers. If you are going to monitor your blood pressure at home, make sure to ask your health care provider to demonstrate to you the correct way to do this; you then should return demonstrate, to them, your correct use of the device (sphygmomanometer). Ask your health care provider how frequently – and when – you should check your blood pressure. Record your results and take your log to all health care appointments.

For more information about VNSNY CHOICE Health Plans from the Visiting Nurse Service of New York, please call 1-855-AT-CHOICE (1-855-282-4642) or visit