Sunday, April 20, 2014

Tracking Your Blood Pressure At Home

A great article from USA Today on how to track your blood pressure at home, and why it is so important to know what your blood pressure is at home during your daily activities and NOT just at the doctor's office. Your blood-pressure checks at the doctor's office may read normal, but that doesn't necessarily mean you're in the clear: Up to 20% of adults have "masked hypertension," according to some estimates. That's when blood pressure measurements are lower at the physician's office than they are at home. Experts aren't completely certain why it happens, but scientists have recently discovered that people with this form of hidden hypertension have a 55% increased risk for heart attack or stroke, compared with those with normal blood pressure, according to a research review. The same analysis found that home blood-pressure monitoring helps identify masked hypertension. Doctors may recommend home monitoring (in addition to regular check-ins at that office) for people diagnosed with high blood pressure, those with pre-hypertension, or even people who just have risk factors for the condition, including family history, advanced age or obesity. Left untreated, hypertension can damage your heart, arteries and kidneys and lead to stroke and vision loss, among other complications. Keep tabs on your pressure at home; that can help doctors make an earlier diagnosis, as well as track your treatment and encourage better blood-pressure control. Talk to your physician; if home blood-pressure monitoring is suggested for you, here are some tips to help you get started:
Choose an arm monitor. It's more accurate and reliable than the devices that take readings from your wrist or finger. The American Heart Association (AHA) recommends this type of monitor. Measure around your bicep, and choose a monitor that comes with the correct cuff size. Digital devices are more expensive than manual ones, but they're easier to use — they automatically inflate and deflate the cuff (instead of you having to pump), and they provide digital readings, as well as pulse rate; certain manual monitors require the use of a stethoscope. Measure at the same time every day. Either in the morning or at night, according to the AHA. Don't smoke, drink caffeinated beverages or exercise 30 minutes before taking a reading. Sit in a chair, with your back straight and both feet flat on the floor and make sure your arm is supported on a flat surface at heart level. Take two or three measurements each time, one minute apart. Track your results. Record every reading, including the date and time; the AHA offers online and printable trackers at You can also download apps to note your pressure, as well as your weight and other lifestyle factors. Some monitors can store your numbers; others allow you to upload readings to a website. One high reading is not a cause for concern, but if your numbers are consistently elevated, consult your doctor. If your pressure reaches a systolic (top number) of 180 mm Hg or higher or a diastolic (bottom number) of 110 mm Hg or higher, wait a few minutes and take it again, the AHA says; if it's still at or above that level, seek emergency treatment. _______________________________________

Tuesday, April 8, 2014

Your End Stage Renal Disease Options

At The Kidney & Hypertesnion Group, we begin education about your options long before you need to make a choice. Education can slow the progression of Kidney Disease by adherence to lifestyle changes and theraputic choices your nephrolgist prescribes. If ESRD approaches, we will have explained your options well in advance, and helped you to find the most suitable method of renal replacement for YOU. We consider most everyone a transplant candidate until proven otherwise, and our goal when possible is a transplant prior to dialysis. If dialysis is necessary we help you consider your 3 options- Home Peritoneal Dialysis, Home Hemodialysis, or In-Center Hemodialysis. We also do In-Center Peritoneal Dialysis while you train for Home PD. And if the method you chose does not suit you after a trial, or in time you need to make a change, we will help you find the method that will work best. Teamwork. You and us. It is what makes our program so successful. If you would like more information on your options, call us for an appointment to discuss them in person. (954)771-3929

Thursday, March 27, 2014

Do You Have Resistant Hypertension and What Can Be Done

What is resistant hypertension? Hypertension is considered resistant if it falls into either of these categories: Blood pressure uncontrolled, greater than 140/90 despite taking three or more antihypertensive medications. (For diabetes or renal disease sufferers : blood pressure greater than 130/80 despite taking three or more medications)or Blood pressure controlled, less than 140/90 (or less than 130/80 for those with diabetes or renal disease), on four or more antihypertensive medications in order to keep blood pressure at goal. The Kidney and Hypertension Doctors are Certified Specialists in Hypertension. We have the latest equipment to achieve a correct diagnosis of your type of blood pressure problem, and the training and experience to adequately treat it with the least amount of medication possible. We also offer lifestyle and adjunct treatments
that can assist in reaching your blood pressure goal. Call us today (954)771-3929 for an appointment to be seen in our Hypertension Clinic by one of our specialists.

How To Take Your Blood Pressure At Home

Before you begin to monitor your blood pressure at home, it's important to know that differences between left-arm and right-arm (interarm) blood pressure are common. Several studies have been done to determine what is a ‘normal’ variation between right and left arm. In general, any difference of 10 mm Hg or less is considered normal and not a cause for concern. Since some studies showed that the average interarm systolic blood pressure difference was significantly greater in patients with known coronary artery disease, it’s a good idea to discuss differences higher than 10 mm Hg with your doctor. When you have your blood pressure taken at the doctor’s office for the first time, it’s recommended that it be taken in both arms. But if you’re measuring your blood pressure at home, readings are often more easily taken in the non-dominant arm. If your home blood pressure readings are different from those taken in the doctor’s office, be sure to discuss this with your healthcare professional. Many factors affect blood pressure. The fact that there are differences in right and left arm readings emphasizes the importance of measuring blood pressure in both arms initially to prevent the misdiagnosis of high blood pressure. If one arm consistently has higher blood pressure than the other, that arm should be used to measure your blood pressure. Make sure the cuff fits. Measure around your upper arm and choose a monitor that comes with the correct size cuff. Be still. Don't smoke, drink caffeinated beverages or exercise within the 30 minutes before measuring your blood pressure. Sit correctly. Sit with your back straight and supported (on a dining chair, for example, rather than a sofa). Your feet should be flat on the floor; don't cross your legs. Your arm should be supported on a flat surface (such as a table) with the upper arm at heart level. Make sure the middle of the cuff is placed directly above the eye of the elbow. Check your monitor's instructions for an illustration or have your healthcare provider show you how. Take multiple readings. Each time you measure, take two or three readings one minute apart and record all the results. Measure at the same time daily. It's important to take the readings at the same time each day, such as morning and evening, or as your healthcare professional recommends. Accurately record all your results. Record all of your readings, including the date and time taken. Share your blood pressure records with your healthcare team. Some monitors have built-in memory to store your readings; if yours does, take it with you to your appointments. Some monitors may also allow you to upload your readings to a secure Web site after you register your profile. Understand the readings. Optimal blood pressure is less than 120/80 mm Hg (systolic pressure is 120 AND diastolic pressure is less than 80). Read Understanding Blood Pressure Readings to learn more about what the numbers mean. Consult your healthcare professional if you get several high readings. A single high reading of blood pressure is not an immediate cause for alarm. However, if you get a high reading, take your blood pressure several more times and consult your healthcare professional to make sure you (or your monitor) don't have a problem. When blood pressure reaches a systolic (top number) of 180 or higher OR diastolic (bottom number) of 110 or higher, emergency medical treatment is required for hypertensive crisis.

Friday, March 21, 2014

The Kidney And Hypertension Group of South Florida Celebrates Another Patient Milestone in Their Large Peritoneal Dialysis Population

The only one happier than our peritoneal dialysis patient, Paul, that he is officially on the road to kidney transplant is our Clinical Nurse Specialist and PD Co-ordinator, Barbara Valle, RN, CNS. Our PD program has grown to it's largest number of patients ever and we credit our wonderful PD team! Congratulations to you too, Paul!

Thursday, March 13, 2014

The Kidney and Hypertension Group of South Florida Offers Same Day Appointments

Our long standing #kidney transplant patient, Meredith, recently sent us a thank you note. "Many thanks for the wonderful response to my problem with the "Rapid Response" clinic. Although my doctor, (Dr. Valle), was not in the Fort Lauderdale office that day, I was immediately given an appointment that morning with your Transplant Nephrologist, Dr. Torres, who handled my problem right expertly. I am so grateful. Thank you!" We offer same day appointments every day in our Fort Lauderdale office with a board certified nephrologist-for new or returning patients. We offer this "Rapid Response" Clinic on most days in our Plantation office as well. If you are concerned-don't wait until the problem gets worse-Call us today. (954)771-3929

Wednesday, March 12, 2014

Dr. Gabriel Valle Greets His Medical Students Before His Lecture

Dr. Gabriel Valle waits to greet his 3rd year medical students as they arrive for his lecture. Today's topic is Potassium and the Kidney, a topic Dr. Valle loves to teach, and even if the students eventually choose Internal Medicine as a speciality, it is a topic of great clinical importance. — at Nova Southeastern University.

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Van C. (Dr. Gabriel Valle's patient-kidney-University of Miami, Cathy O. (Dr. Carlos Bejar-Kidney at University of Miami),Will E. (Dr. Ajuria-kidney-Miami Transplant Institute;Bob I. (Dr. Valle's patient, University of Miami-Kidney), Orlando T. (Dr. Valle's patient, University of Miami, kidney), Sara A. (Dr. Valle's patient, kidney, University of Miami),Steve I. (Dr. Jorge Ajuria's patient, kidney, University of Miami),Sandy L. (Dr. Carlos Bejar's patient, kidney, University of Miami),KATHY C. (kidney-University of Miami, patient of Dr. Valle,MARTIN O. (Dr. Valle patient-Heart/Kidney -University of Miami), ROBERT I. (Dr. Valle's patient Kidney at University of Massachusetts), DREW P.(kidney-University of Florida),BILL L. (University of Florida-kidney), BARBARA L. (University of Miami-kidney), FRANCIS L. (kidney at U. of F.), JONATHAN I. (kidney-at U of F), THERESA L. (kidney-pancreas at University of Miami),JEFF T. (kidney at University of Florida), TERESA R. (kidney-University of Miami), JEANNIE O. (kidney-University of Florida), ELOISE O. (Univ of Florida), JOHN E. (kidney-University of Florida), GENE J. (Kidney-University of South Florida), CAL. M. (kidney- Florida Transplant Hospital in Orlando), TERRY A. (Perfect Match! University of Florida-kidney), TIM A.(kidney-University of Miami), GLORIA R. (kidney -University of Miami), BRAD R. (Kidney (and never on dialysis!!)-at University of Miami),(*both Brad and Gloria got kidneys on the same day!!!), BELINDA (kidney-University of Miami), TOM (kidney-University of Miami), JIM E. (Kidney-University of Miami), HERBERT A., (Kidney-University of Miami), Belinda R. (University of Miami-kidney),




South Florida's Top Nephrologists-(Left to Right) Drs. Ajuria, Hernandez, Bejar, and Valle

Living longer by living smarter.

Living longer by living smarter.
find 20 minutes a day to meditate. It reduces stress, lowers blood pressure, and reduces signs of aging.


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