Guest contributor Esther Rhee, DO, is a board-certified internal medicine physician. She sees patients at the Kaiser Permanente Reston Medical Center.
February is the month of love when we share our hearts with those around us. It is also American Heart Month when we celebrate heart health and remind ourselves of the importance of preventing and treating heart disease.
Heart disease has been the No. 1 leading cause of death in the United States since 1950. One of the greatest risk factors for heart disease is high blood pressure.
What is even more astounding is that nearly half of all American adults have high blood pressure – that could be you or me!
In this article, I want to give readers an overview of high blood pressure: what high blood pressure is, and how we can prevent heart disease by controlling our blood pressure effectively.
What is high blood pressure?
High blood pressure, also known as hypertension, is when blood constantly pushes too hard against the blood vessel walls. It often develops without any symptoms and can cause widespread injury to our bodies. For this reason, high blood pressure is notoriously known as the silent killer.
What does high blood pressure do to my body?
When blood constantly flows through blood vessels at a high pressure, the walls within the blood vessels can tear and get damaged. The damaged walls form scar tissue as part of the healing process. Scar tissue causes the blood vessel walls to become thick and stiff. This is called arteriosclerosis, or hardening of the arteries, and it causes less oxygen to reach the organs. Scar tissue also causes blood vessels to become more susceptible to cholesterol and other substances sticking to the walls. This plaque buildup in the arteries causes blood vessels to narrow and eventually become clogged.
As a result, high blood pressure in the heart can cause a heart attack, coronary artery disease, or heart failure. In the brain, it can cause dementia or stroke. In the kidneys, it can lead to chronic kidney disease and kidney failure. In the eyes, it can cause retinopathy leading to poor vision and blindness.
High blood pressure can lead to many serious health conditions affecting, not just our hearts but the entire body. That’s why keeping your blood pressure under control is vital to protecting your health.
120/80 – what do the numbers mean?
Blood pressure is measured by two numbers. The upper number represents the systolic blood pressure, which measures the pressure against the blood vessel walls when the heart squeezes and pumps blood out into the blood vessels. The lower number represents the diastolic blood pressure, which measures the pressure against the blood vessel walls when the heart relaxes to fill up with blood before it gets ready to squeeze again.
According to American Heart Association, these are the stages of blood pressure readings:
- Normal blood pressure is less than 120/80 mmHg.
- Elevated blood pressure is 120-129 mmHg/80 mmHg.
- Hypertension stage 1 is 130-139/80-89 mmHg.
- Hypertension stage 2 is 140/90 mmHg or higher. Stage 2 is when the risk for developing cardiovascular disease significantly increases. At this stage, blood pressure medication is generally recommended.
What are the risk factors for developing high blood pressure?
Risk factors for high blood pressure include:
- Obesity or being overweight
- High cholesterol, particularly high low-density lipoprotein (LDL) cholesterol
- Unhealthy diet
- Lack of exercise
- Smoking
- Drinking too much alcohol
- Illegal drugs
- Obstructive sleep apnea
- Increasing age
- Having one or more family members with high blood pressure
Most of these risk factors are modifiable. In other words, you have the ability to lower your risk of developing high blood pressure by taking control over these areas in your life.
What are the symptoms of high blood pressure?
Most of the time, high blood pressure does not cause any symptoms. For some people, it can cause headache, fatigue, dizziness, blurred vision, chest pain, difficulty breathing, confusion, or nose bleeds. Seek medical attention if you experience symptoms of high blood pressure.
What are helpful lifestyle changes I can make to prevent or effectively control my blood pressure?
A healthy lifestyle can help prevent high blood pressure. It is an essential first step to controlling blood pressure and lowering risk for heart disease.
Here are lifestyle recommendations that have been proven to help lower blood pressure.
Diet
- Keep a healthy diet with a lot of fruits, vegetables, whole grains, nuts, and legumes.
- Increase foods that are rich in potassium, calcium, and magnesium, such as spinach, kale, potato, sweet potato, banana, avocado, and beans.
- Increase foods that are naturally red or pink, such as watermelon, cooked tomato, pink grapefruit, apricot, and guava. These foods contain antioxidants and substances that help relax blood vessels.
- Reduce salt to less than 2,300 mg per day (about 1 teaspoon of table salt).
- Restrict added sugars and saturated fats, including red meats, cold cuts, and processed meats. Instead, choose lean meats, poultry, fish, and fat-free or low-fat dairy products.
- Limit processed foods, including fast foods, frozen microwaveable foods, and chips.
- Fiber and omega-3 foods will help lower blood pressure. Try using flax seeds. They can be easily sprinkled into smoothies or oatmeal.
Consider the DASH diet, Dietary Approaches to Stop Hypertension, which is an evidence-based healthy eating plan shown to effectively lower blood pressure in as little as two weeks.
Exercise
Keep aerobic endurance exercise a regular part of your weekly routine. Walking, running, cycling, swimming, aerobic dancing, and high intensity interval training are good examples. Cardiac exercise is crucial to keeping a healthy blood flow and keeping blood vessels relaxed and strong. Moderate-intensity aerobic exercise for 30 minutes per day, five times per week is recommended. Moderate-intensity exercise means your heart rate increases and you break out in a sweat 10 minutes after starting a workout routine.
Weight, Smoking, and More
- Weight loss is one of the most effective ways to lower blood pressure. Losing even a small amount of weight can help control your blood pressure.
- Stop smoking. If you smoke, choosing to stop smoking is one of the best decisions you will make for your health.
- Limit alcohol to fewer than two drinks per day for men and one drink per day for women.
- Do not use illegal drugs.
- Sleep is important. Aim to sleep regularly, seven to eight hours per night. If you snore or have been told you gasp for air at night, ask your doctor if you have obstructive sleep apnea that needs to be treated.
What types of medications are used for treating high blood pressure?
Medications are generally recommended for hypertension stage 2 and above. Your doctor will carefully select the best medication for you based on your age, race, and other medical conditions. Some of the most effective blood pressure medications fall into the following classes:
- Thiazide diuretics: These help kidneys clear out extra fluid and salt through urine.
- Angiotensin-converting enzyme (ACE) inhibitors: These prevent the body from making angiotensin (blood vessel constrictor) and help blood vessels to relax.
- Angiotensin II receptor blockers: These prevent angiotensin II from constricting blood vessels and help blood vessels to relax.
- Calcium channel blockers: These keep calcium from entering the muscles cells of the heart and blood vessels, and help blood vessels relax.
- Beta blockers: These help reduce heart rate and reduce the heart’s workload.
How can I monitor my blood pressure at home?
At Kaiser Permanente, patients may be eligible to participate in remote monitoring programs where they receive a Bluetooth-enabled monitor that securely sends blood pressure readings to their electronic health record. Patients concerned about blood pressure can purchase a blood pressure machine at a drug store or medical supply store. Make sure the cuff is the right size for your arm. Upper arm monitors are more accurate than wrist or finger monitors.
I recommend measuring your blood pressure first thing in the morning before eating, drinking your morning coffee, or smoking. Uncross your legs and sit with your feet flat on the floor, with your back straight and supported. Relax for a few minutes. Place your arm on a flat surface, with the upper arm at heart level. Place the cuff directly on your skin above the bend of the elbow. Use a journal or an app on your phone to record the numbers.
If your blood pressure is elevated, don’t panic. Wait five minutes and check it again. Blood pressure can be temporarily elevated for many natural reasons, including physical activity, pain, infection, illness, stress, or anxiety. Check your blood pressure at the same time every day. If your blood pressure remains consistently high or if you have any concerns regarding your blood pressure, reach out to your doctor.
During this American Heart Month, I encourage you to find specific and achievable ways to prevent or control high blood pressure, and thereby improve your long-term heart health. By doing so, you will be able to share love with the people you care about the most even more.
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