At last count, 62,770,000 Americans had or were being treated for high blood pressure,
according to the American Heart Association (AHA). That's almost one-quarter of our country's population. Every year, 31,630 of these individuals die as a direct result of the condition, the AHA says. An additional 147,470 deaths every year occur from stroke (a blood clot that travels to the brain), making it the number-one fatality related to high blood pressure. Another 2,980,000 Americans have had a stroke and lived. Many of these people are now severely disabled and unable to care for themselves.
High blood pressure, or hypertension, is defined as having blood pressure (the force that is created by the heart as it pumps blood into the arteries and through the circulatory system) equal to or higher than 160 systolic (the top number) over 95 diastolic (the bottom number), according to William P. Castelli, M.D., director of the Framingham Heart Study in Framingham, Massachusetts, the oldest and largest heart-disease study in the United States. Between 140 and 159 systolic over 90 to 94 diastolic is considered "borderline" high. Below these numbers is considered normal.
In addition to strokes, high blood pressure can cause blindness, kidney failure, and a swelling of the heart that may lead to heart failure.
Who's at risk for high blood pressure? People with a family history of the condition, blacks (they have an almost one-third greater chance of having high blood pressure compared to whites), overweight individuals, and aging individuals. Also at risk are women who are pregnant or who are taking oral contraceptives.
The good news is that, together with your doctor, you can control hypertension. It won't be easy you'll have to change the way you think and act. You may have to take medication for the rest of your life. You'll definitely have to cut out some bad habits and begin some new, more healthful ones. However, your efforts are likely to pay off in a longer, healthier life. Here's to your health!
Join the club.
It may sound trivial, but the first step toward controlling your blood pressure is actually accepting that you've got a problem to begin with, says David B. Carmichael, M.D., medical director of the Cardiovascular Institute at Scripps Memorial Hospital in La Jolla, California. "People must accept the fact that they've got hypertension, he says. "The worst person in the world is an aggressive 40-year-old male who comes in feeling fine and is told he has hypertension and will have to monitor his blood pressure. They often just won't believe it. In fact, if I ask myself what type of patient has left my practice over the years, I would say it has been the hypertensives." Carmichael likens this type of acceptance to joining a fraternal lodge. "You've got to do certain things: go to the doctor, take your medications faithfully, modify your diet, report bizarre symptoms. You have got
to join the club."
Lose weight.
"At all levels of blood pressure, increased weight contributes to the degree of blood pressure elevation," says Robert A. Phillips, M.D., Ph.D., director of the Hypertension Section and associate director of the Cardiovascular Training Program in the Division of Cardiology at Mount Sinai Medical Center in New York. "Weight loss lowers blood pressurenot in everybody, but in many people. It's worth a try" Phillips explains that for each pound of excess body weight that is lost, blood pressure may drop by two points. "It's always a good thing to do, even if you are severely hypertensive," he says. "If you are mildly hypertensive, that weight loss may enable you to stay off of medication." Even a modest amount of weight loss is better than none at all, according to Castelli. "The most common problem in hypertension is borderline hypertensionbetween 140 and 159 systolic and 90 to 94 diastolic," says Castelli. "That level of blood pressure increases the risk of stroke three times. And yet, virtually all of those people would be cured with a ten-pound weight loss."
Invest in a home blood pressure monitor.
If you have been diagnosed as hypertensive, or if your doctor wanted more blood pressure readings before making a definitive diagnosis, he or she may have prescribed you a home blood pressure monitor. At-home monitoring has several benefits first and foremost, warning you if your pressure becomes dangerously high, so you can get medical attention early Second, a monitor can save you money, because it will save you trips to the doctor. "This is now very common," says Carmichael. "It is also easy to do. If the patient is afraid to use the monitor [some people become panicky if they find their pressure is high], another person, such as a spouse, can do it for them. The blood pressure should be checked at close to the same time of day, under the same conditions." Carmichael says that most insurance companies will cover the purchase of such devices if prescribed by a physician.
Start an exercise program.
Along with helping with weight loss, exercise confers additional benefits for those with high blood pressure, says Phillips. "For people who are severely hypertensive, they shouldn't exercise until their blood pressure is controlled," he says, "but people with mild hypertension can exercise aerobically for 20 to 30 minutes, three times per week, and will benefit with a reduction in blood pressure by about eight points that will last at least half a day." It's best to check with your doctor before beginning any exercise program, especially if you have been sedentary. The types of exercise that are most likely to benefit your blood pressure are walking, jogging, stair-climbing, aerobic dance, swimming, bicycling, tennis, skating, skiing, or anything else that elevates your pulse and sustains the elevation for at least 20 minutes. Nonaerobic exercise, such as weight lifting, push-ups, and chin-ups, may actually be dangerous for hypertensives. These types of exercise should not be done without the explicit consent of your doctor. |
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Take your blood pressure medicine.
The biggest danger with hypertension, Carmichael says, is that it is usually asymptomatic until its final stages, where it becomes fatal. That's why the condition is often labeled "the silent killer." Unlike people who have other chronic illnesses, such as diabetes, you'll probably feel just fine if you don't take your medicine. However, inside your body, the disease will continue to progress, damaging the arteries in your eyes, destroying your kidneys, causing your heart to swell, and so on. Another problem that can occur when you stop taking your blood pressure medicine is a rebound phenomenon, where the blood pressure rises to a higher level than it was before you started taking the medication. The moral of the story? "If you're starting and stopping taking your medication, you
haven't joined the club," says Carmichael.
Cultivate a taste for less-salty foods.
"There is no question that salt in the diet has a relationship with blood pressure," says Jeffrey A. Cutler, M.D., a hypertension specialist and chief of the Prevention and Demonstration Research Branch of the National Heart, Lung, and Blood Institute in Bethesda, Maryland. "We Americans take in far more salt than we need. We've become accustomed to the taste. However, the fact is that our taste sense is adaptable. People who lower the salt in their diets, after a period of time, have been shown to taste something as salty at a much lower level of salt than before." The average American takes in about eight to ten grams of salt a day, Cutler says. However, studies have shown that by cutting that amount down by a third, blood pressure can be significantly reduced, he says. Ideally, he says, people should cut down to six grams per day as a short-term goal, and to about four-and-a-half grams per day as a long-term goal. Read labels. So how do you know how much salt you're eating? As far as table salt goes, one teaspoon contains over two grams almost half of the recommended daily amount. Also, says Cutler, the average American adult takes in somewhere between one-and-a-half to two extra teaspoons of salt a day without knowing it. These insidious salt sources are frozen entrees, canned vegetables, even antacid medications. To avoid this extra salt, read labels. Many labels will express the amount of sodium in milligrams (1,000 milligrams is equivalent to 1 gram). To calculate the amount of sodium chloride, or salt, multiply the amount of sodium by two-and-a-half, Cutler says.
Say no to a second round.
Restriction of alcohol consumption to one drink (1.5 ounces of hard liquor, 4 ounces of wine, or 12 ounces of beer) per day does not appear to increase the risk of high blood pressure, but consuming two or three drinks per day is associated with an elevated risk of hypertension, according to Phillips. Eat a banana. One substance (other than prescription medication) that has been proven to reduce blood pressure is potassium, says Cutler. However, it may be difficult to increase your intake of potassium enough to lower blood pressure, he adds. While supplements may help, they are not recommended without the permission of a doctor, since they may be hazardous in individuals with certain medical conditions. "The average person needs three to four servings of potassium-rich fruits and vegetables per day," he says "It would probably benefit your blood pressure in a detectable way if you could double that number of servings. A little more may be a little better, and a lot more may be a lot better." Potassium-rich foods include bananas, raisins, currants, milk, yogurt, and orange juice.
Drink your milk.
Some studies have shown that extra calcium added to the diet may have a modest effect on blood pressure, says Phillips. Although the effect may not be significant, there's certainly no harm in adding a few extra glasses of skim milk, low-fat yogurt, or leafy green vegetables to the daily diet, he says.
Add polyunsaturated oils to your diet.
Most people know that by substituting polyunsaturated oils for saturated fats in their diets they can reduce their level of blood cholesterol. However, what most people don't know is that polyunsaturates can also reduce blood pressure, according to James A. Hearn, M.D., an assistant professor of medicine at the University of Alabama at Birmingham. "Switching to canola and safflower oils in cooking can cut your blood pressure by ten points," he says.
Quit smokingnow.
Cigarette smoking is the number-one taboo for hypertensives, says Phillips. Not only does the nicotine in the smoke cause blood pressure to rise, but it dramatically raises your risk of stroke, he says. According to the AHA, cigarette smoking can thicken the blood and increase its propensity to clot. Blood clots in the arteries leading to the heart can cause a heart attack, while blood clots in the artery leading to the brain may cause a stroke, according to the AHA. The good news is, you get an immediate benefit by giving up the habit right now. "Two years after you quit smoking, your risk of developing coronary artery disease has dropped to the same level as someone who never smoked," Phillips says. In contrast, it can take much longer for a person's risk of lung cancer to drop to that level. Your doctor can be a great source of help to you in quitting smoking. He or she may prescribe nicotine gum or skin patches to reduce withdrawal discomfort. Your local Heart Association may also be able to provide you with resources.
Learn to relax.
Many people misunderstand the term hypertension, believing it to mean a condition where the patient is overly tense. This isn't true. The term is defined solely by blood pressure levels. However, many hypertensives are the consummate "Type A" personality aggressive, workaholic, hostile, frustrated, or angry, says Carmichael. For these people, some form of relaxation, be it prayer, yoga, biofeedback, or just resting, may be an important component of treatment, he says. "People need to recognize their personality traits and do their best to change," he says. Some chronically stressed-out individuals release a lot of adrenaline into their systems. That rush of hormone can constrict the arterioles (tiny blood vessels), causing them to go into spasm. It is difficult for the heart to push blood through constricted arterioles. The effect? Higher blood pressure, says Carmichael. |
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