High Blood Pressure…..
And what you can do to control it
Hypertension, or high blood pressure, is another one of America’s epidemics. The current estimate on the Million Hearts website is that 116 million people have hypertension ( 1 out of 2 adults) and over 92 million are uncontrolled.
In some ways, hypertension may be in all of our futures. By age 65, one out of two Caucasians have hypertension; the numbers are worse for Hispanics and African Americans.
So what drives us to become hypertensive? In short, it is a combination of factors.
As we age, our blood vessels become stiffer and can’t accommodate the blood flow as when we were younger. There are a variety of hormonal issues at play regarding substances like renin, angiotensin and aldosterone which play a role but are beyond the scope of this article.
And of course, being obese or overweight, along with a diet high in salt are all contributors. And my favorite, a lack of exercise also contributes to the problem.
Hypertension Defined
Blood pressure readings involve the systolic pressure ( SBP) and the diastolic (DBP) readings or more commonly known as the “top and bottom numbers” respectively.
Hypertension is now defined as:
Stage 1- SBP 130–139 or DBP 80–89
Stage 2- SBP >140 or DBP >90
Hypertensive Crisis- SBP > 180 and/or DBP > 120
The decision to start medication will depend on your clinical circumstance including what other diseases you have ( diabetes, heart attacks, strokes, etc) or your clinical risk score for Atherosclerotic Cardiovascular Disease (ASCVD) which your doctor can calculate.
Beside medicines, what can you do to make things better?
I already hinted at some of them.
- Try to get some aerobic exercise 90–150 minutes a week ( check with your doctor before starting any exercise program!)
- Avoid medications like ibuprofen, naproxen, and other pain relievers in the NSAID family
- Try to lose a minimum of 10 pounds with an ultimate goal to achieve a body mass index closer to 25
- Get screened for Obstructive Sleep Apnea if you are someone who snores
- Stop smoking! In addition, did you know that if you stop smoking, your risk for cardiovascular disease is cut in half!
- Limit alcohol intake to one drink a day or less
I counsel patients that hypertension is treatable but not curable ( the exception may be in someone who is morbidly obese, loses a few hundred pounds, and comes off of their medications. ) I do work with them to reduce the number of meds they are on if they are achieving weight and exercise goals. So a more reasonable goal is less medication instead of no medication.
By the way, the average person who has their blood pressure under control is on somewhere between 2 and 3 medications. Even if you start off on one med, with time you may need a second or a third.
Lastly, if you drop your blood pressure just 10 mm, you will decrease your risk of -
- Stroke by 27%
- Congestive Heart Failure by 28%
- Coronary Heart Disease 17%
Every little bit helps when it comes to controlling blood pressure. Hopefully I have given you some tools to consider. Make it a point to discuss this with your physician on your next visit. Good control of blood pressure is a team effort.
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Remember- the information I present is for your information only , and should not be used to diagnose or treat any medical condition. You should seek medical care from a qualified medical doctor.
Disclaimer- the words and opinions expressed are the author’s and his alone, and not those of his employer.
Originally published at https://medupdate.substack.com on November 6, 2022.
