Under Pressure:

Hypertension

You might assume that the tension in hypertension refers to stress and anxiety. It actually means having higher-than-normal pressure on the walls of the arteries as blood travels out of the heart and throughout your body commonly known as high blood pressure. Normally, blood pressure fluctuates as you go through periods of rest, physical exertion or anxiety throughout the day. But if you have prehypertension or hypertension, it stays high, even when youre resting. This increased pressure exists because either your heart is pumping blood into your arteries with too much force or your blood vessels have become stiffer, making it harder for blood to flow through (or both). Over time this strong, continuous pressure can damage and weaken your arteries and vital organs putting you at risk for heart attack and stroke.

Blood pressure is determined by:

The force of blood pumped out of the heart (more force = more pressure) The amount of blood pumped out of the heart (more blood = more pressure) The size and flexibility of the arteries (smaller and less flexible = more pressure)

Hypertension and Your Health

Hypertension is a serious and potentially life-threatening disease. The American Heart Association stresses the importance of stopping the condition before it starts by making healthy lifestyle changes. Even so, if hypertension is detected, treated and controlled early, many of its dangerous complications can be avoided. In most instances, lifestyle modifications should be initiated even if you require medication to adequately lower your blood pressure level. Hypertension and prehypertension ( see categories below) put excess pressure on your arteries, which can damage blood vessels in your heart, kidneys, brain and eyes. The effects of chronic hypertension include: Significant increase in risk for strokes and heart attacks - 10 times the normal risk for stroke - Five times the normal risk for heart attack Memory loss and mental decline Increased risk of developing diabetes and kidney disease Decreased erections in men People with prehypertension have three times the normal risk for heart attack and are twice as likely to develop coronary artery disease.

Avoid a sneak attack

One in three American adults about 65 million people has elevated blood pressure levels, yet a third of them dont even know it. Hypertension can go undetected for years. Called the silent killer, it causes few, if any, symptoms until late in its course. The key to better health is to know your numbers and to make appropriate lifestyle changes before irreversible damage occurs throughout your bodys vascular system. Your heart is an amazing organ, pumping roughly 1,500 to 2,000 gallons of blood through your body each day!

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Blood pressure categories

The only way to know if you have high blood pressure is to have it tested. Because levels can vary under different conditions, a single reading is not enough to determine your true blood pressure range. Hypertension or prehypertension is defined as having chronic (not temporary) blood pressure that is higher than normal. Healthy normal blood pressure less than 120/80 mmHg Prehypertension 120-139/80-89 mmHg Stage I Hypertension 140-159/90-99 mmHg Stage II Hypertension greater than 160/100 mmHg

Monitoring Your Blood Pressure

At any age, knowing your blood pressure numbers will give you a clearer picture of your health. The American Heart Association recommends annual blood pressure checks starting at 3 years of age. If you are at risk for developing hypertension or heart disease, your physician may want you to check your blood pressure more frequently. And even if your blood pressure is normal at age 45, it may not be at 55. Because of changes to your blood vessels over time, your blood pressure should be regularly monitored as you grow older. Even if you begin to feel better, never discontinue your blood pressure medicine without your physicians approval.

Typical daily blood pressure variations

Blood pressure is usually highest at work It drops slightly at home It dips to its lowest level while you sleep And it spikes up again first thing in the morning in people with severe high blood pressure, this is the highest risk period for heart attack and stroke

What Do the Numbers Mean?

If youve ever had your blood pressure taken, you know it consists of two numbers. For example, lets say that your blood pressure reading is 132/82 mmHg (132 over 82). Blood pressure is measured in units representing millimeters of mercury (mmHg). The first and higher number is your systolic blood pressure (132). This is the maximum force on the arteries as blood is being pumped out of the heart. Having high systolic blood pressure puts you at risk for heart, kidney and circulation diseases, and even death. The second and lower number is your diastolic blood pressure (82). It measures the pressure in the arteries when your heart is at rest between beats. High diastolic pressure also increases your risk for heart attack and stroke.

Pulse Pressure
Your pulse pressure the difference between your systolic and diastolic numbers is an indicator of stiffness and injury in the blood vessel walls. Using our example, 132-82 = 50, so 50 is the pulse pressure. A wide gap between the two numbers means your heart needs to work harder to get blood past hardened arteries and into circulation. Some studies suggest that for people over age 45, every 10 mmHg increase in pulse pressure increases the risk for stroke or heart disease by about 10 percent and overall death by 16 percent. In younger adults, these percentages are even higher.

White Coat Hypertension

Sometimes people have high blood pressure readings that occur in the doctors office but lower readings at home. Before confirming a diagnosis of hypertension, your physician may want you to wear a device that measures your blood pressure over 24 hours. This allows your doctor to better understand the highs and lows your blood pressure goes through in a day.

Risk Factors You Cant Control

Although you obviously cant alter your genetic make-up, you need to understand the influence your DNA has on your risk for high blood pressure. Having one or more of these factors should make you more aware of monitoring your blood pressure, as well as controlling the factors you can modify. Family history If you have a parent, sibling or other close relative with high blood pressure, heart disease or diabetes, you are more likely to develop hypertension Race More than 40 percent of African Americans have high blood pressure, often developing the condition at an earlier age and experiencing more severe cases. Hypertension and other heart diseases also occur more often among Native American adults. Age Because of progressive hardening and decreased elasticity of the arteries that occurs naturally over time, adults over age 50 have an increased risk Gender Simply being male doubles your risk for high blood pressure. After menopause, however, when the heart-protective effects of estrogen begin to diminish, a womans risk for hypertension and other cardiovascular diseases also increases.

Temporary Blood Pressure Increases

Temporary spikes in blood pressure are relatively harmless in people with normal blood pressure. If you already have elevated blood pressure, though, these increases may be enough to put you at risk for heart disease and stroke. Intense exercise or activity, caffeine, some prescription medications and various over-the-counter drugs, such as decongestants, weight loss pills, energy pills, birth control, steroids and pain relievers, can all cause a temporary rise in blood pressure.

Risk Factors You Can Control

When it comes to controlling your blood pressure, most doctors agree the lower the better. So, even if youve been diagnosed with prehypertension or hypertension, there is much you can do to minimize your risk. Making even small lifestyle changes can have a significant blood pressure-lowering effect a drop as little as 2 mmHg can greatly reduce your risk for diseases associated with hypertension. Studies have shown that lowering systolic pressure by 15 mmHg and diastolic pressure by 6 mmHg reduced the incidence of stroke by 34 percent and coronary heart disease by 19 percent over five years. Overweight and obesity. Pure and simple, excess weight stresses your heart and blood vessels. Even moderately overweight adults have double the risk of developing hypertension than people who have a healthy weight. Fortunately, losing just 10 pounds has been shown to significantly improve blood pressure in some people. Lack of exercise. An inactive lifestyle contributes to your chances of having hypertension or other heart diseases even if your blood pressure is normal now. The good news is, being physically active can help blood pressure drop by as much as 10 mmHg. Be sure to check with your doctor before starting an exercise program. Diet. Foods high in salt cause water retention, which puts additional pressure on the walls of the blood vessels. A diet thats high in saturated fat, trans fats and refined carbohydrates can also increase your risk for high blood pressure, as well as diseases that cause it. On the flip side, multiple studies have shown that eating lots of whole grains, lean vegetable proteins and healthy fats all rich sources of the beneficial nutrients potassium and magnesium can contribute to substantial drops in blood pressure. Smoking. Research indicates that smoking can chronically raise blood pressure 10 mmHg higher than nonsmokers. If you smoke whether cigarettes, cigars or a pipe stop! Alcohol. There is a strong relationship between the amount of alcohol you consume and a rise in blood pressure. And the more you drink, the higher your blood pressure may be. Its important to limit alcohol intake to no more than two drinks per day for men and one drink per day for women to reduce the risk of developing hypertension. A standard drink is one 12-ounce beer, five ounces of wine or one ounce of hard liquor. Stress. People who are anxious and depressed have twice the risk of developing high blood pressure. When you have frequent, high levels of stress, your body continually releases hormones that cause your heart to race and constrict your arteries, spiking your blood pressure. Its important to learn healthy ways to manage stress, anger, anxiety and depression.

Talk with your physician about additional factors that can have a negative effect on your blood pressure, including: Diabetes and insulin resistance Conditions such as kidney disease and Cushings disease Sleep apnea A spouse or other close family member or friend with hypertension

Potassium and magnesium help regulate blood pressure. Although we dont know exactly why, studies suggest that people who eat the recommended amount of potassium and magnesium have less inflammation and lower instances of high blood pressure. While not a cure, eating foods high in these nutrients seems to help. Its important that you get your daily serving of potassium and magnesium from food and not supplements, unless directed by your physician. Lucky for you, both minerals are found in a variety of fruits, vegetables, low-fat dairy products, legumes (peas and beans) and grains. Note: People with diabetes, kidney disorders or severe congestive heart failure should eat less than the recommended 4.7g of potassium daily. The same goes for people taking certain medications, such as ACE inhibitors or potassium-sparing diuretics. If youre in one of these groups, you should first discuss potassium use with your doctor.

HIGH POTASSIUM FOODS

POTASSIUM RECOMMENDATIONS:
Men/women 4,700 mg/day Potato with skin Dried prunes Raisins Broccoli Lima beans Banana Spinach Orange juice Tomato Cantaloupe Strawberries 1 medium cup cup 1 medium stalk cup cooked 1 medium cup cooked 6 fluid oz 1 medium medium 8 medium 720-926 mg 637 mg 598 mg 540 mg 485 mg 450 mg 420 mg 372 mg 360 mg 280 mg 270 mg

HIGH MAGNESIUM FOODS

MAGNESIUM RECOMMENDATIONS:
Women 310-320 mg/day Men 400-420 mg/day All-Bran cereal Brown rice Almonds Frozen spinach Swiss chard Lima beans Shredded Wheat cereal Peanuts 1% milk Cantaloupe Strawberries cup 1 cup cooked 23 whole (1 oz) cup cooked cup cooked cup cooked 2 large biscuits 30 whole (1 oz) 8 fluid oz medium 8 medium 93 mg 86 mg 78 mg 78 mg 75 mg 63 mg 61 mg 48 mg 34 mg 280 mg 270 mg

If you are prehypertensive, there is much you can do to help improve your numbers, delay the need for medication and, if possible, prevent the progression to hypertension. Even if youve been diagnosed with hypertension, implementing key strategies now and sticking with them over the long term will produce health benefits that will last a lifetime.

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