Lifestyle choices for health improvement

The Centers for Disease Control and Prevention reports one-in-three adults in the United States suffers from hypertension – approximately 67 million people. Less than half of these have their hypertension under control. Another one-in-three has prehypertension, blood pressure that is higher than normal but not yet in the high range.

The CDC defines blood pressure ranges in the following way:

• Normal is defined as having a systolic (top number) of less than 120 and a diastolic (bottom number) less than 80.

• At-risk (prehypertensive) is defined as having a systolic reading between 120 and 139 and a diastolic reading between 80 and 89.

• A high blood pressure (hypertensive) is defined as a systolic number of 140 or higher or diastolic number of 90 or higher.

“Hypertension is a medical illness that is by definition an elevation of the blood pressure. It can lead to renal (kidney) insufficiency, renal failure, enlargement of the heart, congestive heart failure and stroke,” Dr. Robert C. Hernandez, a board-certified doctor of internal medicine for Willis-Knighton Health System, said. “Most of these complications are due to control of the hypertension.

“The most recent recommendations are that we try to keep the pressure below 140/90.

“Although more men have hypertension, they also have poorer outcomes. The most frequent occurrence of hypertension is in the black male,” Hernandez said. “They also have the poorest control because of the side effects of the medications and the difficulty with control. The outcomes are the same regardless of gender. The poorer the control, the worse the outcome.”

Many factors affect hypertension.

Weight and body individual physique put more stress on the body’s blood pressure. Diet can play such an important role. Low-sodium diets are very important because of salt sensitivity.

Low-cholesterol and low-fat diets also play some role in hypertension.

The biggest factor is taking medications.

Patients with hypertension need to take their medicines as prescribed.

They need to monitor for control.

Twenty-five percent of patients have white coat hypertension (elevated blood pressure in a clinical setting but not elsewhere), so it is important to know what their pressure is at home.

The CDC gives the risk factors for hypertension as:

• Prehypertention – It increases the risk of developing chronic high blood pressure.

• Diabetes – About 60 percent of people with diabetes also have high blood pressure.

• Sodium – Too much in the diet causes retention of fluid, increasing blood pressure.

• Being overweight or obese – Excess body weight can lead to high blood pressure.

• Physical inactivity – Adding exercise to a daily routine can help you from gaining weight.

• Alcohol – Excess long-term use (more than two drinks per day) may cause heart damage.

• Age – Blood pressure tends to rise as people get older.

• Race or ethnicity – African- Americans have a higher prevalence of high blood pressure than whites.

• A genetic predisposition to high blood pressure can run in families.

“Warning signs that should have someone seek medical attention include markedly elevated blood pressure of over 200/100 and signs and symptoms of stroke or congestive heart failure. These symptoms would include chest pains, lightheadedness, shortness of breath, feeling bad or any signs of stroke,” Hernandez said. “These symptoms would include weakness of an arm or leg, numbness, altered mental status, syncope (fainting) or coma.”

To help and treat hypertension, the National Institutes of Health recommends maintaining healthy lifestyle changes consisting of healthy diet, exercise, weight management, smoking cessation and stress management. Blood pressure medicines to treat existing hypertension include diuretics, beta blockers, ACE inhibitors, various receptor blockers and nervous system inhibitors and vasodilators.

The NIH has established an eating plan called DASH, an acronym for Dietary Approaches to Stop Hypertension, which has demonstrated in studies sponsored by the National Institute of Health Heart, Lung and Blood Institute to dramatically reduce high blood pressure.

DASH incorporates whole-grain products, fish, poultry and nuts and a reduction in the consumption of lean red meat, sweets, added sugars and sugar-containing beverages as compared to the typical American diet.

In particular, it emphasizes a low intake of sodium.

The DASH eating plan also includes foods rich in potassium, magnesium and calcium and is high in protein and fiber.

Hernandez said, “There are multiple approaches to reduce the risk of hypertension. Proper diet will go a long way in treating high blood pressure. Maintenance of a low-salt diet and watching cholesterol and triglycerides are very important.

“Keep your weight down and exercise, walk five days a week for at least 30 minutes. Continue taking your medication if you are on medicine for high blood pressure. Monitor your blood pressure regularly. If you are not under control contact, your physician. You can make a difference.”