Understanding Hypertension - lifestylemedicalcenters.com · Stage 1 Hypertension 140-159 90-99...
Transcript of Understanding Hypertension - lifestylemedicalcenters.com · Stage 1 Hypertension 140-159 90-99...
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Understanding Hypertension
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Blood pressure does vary some throughout the
day; it is lowest as you sleep and rises when
you get up. It also can rise when you are active,
excited, or nervous. Still, for most of your
waking hours, your blood pressure stays pretty
much the same while you are standing still or
just sitting. It is possible, though uncommon, for
someone to have blood pressure that is so low
that it is unhealthy. However, the much more
common problem is blood pressure that is too
high, and this is called ‘hypertension’.
What do the blood pressure numbers mean?Blood pressure is always given as two numbers.
The first number is the pressure when the heart
contracts; this is called the systolic pressure
and is the higher number. The second number
is the pressure between heart beats; this is the
diastolic pressure and is the lower number.
Both are important. Usually they are written
one above or before the other, such as 120/80
mmHg. Verbally this blood pressure would be
expressed as “120 over 80.” The diagnosis of
hypertension is based on your blood pressure
numbers, as shown in the table below:
Blood Pressure Category Systolic Diastolic
Healthy less than 120 less than 80
Prehypertension 120-139 80-89
Stage 1 Hypertension 140-159 90-99
Stage 2 Hypertension 160 or higher 100 or higher
Notes: When the systolic and diastolic blood
pressures fall into different categories, the
higher category should be used to classify
blood pressure level. For example, 150/82
would be stage 1 hypertension. Also, if you are
taking medication to lower your blood pressure,
you are still diagnosed with ‘hypertension’
regardless of your current blood pressure
numbers.
Why should I care about my blood pressure?Higher blood pressure puts excessive
mechanical stresses on the arteries, which
damages them and increases the workload on
the heart. Over time the health consequences
of this can include:
• Damage to the heart muscle, including
thickening, weakening, and failure
• Stroke
• Kidney failure
• Loss of vision
• Erectile dysfunction
• Memory loss and dementia
• Fluid in the lungs
• Angina (chest pain) and heart attacks
• Peripheral vascular disease
It is important to
understand that these
are not the symptoms
of hypertension;
these are the
consequences of
hypertension. High
blood pressure
is sometimes
called ‘the silent
killer’ because it
contributes to these
serious and sometimes
Blood is carried from the heart out to all parts of your body in vessels called arteries. Blood pressure is the force generated against the walls of the arteries by the blood as it moves along. Each time the heart beats it generates pressure and pumps blood out into the arteries. Your blood pressure is at its highest when the heart beats, pumping the blood. When the heart is at rest, between beats, your blood pressure falls.
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even fatal consequences without causing any
symptoms until the damage has already been
done. Find out if you have high blood pressure
BEFORE these devastating problems develop.
If diagnosed early, you can still take steps to
prevent and to some extent even reverse the
damage.
Who should have their blood pressure checked?The American Heart Association recommends
that all persons over the age of 20 years have
their blood pressure checked. This is good
advice even if you are young, slim, and fit since
genetic factors could be working against you
even if everything else is very favorable. As
long as your blood pressure is good (less than
120/80 mmHg), then checking it only at regular
healthcare visits, or at least every 2 years, is
reasonable. If your blood pressure
reading is higher than normal, your
health care provider may take
several readings over time
and/or have you monitor
your blood pressure at
home before diagnosing
you with high blood
pressure.
It is also important to know
that your risk of damage
from high blood pressure is
even greater if you have high
blood pressure along with:
• Obesity or being overweight
• Smoking
• High cholesterol
• Diabetes
• Physical inactivity
• Family history of high blood pressure, or
any other problems associated with high
blood pressure
If any of these apply to you, then it becomes
even more important for you to keep a close
eye on your blood pressure!
What should I do if my blood pressure is elevated?The first step is for you and your health care
provider to look at multiple factors, and not just
the numbers from a one-time measurement of
your blood pressure. If after that the decision
is made to take steps, then there are several
factors to consider.
Diet: Your diet, and whether it is contributing to
your elevated blood pressure, is one potentially
important issue to discuss with a health care
provider well trained in nutrition. Clinical studies
have shown that changes in your diet can lower
your blood pressure, even if you do not lose
weight1. A knowledgeable provider can evaluate
your current diet and then work with you on
implementing changes that will help to lower
your blood pressure.
Weight Loss: If you are
overweight and have an elevated
blood pressure, then losing
some of those extra pounds
can be a very effective way to
significantly lower it. However,
it is not necessary to get ‘slim’
in order to help your blood
pressure. Studies have shown
that even a modest weight loss,
such as 5 to 10 percent of your
total body weight, can produce
significant health benefits.2,3 This means
that someone who weighs 200 pounds can help
lower their blood pressure by losing just 10 to
20 pounds.
There are many diets and weight loss programs
to choose from, but there is no one diet or
weight loss program that is ‘best’ for everyone.
Be cautious about getting important health
care information from TV advertisements and
magazine articles in the grocery checkout lanes;
these sources of information know nothing
about you. The critical factor is to develop a
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weight loss program that will enable you to lose
weight, lower your blood pressure, provide all
essential nutrients, and be a diet you can live
with. Developing a weight loss program with
the greatest chance of success must start with
a careful and thorough assessment of your
current status. But that is just the beginning.
Continuing support, education, monitoring, and
adjustments will be necessary as you work with
your program.
It is also important to know that not all weight
loss is the same when it comes to improving
your health. For example, weight loss
programs advertising large
amounts of weight loss in
a very short time fail to
mention that most of
the lost weight is water
rather than body
fat. Losing body fat
is the key. A good
weight loss program
should include more
than just measuring
your body weight; it
is important to monitor
your body composition to
track changes in fat, water, and
the other tissues as you lose weight.
Specialized centers like LifeStyle Medical Clinic
can easily measure your body composition using
equipment that looks much like a regular scale.
Exercise: Clinical studies have shown that exercise
can help to lower blood pressure4. But does
knowing this mean that you will start spending
an hour in the gym 5 times a week? Probably not.
Having a healthy lifestyle and lowering your blood
pressure generally includes getting some exercise,
but how much exercise? What kinds of exercise?
How often and for how long?
These are important questions for you to ask,
but no one can give you the answers without
first talking with you about your situation:
• Knee arthritis or a bad back?
• Medical conditions that impact your
exercise tolerance and safety?
• Never been to a health club or do not
have ready access to one?
• Too much work and not enough time?
• Exercise activities you enjoy, and ones you
do not?
As with a weight loss program, the critical
factor is developing a safe exercise program
that you can stick with, and that starts with
a careful evaluation of your current status
and includes the support, education, and
adjustments necessary to implement lasting
changes.
Medications: If your resting blood pressure
falls in the pre-hypertension range (systolic
between 120 and 139 mm Hg OR diastolic
between 80 and 89 mm Hg), the initial treatment
will usually be changes in your diet, weight loss,
and exercise as discussed above. However, if
your blood pressure is 140/90 or higher, then in
addition to lifestyle modifications, doctors will
usually recommend starting medication5.
It is important that you fully discuss blood
pressure medications with your health care
provider, and then carefully follow their
recommendations. The unfortunate truth is that
sometimes effective treatment of hypertension
may mean taking medication every day for the
rest of your life; the need for this will depend to a
great extent on your success with diet changes,
weight loss, and increased physical activity.
Where can I get help?The most important thing is that you check your
blood pressure. If it is elevated, get some help
understanding what the numbers really mean
for you. Most primary health care providers
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can provide you with this service. Hypertension
has potentially catastrophic consequences. Do
not miss the opportunity to lower your blood
pressure before you develop hypertension.
Anyone committed to lowering
their blood pressure and
improving their health
will be best served by
working with a clinic
that specializes in
the evaluation and
management of
chronic conditions.
Hypertension is
a lifelong disease,
and by partnering with a healthcare team like
LifeStyle Medical Center we can combine medical
and lifestyle treatments into an individualized
treatment plan that will help you successfully
reach your treatment goals and enjoy the benefits
of better health. On-going evaluation, education,
support, monitoring, and adjustments are the keys
to your success.
For more information about our services,
insurance coverage, clinic location and hours,
please feel free to Call (919) 354-7077 or e-mail
us at [email protected].
References:1 Appel LJ, et al. Dietary Approaches to Prevent and Treat Hypertension: A Scientific Statement From the American Heart Association. Hypertension, volume 47,
pages 296-308, 2006.
2 NIH, NHLBI Obesity Education Initiative. Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults. Available online
from the Center for Disease Control: http://www.nhlbi.nih.gov/guidelines/obesity/ob_gdlns.pdf
3 Blackburn G. Effect of degree of weight loss on health benefits. Obesity Research, volume 3, pages 211S-216S, 1995.
4 Kokkinos PF, Papademetriou V. Exercise and Hypertension. Coronary Artery Disease, volume 11, pages 99-102, 2000.
5 Chobanian AV, et al. Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Hypertension,
volume 42, pages 1206-1252, 2003.