High Blood Pressure
High blood pressure affects 1 in 3 Americans, and is known as the "silent killer" because there are often no symptoms until more serious problems such as heart, brain or kidney problems have developed.
WHAT IS "BLOOD PRESSURE"?
Blood is carried throughout the body via arteries, and blood pressure is the force of the blood pushing against the artery walls. Every time your heart beats (60-70 times per minute at rest) it pumps blood into the arteries. Blood pressure is at is hightest when the heart beats (pumping the blood), which is known as systolic pressure - this it the top number. When at rest (between beats) it is diastolic, which is the bottom number. A blood pressure reading of 120/80 is considered to be "perfect".
Blood pressure varies throughout the day based on your activities and stress levels. It is lowest when you sleep and highest when you are active. A reading higher than 140/90 is considered high blood pressure. If you are diabetic or have chronic kidney disease 130/80 is considered high. If your pressure averages between 120-139 (top number) and 80-89 (bottom number) you are considered to have "prehypertension".
CAUSES OF HIGH BLOOD PRESSURE:
According to the American Heart Association up to 95% of cases of hypertension have no identifible cause, and the rest are usually from an underlying condition, which is called secondary hypertension, from things such as: sleep apnea, high cholesterol, kidney problems, congenital heart defects, tumor on the adrenals, medications such as birth control pills, cold remedies , decongestants and pain relievers. Stress can cause temporary but dramatic increases in pressure, and long-term, constant stress can lead to more serious problems.
As mentioned previously, there are often no symptoms and pressure problems are discovered during a routine doctor's office visit. Two more common symptoms can be dull headaches and dizziness, so if you are experiencing either with no known cause, have your blood pressure checked.
- Age - the older you get: usually middle-age for men and after menopause for women
- Race - it is more comon for blacks to get it at an earlier age and to have complications
- Family History - it tends to run in families
- Being Overweight - the heavier you are the more blood you need to supply oxygen and nutrients to your tissues
- Inactivity - lack of exercise can actually cause your heart to work harder
- Smoking - chemicals in tobacco can damage the walls of the arteries
- Sodium - too much salt can lead to fluid retention
- Low Potassium - potassium helps to balance the amount of sodium in the cells, not enough can create fluid retention
WHAT YOU CAN DO TO LOWER BLOOD PRESSURE:
The good news is that eating a well balanced diet, exercising, sleeping well and reducing stress in your life can help you to get your blood pressure under control.
- Reduce the amount of protein (meat, eggs, etc) you eat and add more fruits and vegetables to your diet.
- Cut back on salt, have no more than 1/2 teaspoon per day.
- Eat potassium rich foods like bananas, apricots, raisins and dried fruits, tomato puree, whole wheat and potatoes (boiled with the skin on and without adding butter!).
- Maintain a healthy weight and increase your physical activity.
- Limit alcohol
- No smoking
- Manage Stress (see Meditation, Relaxation Techniques, Visualization)
- Practice Slow Breathing (see Healthy Breathing)
- Garlic - this spice is not only good for your immune system, but your pressure as well - try adding raw garlic to your food every day or consider taking 2-3 capsules.
- Lemon - high in Vitamin P, can help to prevent capillary fragility
- Grapefruit - also high in Vitamin P, helps to tone the arteries
- Rice - low in cholesterol and fat, and brown rice is high in calcium which is good for the nervous sytem to relax you
- Parsley - good for the capillaries
- Vegetable juice - especially carrot and spinach, drink 1 glass 2 x per day
The following information on medication is from the Mayo Clinic website, a great resource for information about high blood pressure and other health issues.
The major types of medication used to control high blood pressure include:
- Thiazide diuretics These medications act on your kidneys to help your body eliminate sodium and water, reducing blood volume. Thiazide diuretics are often the first — but not the only — choice in high blood pressure medications. In a 2006 study, diuretics were a key factor in preventing heart failure associated with high blood pressure.
- Beta blockers These medications reduce the workload on your heart, causing your heart to beat slower and with less force. When prescribed alone, beta blockers don't work as well in blacks — but they're effective when combined with a thiazide diuretic.
- Angiotensin-converting enzyme (ACE) inhibitors These medications help relax blood vessels by blocking the formation of a natural chemical that narrows blood vessels. ACE inhibitors may be especially important in treating high blood pressure in people with coronary artery disease, heart failure or kidney failure. Like beta blockers, ACE inhibitors don't work as well in blacks when prescribed alone, but they're effective when combined with a thiazide diuretic.
- Angiotensin II receptor blockers T hese medications help relax blood vessels by blocking the action — not the formation — of a natural chemical that narrows blood vessels. Like ACE inhibitors, angiotensin II receptor blockers often are useful for people with coronary artery disease, heart failure and kidney failure.
- Calcium channel blockers These medications help relax the muscles of your blood vessels. Some slow your heart rate. Calcium channel blockers may work better for blacks than do ACE inhibitors or beta blockers alone. A word of caution for grapefruit lovers, though. Grapefruit juice interacts with some calcium channel blockers, increasing blood levels of the medication and putting you at higher risk of side effects. Researchers have identified the substance in grapefruit juice that causes the potentially dangerous interaction, which may one day lead to commercial grapefruit juices that don't pose a risk of interaction. For now, however, talk to your doctor or pharmacist if you're concerned about interactions.
- Renin inhibitors A new drug Tekturna (aliskiren) is a renin inhibitor. Renin is an enzyme produced by your kidneys that starts a cascade of chemical steps that increases blood pressure. Tekturna works by reducing the ability of renin to begin this process. Tekturna acts earlier in your body's blood pressure regulation process than most other blood pressure medications. It also can be used well with the other major classes of blood pressure drugs to improve their actions. Tekturna can be used alone, but it's more effective when used in combination with existing high blood pressure medications, such as water pills (diuretics). Tekturna's effects on blood pressure last more than 24 hours, so it can be taken once daily in oral tablet form.
If you're having trouble reaching your blood pressure goal with combinations of the above medications, your doctor may prescribe:
- Alpha blockers These medications reduce nerve impulses to blood vessels, reducing the effects of natural chemicals that narrow blood vessels.
- Alpha-beta blockers In addition to reducing nerve impulses to blood vessels, alpha-beta blockers slow the heartbeat to reduce the amount of blood that must be pumped through the vessels.
- Central-acting agents These medications prevent your brain from signaling your nervous system to increase your heart rate and narrow your blood vessels.
- Vasodilators These medications work directly on the muscles in the walls of your arteries, preventing the muscles from tightening and your arteries from narrowing.
Once your blood pressure is under control, your doctor may add aspirin to your regimen to reduce your risk of cardiovascular disorders.
When your blood pressure is difficult to control
If your blood pressure has remained stubbornly high despite taking at least three medications from different classes of antihypertensive drugs, one of which is a diuretic, you may have resistant hypertension — blood pressure that is resistant to treatment.
This doesn't mean your blood pressure will never get lower. In fact, if you and your doctor can identify what's behind your persistently high blood pressure, there's a good chance you can meet your goal with the help of treatment that's more effective. You may need to see a hypertension specialist if your primary care doctor isn't able to pinpoint a cause.
Your doctor or hypertension specialist can evaluate whether the medications and doses you're taking for your high blood pressure are appropriate. You may have to fine-tune your medications to come up with the most effective combination and doses.
If you don't strictly follow the prescribed medication regimen, your blood pressure can pay the price. If you skip doses because you can't afford the medication, because you have disagreeable side effects or because you simply forget to take your medications, talk to your doctor about solutions. Don't alter your treatment without your doctor's guidance.
In addition, you and your doctor can review medications you're taking for other conditions. Those or other substances or foods can worsen high blood pressure or prevent your medications from working effectively. Be open and honest with your doctor about all the medications, substances, supplements and products you take. Underlying causes of resistant hypertension should also be considered such as sleep apnea and kidney or hormonal abnormalities.
Other websites with information about High Blood Pressure:
If you have any questions or comments, please email me: andrea@HealWithHope.com