Blood Pressure - Just the Facts

Many of us don’t think twice when we pick up the salt shaker to season our foods, but it’s one of the worst things we can do for our overall health. Added sodium is one of the major factors for increased blood pressure, which can result in many debilitating and deadly conditions. The higher the blood pressure, the greater the risk of stroke, cardiovascular disease, heart failure, heart attack, kidney disease and diabetes. More than 45 million Americans are classified as having high blood pressure.

In the past, most of us thought that having a blood pressure reading of below 140 mm Hg/90 mm Hg (see chart below) meant that we were safe, but new guidelines issued last year by the National Heart, Lung and Blood Institute (NHLBI) has recategorized the levels to better prevent, detect and treat high blood pressure. The new guidelines feature a new category, called “prehypertension,” a reading that covers about 22 percent of American adults or about 45 million people. This new prehypertension level describes people with a reading of 120 to 139/80 to 89 mm Hg. According to NHLBI research, those in the prehypertension range are more likely to move into the hypertension range where medication is required. At this early stage, most physicians advise lifestyle changes, such as cutting sodium and adding more physical activity to lower the levels.

“I first recommend that people with mild hypertension cut their sodium intake, avoid adding salt and choose lower sodium options,” explains L Allen Kindman, cardiologist with Cardiovascular Care of Northern Carolina in Roxboro and Oxford. “If that doesn’t work, patients can make a choice about either more aggressively restricting sodium or starting medication. If medication and prudent dieting don’t work, then I recommend that they consciously restrict each serving of food to 100 mgs. of sodium.”

American Heart Association recommended blood pressure levels
Blood pressure is the force in the arteries when the heart beats (systolic) and when the heart is at rest (diastolic.) It is measured in millimeters of mercury (mm Hg).

Blood pressure category	Systolic (mm Hg)		Diastolic (mm Hg)
Normal	Less than 120	and	Less than 80
Prehypertension	120 to 139	or	80 to 89
High – Stage 1	140 to 159	or	90 to 99
High – Stage 2	160 or higher	or	100 or higher

Ten ways to control your high blood pressure
from the American Heart Association

1. Know your blood pressure, and have it checked regularly.
2. Know what your weight should be, and keep it at that level or below.
3. Don’t use too much salt in cooking or at meals. Avoid salty foods. Use herbs and natural seasonings to spice up foods. (note that Dr. Kindman recommends no more than 100 mgs. of sodium per serving if medication and simple restrictions are not effective in lowering blood pressure.)
4. Eat a low in saturated fat diet according the American Heart Association recommendations.
5. Control alcohol intake. Don’t have more than one drink a day for women or two a day for men.
6. Take your medicine exactly as prescribed. Don’t run out of pills even for a single day.
7. Keep appointments with the doctor.
8. Follow your doctor’s advice about physical activity.
9. Make certain your parents, brothers, sisters and children have their blood pressure checked regularly (based on your physician’s recommendations.)
10. Live a normal life in every other way.

Are you at risk?
High blood pressure can occur in both children and adults, but it’s more common in people over age 35 and especially in African Americans, middle-aged and older adults, overweight and obese people and heavy drinkers. Plus, if you have diabetes, gout or a kidney disorder, you may also run a higher likelihood of developing high blood pressure. It can run in families, but lifestyle factors can greatly reduce your risks.

Special risks for women

• Women who are taking birth control pills
• Women after menopause has a greater chance of developing high blood pressure than men
• Pregnant women can develop elevated blood pressure during the last trimester

How do you know if you have high blood pressure?
Detection is normally found during your routine physical or if you have your pressure checked by a nurse at work or clinic or at a health fair; however, a single reading doesn’t indicate that you have elevated blood pressure. You need to have it checked over a period of time, recommended by your doctor, to see if the readings are consistently high.

There are usually no warning signs of high blood pressure; however, according to Dr. Kindman, some people have early indication of the problem. “Most notable is an increase in headaches, particularly one that mimics a sinus headache, and we’ve found that some of our patients are short of breath when they bend over to do a simple task, such as tying their shoes.” Many people think that being tense or nervous increases your chances, but calm and relaxed people also have the condition.

The key to controlling blood pressure is to monitor it throughout your life, beginning with childhood. With vigilant monitoring, your doctor can keep a close watch if you become prehypertensive, and teach you how to control your blood pressure early on with diet and exercise. If you are diagnosed with stage one or two hypertension, most likely your physician will prescribe, along with diet and exercise, medications such as diuretics (to reduce fluid that can contribute to high blood pressure), angiotensin converting enzyme (ACE) inhibitors, beta-blockers or calcium channel blockers.

Talk to your doctor if you have one or more of the risk factors to determine the best course of treatment. For more information, go to www.americanheart.org.

Quick stats for high blood pressure (HBP)

• More men than women have HBP until age 55. From 55 to 74, the percentage of women is slightly higher than men.
• One in four adults has HBP.
• HBP is two to three times more common in women taking birth control pills.
• More people in the Southeastern US have HBP more than any other region of the country.
• The overall death rate from HBP in 2001 was 251,000 people or 16.5 percent. Of that percentage:
  • 13.7 percent were while males.
  • 47.8 percent were black males.
  • 13.4 percent were while females.
  • 38.9 percent were black females.
• In 2004, the direct and indirect cost of HBP is estimated at $55.5 billion.