Nearly two-thirds of the 65 million American adults with high blood pressure donâ€™t have it under control. Thatâ€™s a big problem, because itâ€™s a major cause of stroke, heart attack, heart and kidney failure, and early death.Blood pressure basics
Some pressure is absolutely essential for circulation. Without it, blood couldnâ€™t move from the heart to the brain and toes and back again. The heart provides the driving force â€” each contraction of the left ventricle, the heartâ€™s main pumping chamber, creates a wave of pressure that passes through the aorta and all the arteries in the body.
Relaxed and flexible arteries offer a healthy amount of resistance to each pulse of blood. Arteries that are tensed, constricted, or rigid offer more resistance, which shows up as higher blood pressure. It also makes the heart work harder.
High blood pressure is not a disease. Instead, it is a sign that something isnâ€™t right in the heart, blood vessels, kidneys, or elsewhere. Sometimes it stems from the overproduction of hormones by the thyroid or adrenal glands. It can also be caused by the use of prescription or over-the-counter medications such as aspirin, ibuprofen, pseudoephedrine, some antidepressants, steroids, and others. Most of the time, though, high blood pressure canâ€™t be traced to a specific source.
|Classifying high blood pressure|
Current national guidelines (JNC 7)
American Society of Hypertension proposal
Systolic under 120 and diastolic under 80
Normally less than 120/80 and no cardiovascular risk factors or signs of target-organ damage
Systolic 120â€“139 OR diastolic 80â€“89
Systolic 140â€“159 OR diastolic 90â€“99
Blood pressure sometimes above 120/80 OR risk factors or markers suggesting early cardiovascular disease
Systolic 160 or higher OR diastolic 100 or higher
Blood pressure routinely above 120/80 OR signs of progressive cardiovascular disease or early target-organ damage
Marked and sustained high blood pressure OR signs of advanced cardiovascular disease and target-organ damage
High blood pressure isnâ€™t usually something that can be cured. Like an in-law who comes to stay for good, itâ€™s something most people need to learn to live with. Drugs offer an easy fix, but most also cause unwanted side effects. Making healthful lifestyle changes is harder, but it yields benefits far beyond better blood pressure. Thatâ€™s why it makes sense to start with these, and add medications only if needed. Here are 10 steps that can help you lower your blood pressure and keep it under control.
1. Check it. You canâ€™t do much about your blood pressure unless you know what it is. Your doctor should check it at every visit. Measuring it at home is even better. Relatively inexpensive home monitors are available in most pharmacies.
2. Get moving. Regular exercise, even something as simple as brisk walking, improves blood vessel flexibility and heart function. It can lower blood pressure by 10 points, prevent the onset of high blood pressure, or let you reduce your dosage of blood pressure medications.
3. Eat right. A landmark study called Dietary Approaches to Stop Hypertension (DASH) showed that you can eat your way to better blood pressure. The DASH diet emphasizes fruits, vegetables, low-fat dairy products, whole grains, poultry, fish, and nuts, and downplays red meat, sweets, sugar-containing beverages, and saturated fat and cholesterol.
4. Control your weight. If you are carrying too many pounds for your frame, losing weight can lower your blood pressure. You donâ€™t need to become rail-thin â€” losing 10% of your current weight, or even 10 pounds, can make a big difference.
5. Donâ€™t smoke. Nicotine constricts small blood vessels. Smoking a cigarette can cause a 20-point spike in systolic blood pressure. Quitting is tough, but there are now more aids to help.
6. Drink alcohol in moderation. A drink a day for women and one or two a day for men is good for the heart and blood vessels. Going beyond that can contribute to higher blood pressure.
7. Shake up your salts. Too much sodium and too little potassium boost blood pressure in people who are sensitive to salt. Aim for less than 1.5 grams of sodium a day, and at least 4.7 grams of potassium.
8. Sleep is good. Burning the candle at both ends night after night can contribute to high blood pressure, not to mention increase the chances of developing heart disease or a sudden cardiac arrest. How much sleep is enough? At least six hours a night, though eight hours is probably more like it for most people.
9. Reduce stress. As surely as mental and emotional stress can raise blood pressure, meditation, deep breathing, and other stress-busting activities can lower it.
10. Stick with your medications. Taking pills to keep your blood pressure in check wonâ€™t make you feel any different. But it can keep you from having a stroke, heart attack, or other problem.
The Harvard Heart Letter provides eight pages of monthly heart news, directly from the more than 8,000 doctors and researchers at Harvard Medical School. Itâ€™s a source of expert advice for people who may already suffer from heart disease (or their family members) and for people concerned about their risk who wish to take steps towards positive change.
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