In last month’s blog, Dr.Troutman discussed the basics of blood pressure and the proper use of a home blood pressure monitor, identifying possible causes of potential differences between readings taken at home and those taken in the doctor’s office. In this blog, she will look at the consequences of this “silent disease” and how you can help control it.
What are the consequences of high blood pressure?
In most cases, the damage done by high blood pressure takes place over a prolonged period of time:
• Heart attack—High blood pressure damages arteries that can become blocked and prevent blood flow to the heart muscle.
• Stroke—High blood pressure can cause blood vessels in the brain to clog more easily or even burst.
• Heart failure—The increased workload from high blood pressure can cause the heart to enlarge and fail to supply blood to the body.
• Kidney disease or failure—High blood pressure can damage the arteries around the kidneys and interfere with their ability to filter blood effectively.
• Vision loss—High blood pressure can strain or damage blood vessels in the eyes.
• Sexual dysfunction—High blood pressure can lead to erectile dysfunction in men or lower libido in women.
• Angina—Over time, high blood pressure can lead to heart disease or microvascular disease (MVD); angina, or chest pain, is a common symptom.
• Peripheral artery disease (PAD) — Atherosclerosis caused by high blood pressure can cause a narrowing of arteries in the legs, arms, stomach and head, causing pain or fatigue.
What are blood pressure targets?
Your physician may give you a target blood pressure reading that is based on your risk for having a future cardiovascular event:
• Patients with atherosclerotic cardiovascular disease - prior history of coronary artery disease - prior stroke or transient ischemic attack (TIA) - peripheral arterial disease • Patients with heart failure
• Patients with diabetes mellitus
• Patients with chronic kidney disease (CKD)
• Older adults—There are different guidelines from different medical societies for adults older than sixty-five. Target blood pressure recommended in this age group can be less than 130/80 (American College of Cardiology/American Heart Association) or less than 150/90 (American College of Physicians/American Academy of Family Physicians)
• Patients with multiple cardiovascular risk factors (and an estimated ten-year risk of future cardiovascular events of 10% or greater) Patients without any of these characteristics are considered lower risk, and a less intensive target blood pressure is recommended.
Your healthcare provider will help you plan how to lower your blood pressure. Make a few lifestyle changes.
In many cases, this will be your doctor’s first recommendation, likely in one of these areas:
• Maintain a healthy weight—Strive for a body mass index (BMI) between 18.5 and 24.9.
• Eat healthier—Eat lots of fruit, veggies and low-fat dairy, and less saturated and total fat.
• Reduce sodium—Target less than 2,000 mg of sodium (salt) intake per day.
• Get active—Aim for at least 90 to 150 minutes of aerobic and/or dynamic resistance exercise per week and/or three sessions of isometric resistance exercises per week.
• Limit alcohol—Drink no more than 1-2 drinks a day. (One for most women, two for most men.)
• Limit caffeine.
• Avoid frequent use of non-steroidal anti-inflammatory medications (NSAIDs) such as Advil, Aleve, Motrin, Ibuprofen, Naproxyn, Meloxicam, and Celebrex, as these medications will raise blood pressure. • Regularly check your blood pressure at home.
Take ownership of your treatment
by keeping records of your blood pressure readings at home and bring the results to you doctor for review. Take your medication exactly as your doctor tells you at a similar time each day.
Avoid foods with high sodium content:
• Canned foods
• Frozen TV dinners
• Frozen pizzas
• Deli meats like hams, salamis, bolognas
• Sausages, bacon and other cured meats
The best way to control sodium content is to prepare meals yourself so that you have much more control over what is in the food. One example of a heart healthy diet is the DASH
(Dietary Approaches to Stop Hypertension) diet. It does not require any special foods and provides daily and weekly nutritional goals. The DASH plan recommends: • Eating vegetables, fruits, and whole grains • Including fat-free or low-fat dairy products, fish, poultry, beans, nuts, and vegetable oils • Limiting foods that are high in saturated fat, such as fatty meats, full-fat dairy products, and tropical oils such as coconut, palm kernel, and palm oil • Limiting sugar-sweetened beverages and sweets.
We thank Dr. Hannah Troutman, Clinical Assistant Professor, Division of Nephrology, Jefferson Health, for joining our conversation. These articles also appeared in the April and May issues of The Village View, the Penn’s Village newsletter.