Dr. Carlene Wilson, Wellness Corner, 7/8/14

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New guidelines for high blood pressure

High blood pressure is often called “the silent killer” because most people have no symptoms, even when their blood pressure is dangerously high. In the U.S., about one-third of people who have high blood pressure do not know it. 

When you have high blood pressure, your heart is working harder to pump blood through your body. Over time, high blood pressure contributes to hardening of the arteries and the development of heart disease. Untreated, high blood pressure can lead to stroke, heart disease, kidney failure and vision loss.

For many adults, high blood pressure develops gradually over the years. For some people, high blood pressure has an underlying cause, such as kidney disease, thyroid problems, an adrenal tumor, or alcohol or drug abuse. High blood pressure can also be hereditary, or a side effect of taking certain medications.

High blood pressure can be easily detected by taking a blood pressure reading at a routine checkup or doctor’s appointment. Your blood pressure should be checked at least every two years, starting at the age of 18.

A blood pressure reading measures the force with which your heart pumps blood through your arteries. The blood pressure reading consists of two numbers. The top number indicates the pressure while your heart is beating (systolic), and the bottom number indicates the pressure while your heart is at rest between beats (diastolic). Normal blood pressure is 120/80. If your blood pressure is higher than that, your doctor will recommend the following lifestyle changes: 

+ Be physically active for at least 30 minutes every day.

+ Stop smoking.

+ Lose weight or maintain a healthy weight. If you are overweight, losing just five pounds can lower your blood pressure.

+ Limit your alcohol consumption to one drink per day for women, and no more than two drinks per day for men. 

+ Manage stress levels and make sure you get enough sleep.

+ Add more fruits, vegetables, fish, nuts and whole grains to your diet, and cut back on salt.

Studies have shown that the DASH (Dietary Approaches to Stop Hypertension) diet can significantly lower blood pressure within two weeks. DASH includes cutting back on red meats and sweets, and eating foods that are rich in magnesium, potassium, and calcium.

If your blood pressure is not lowered by diet and exercise, your doctor will prescribe medication to reduce it quickly and prevent complications. Blood pressure medications include diuretics, ACE inhibitors, beta blockers and medications that block the effects of certain hormones or prevent calcium from going into the heart and blood vessel cells. Your doctor will work with you to find the best medication or combination of medications for your particular circumstances.

In December 2013, a national panel of experts concluded that people older than 60 should only take blood pressure medication if their blood pressure is higher than 150/90, and that many younger people may not require intense drug therapy for high blood pressure. This means that many people currently on blood pressure medication might be able to reduce their dosage and avoid unpleasant side effects. 

If you are taking blood pressure medications, schedule an appointment with your doctor to discuss options for managing your blood pressure. Do not attempt to reduce your blood pressure medication without your doctor’s supervision, because sudden withdrawal could have serious health consequences.

Further reading:

High Blood Pressure (hypertension).  Mayo Clinic. (www.mayoclinic.org/diseases-conditions/high-blood-pressure/basics/defini...)

3 Things to Know About the New Blood Pressure Guidelines, by Harlon M. Krumholz, M.D. Well. (http://well.blogs.nytimes.com/2013/12/18/3-things-to-know-about-the-new-...)

Dr. Carlene Wilson is a board-certified internist and pediatrician in private practice in Crystal River. Call her at 352-563-5070 or visit www.IMPWellnessCenter.com.