What is high blood pressure or hypertension?
High blood pressure is common, especially as we get older. Based on new blood pressure guidelines almost 50 percent of American adults have high blood pressure. Your blood pressure depends on how much blood your heart is pumping, and the resistance in your arteries which allows the blood to flow. The narrower your arteries, the higher your blood pressure.
High blood pressure puts more strain on your heart because it must work harder, and can cause damage to your arteries. Risk factors include obesity, smoking, family history, and drinking too much alcohol. In some cases, the cause is unknown. This condition is known as the “silent killer” because there are not usually noticeable symptoms. You may live with high blood pressure for years and not know. Uncontrolled high blood pressure over time can damage your heart, lungs, blood vessels, brain, and kidneys putting you at higher risk for heart disease, stroke, and kidney disease.
Up to age 45, men are more likely to have high blood pressure than women, and by age 65, it’s more common in women. Here is a 7-Step Plan for Managing Blood Pressure through lifestyle choices:
1. Maintain a healthy weight
Blood pressure often increases as weight increases. According to the American Heart Association, a healthy BMI between 18.5-24.9 is the goal. Losing just 10 pounds can help reduce or prevent high blood pressure. Your caloric intake to lose weight safely should be discussed with your dietitian and each case should be individualized. Increasing the amount of exercise with the appropriate daily caloric intake can help promote a healthy weight. Weight loss in overweight and obese patients lowers diastolic and systolic blood pressure by five mmHg.
Keep in mind more weight around the waistline puts you at a greater risk of high blood pressure. In general, men are at risk if their waist measurement is greater than 40 inches and women are at risk if their waist measurement is greater than 35 inches. These numbers can vary, and should be monitored.
2. Monitor blood pressure at home
Your blood pressure is measured in millimeters of mercury (mmHg). A normal blood pressure is around 120/80 mmHg or less. Normal levels can fall below this, yet consistent readings above this can lead to a high blood pressure diagnosis. The top number of the reading is called the systolic and shows the pressure in your blood vessels when your heart beats. The lower number is called the diastolic and it measures the pressure at rest between heartbeats when the heart refills with blood.
If you are diagnosed with high blood pressure discuss your personal blood pressure goal with your doctor. Blood pressure readings above 120/80 mm Hg are considered elevated and above 130/80 mmHg is Stage I Hypertension.
By monitoring your blood pressure at home, you will monitor trends more consistently and be able to supplement the readings taken by your doctor for a more accurate picture of your blood pressure.
3. Exercise regularly
Be regularly active to promote healthy blood pressure levels. Regularly increasing heart rate during exercise strengthens the heart muscle and allows your heart to pump blood throughout the body more efficiently.
If your blood pressure is elevated, meaning above 120/80 but below 130/80, exercise is a great tool you can use to prevent a high blood pressure diagnosis. According to the Nutrition Care Manual, regular physical activity of at least 30 minutes for five days or more can lower your blood pressure an average of four to nine mm Hg.
Discuss with your doctor, but typically the best forms of exercise for lowering blood pressure include walking, jogging, cycling, swimming or dancing. Strength training can also help reduce blood pressure.
If you are already diagnosed with high blood pressure and being treated, regular exercise will boost the effectiveness of certain blood pressure medications.
4. Eat a healthy diet
Diet plays a large part in lowering blood pressure. The DASH (Dietary Approach to Stop Hypertension) diet can lower blood pressure up to 14mm Hg. The DASH Diet emphasizes vegetables, fruits, whole grains, low-fat dairy products, and limiting the amount of fat (specifically saturated fat and cholesterol).
Serving size may differ depending on each individual person, but there are some recommended guidelines:
- Seven to eight servings of grains daily, three of which should be whole grain
- Four to five servings of fruits a day
- Four to five servings of vegetables a day
- Two to three servings a day of low-fat or nonfat dairy
- Two or fewer servings of lean meat, fish, or poultry a day
- Four to five servings of nuts, seeds, and legumes weekly
- Limited fats and sweets
Sodium should be limited to 1500-2400mg per day. Incorporate foods rich in potassium to counteract the impact of sodium on blood pressure. Potassium-rich foods include bananas, oranges, apricots, spinach, greens, sweet potatoes, fish, and low-fat dairy.
5. Reduce intake of sodium
The 2015-2020 Dietary Guidelines recommend not getting more than 2,300 mg of sodium a day.
You may need to restrict your sodium intake further, to less than 1,500 mg a day or less, depending on age and other determining factors. Discuss with your doctor.
The DASH diet recommends 1500-2400mg of sodium a day. A salt restricted diet can lower systolic blood pressure by two to eight mmHg on average. Salt-restricted diets will also enhance the effects of most blood pressure medications.
Read food labels to learn how much sodium is in your food choices. Processed foods, chips and other snacks, soups and canned foods, and deli meats typically contain high levels of sodium. Foods that are considered “low-fat” usually contain extra sodium to make up for the loss of fat for flavor. If the food label contains 20 percent or more sodium the sodium content is considered high.
Many restaurant foods are also higher in sodium. One teaspoon of table salt has 2300mg of sodium. To cut back on salt while cooking, try adding herbs and spices to your food for flavor.
6. Limit amount of alcohol
Limiting the amount of alcohol consumed to less than two drinks per day for men and less than one drink per day for women lowers blood pressure by two to four mmHg on average.
One drink is considered 12 ounces of beer, 5 ounces of wine, or 1.5 ounces of distilled spirits.
Drinking more than the recommended amounts can raise blood pressure and reduce effectiveness of blood pressure medications. Discuss with your doctor if you receive a blood pressure medication prescription.
7. Quit smoking
Not only good for overall health, quitting smoking promotes a lower blood pressure. The chemicals in tobacco damage the arterial walls, causing them to harden and become narrow. Being exposed to second hand smoke has the same effect. Stop smoking and avoid second hand smoke.
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Lisa Nelson RD, a registered dietitian since 1999, provides clients step-by-step guidance to lower cholesterol and lower blood pressure, so they can live life and enjoy their family for years to come. Because her own health is the foundation of her expertise, you can trust that Lisa will make it truly possible for you to see dramatic changes in your health, without unrealistic fads or impossibly difficult techniques. She can be found on Twitter @lisanelsonrd and Facebook at hearthealthmadeeasy.