Hypertension and Multiple Sclerosis: How They're Connected
Researchers have found that hypertension and prehypertension are common in multiple sclerosis (MS). Among 95 people with relapsing-remitting MS, only 29.5 percent had normal blood pressure levels, with 52.6 percent suffering from prehypertension and 17.9 percent with hypertension. Results from this recent study found that increased blood pressure, particularly systolic blood pressure, is related to damage to white brain matter and greater gray matter atrophy. Both of these types of damage are related to MS disability.
What is hypertension?
Hypertension, or high blood pressure, is a common comorbidity associated with cardiovascular disease that can increase the risk of disability in the general population. Hypertension is the third most prevalent comorbid condition that affects people with MS. Results from several studies indicate that hypertension is quite prevalent in MS, affecting 17.1 percent to 30.1 percent of people with MS in North America, based on self-reports, medical records, or formal evaluation.
High blood pressure is one of several conditions, including high cholesterol and diabetes, that collectively increase the risk of cardiovascular disease. Other factors that increase risk of heart disease include eating an unhealthy diet, physical inactivity, obesity, drinking too much alcohol, and tobacco use.
Sedentary behavior in MS: a risk for hypertension
In multiple sclerosis, sedentary behavior has been singled out as a behavior that is associated with higher blood pressure, similar to how it affects adults in the general population. This connection between physical inactivity, blood pressure, and disability can become a vicious cycle. Physical inactivity can lead to disability. Disability may contribute to sedentary behavior. Sedentary behavior increases the risk of high blood pressure. High blood pressure contributes to cardiovascular disease. And cardiovascular disease can lead to physical inactivity and increased disability progression.
How sedentary are you?
A few years ago, I participated in a research study that involved wearing an accelerometer on a belt around my waist for seven days and recording the times that I put it on and took it off. The accelerometer measured my physical activity. I learned in reading prior research conducted by the same research team that extended periods of time without any movement would be thrown out as potentially faulty information. It was important for me to get up and move at least every hour to keep the measurements valid.
Participating in this study highlighted to me just how sedentary I can be during the day when I’m writing. I can easily stay in my recliner with the laptop and not get up for two or three hours at a time. Not a behavior that is good for my health. Coincidentally in recent years, my blood pressure has crept up higher and higher. Also not good for my health.
How blood pressure is measured
Blood pressure is measured using two numbers, e.g., 120/80 mmHg. The systolic blood pressure (the first number) measures the pressure in blood vessels when the heart beats. The diastolic blood pressure (the second number) measures the pressure in blood vessels when the heart rests between beats. Blood pressure less than 120/80 mmHg is normal. Hypertension is marked by blood pressure of 140/90 mmHg or higher. Prehypertension occurs between 120/80 and 140/90 mmHg.
Strategies to reduce blood pressure
As hypertension can increase the risk of MS disability, it is important that our doctors monitor our blood pressure and make appropriate recommendations to reduce blood pressure when necessary. If you are interested in knowing what you may do to reduce blood pressure, I would start with these 10 strategies:
- Maintain a healthy weight
- Increase physical activity
- Try the DASH diet
- Reduce your sodium
- Limit your caffeine
- Manage stress
- Cut back on alcohol
- Stop smoking
- Consult your physician
- Seek support
In looking at this list of recommendations, I can see a few things that I can do on my own to try to lower my blood pressure and keep it in the normal range. I think I’ll start with losing a few pounds.
What do you do to keep your blood pressure in check? Come share your favorite strategies in our Facebook community.
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