Allison Griffin
Montgomery Advertiser, Ala.
02-07-12
Feb. 07–HYPERTENSION — high blood pressure — was a primary or contributing cause of death for 326,000 Americans in 2006, according to the Centers for Disease Control and Prevention. It puts us at risk for heart disease and stroke, the first and third leading causes of death in the U.S.
Despite the statistics, high blood pressure can be controlled, and it is not a death sentence. But as with other chronic conditions, awareness of it, and compliance with a doctor’s instructions and/or medication to treat it, is crucial to its control.
About one in three Americans — 31 percent — has high blood pressure. But one local cardiologist thinks there’s probably a percentage who aren’t even aware they have it.
Even more alarming, Dr. Paul Moore said, is that many who have been diagnosed with it aren’t controlling it.
“Part of it is noncompliance on the patient’s part,” said Moore, who is part of the Montgomery Cardiovascular Associates practice. “They can’t afford the medications, they don’t like taking medications, or they don’t like the way they make them feel.”
But another part of it is that physicians in general are perhaps not as attentive to high blood pressure as they should be, Moore said.
“There are so many other things you have to take care of in patients, and sometimes hypertension doesn’t rise to the surface.”
Blood pressure is the force of blood pushing against the walls of the arteries as the heart pumps the blood. If this pressure rises and stays high over time, it can damage and scar the body’s arteries.
It’s expressed as two numbers. The first, or systolic, represents the pressure in your blood vessels when the heart beats. The second, or diastolic, represents the pressure in the vessels when the heart rests between beats.
Normal is considered less than 120 over 80 millimeters of mercury. At risk is 120 to 139 over 80 to 89, and high is 140 over 90 or higher.
Most hypertension, called essential hypertension, has no specific cause, Moore said, though genetics play a real role. And most Americans are aware that too much salt in the diet can lead to fluid retention, which increases blood pressure.
Among the other risk factors are age, race (hypertension is more common in African Americans), being overweight, lack of physical activity, tobacco use, low potassium intake, excessive alcohol and stress.
Know your numbers
Because hypertension often has no signs or symptoms, the only way to find out if you have it is to have your blood pressure taken by a health care professional.
Some tips to follow before having a reading taken:
Don’t drink coffee or smoke cigarettes 30 minutes before a reading.
Before the test, sit for five minutes with your back supported and your feet flat on the ground.
Wear short sleeves, or if you must wear long sleeves, wear a shirt made of a light, thin material.
Go to the bathroom prior to the reading; a full bladder can change the reading.
Have two readings taken, at least two minutes apart, and average the results.
Be sure to ask the nurse to tell you the blood pressure reading, in numbers.
If you are diagnosed with hypertension, your physician may suggest purchasing a small blood pressure monitor to use at home, to keep regular track of your readings between visits. Monitors start at about $35 and go up from there.
“That gives me a better impression than when they’re in the doctor’s office,” Moore said, noting that the so-called “white coat hypertension” — when a person’s blood pressure is elevated because he or she is in the doctor’s office — is a real factor.
If you check your blood pressure at home, it’s a good idea to take your at-home machine to the doctor’s office on your next trip to have the staff compare its reading to their reading, said Susan Mann, registered dietitian and instructor with Baptist’s Center for Diabetes/Nutrition Education.
Check your foods
Mann teaches classes on hypertension and its management, focusing on the dietary factors that contribute to it — especially sodium.
Sodium lurks in most processed and commercially prepared foods, even ones that you might not suspect. Cheeses and lunch meats, for example, can be packed with sodium.
The current recommendation is no more than 2,300 milligrams a day, equal to about one teaspoon of table salt. But the daily recommendation is for all sodium — not just what you add at the table.
Read labels carefully to check the sodium amount, and note the serving size. But the best way to lower your sodium intake is to prepare meals at home, using fresh ingredients. That way, you control the amount of seasonings.
Salt is a learned taste, Mann said, and if you practice cutting back on it, your tastes will adapt.
If you prefer to follow a prescribed meal plan, one of the best for lowering blood pressure is the Dietary Approaches to Stop Hypertension, or DASH, eating plan, developed by the U.S. Department of Health and Human Services.
U.S. News and World Report has ranked the DASH diet as one of the top commercially available plans on the market, thanks to its nutritional requirements, safety and effectiveness.
“DASH has a lot of fruits and vegetables that are high in nutrients like potassium, magnesium and fiber, and potassium has been associated with lowering blood pressure,” said Catherine Loria, nutritional epidemiologist with the National Heart, Lung and Blood Institute.
Loria said DASH also focuses on lean meats, nuts, seeds and legumes and whole grains.
It was originally developed to test the effectiveness of these micronutrients in controlling blood pressure, and if foods in combination could lower blood pressure, Loria said.
It offers the choice between two levels of sodium consumption — 2,300 and 1,500 milligrams per day.
Since its inception more than 15 years ago, it has earned the respect of physicians and dietitians.
“I give the DASH diet to almost all my patients,” Moore said. “I think it’s very legitimate.”
Loria said DASH also helps with portion sizes, which is confusing for some dieters. “The good thing about DASH is that it tells you what a serving size should be.”
Additional sources: American Heart Association, National Heart, Lung and Blood Institute, Baptist Health
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