High Blood Pressure

Taken from a MAYO CLIMC HEALTH LETTER

As many as 50 million Americans have high blood pressure or are taking medication for high blood pressure properly referred to as hypertension. See the table.

Doctors have always recognized high blood pressure as a major risk factor for cardiovascular disease. All stages of hypertension are associated with an increased risk of nonfatal and fatal heart conditions, stroke and kidney disease. The higher your blood pressure the greater your risk.

Lifestyle factors need more attention

There is now a great deal of information dealing with how lifestyle behaviors help prevent and manage high blood pressure. If you have high blood pressure your goal is to lower your systolic level to below 140mm Hg and your diastolic level to below 90 mm Hg. If you have high-normal blood pressure, family history of hypertension, and at least one lifestyle factor that contributes to high blood pressure as you age, you're more likely to develop hypertension.

To lower blood pressure the following lifestyle changes are recommended:

Lose excess pounds

If you are overweight, losing as few as 10 pounds may cause a meaningful drop in blood pressure. Weight loss also can enhance the blood pressure-lowering effects of medications.

Limit alcohol

If you have high blood pressure, limit alcohol to no more than 2 ounces of 100 proof liquor, 8 ounces of wine, or 24 ounces of beer a day. Better yet, especially for athletes. It is suggested that alcohol be avoided altogether.

Exercise

Regular, moderate activity such as 30 to 45 minutes of brisk walking three to five times a week, may help prevent and treat high blood pressure. People who have normal blood pressure, but are out of shape have 20 - 50% increased risk of developing; hypertension compared to more active people. If you have high blood pressure, regular physical activity can reduce your systolic blood pressure by about 10 mm Hg.

Limit sodium

Only about 10 percent of Americans and half the people with hypertension are "sodium (table salt ) sensitive". If you are sodium sensitive, salt may raise your blood pressure. Cutting back may lower it. Don't smoke- Smoking cigarettes doesn't cause high blood pressure. But, smoking is a major risk factor for cardiovascular disease. That is why everyone, especially people with high blood pressure, need to quit smoking or never start. Smoking reduces the value that healthy lifestyle practices contribute to reducing your risk of cardiovascular disease.

A lifestyle change may be enough

For many, losing weight, exercising regularly, not smoking and limiting salt and alcohol intake are enough to lower blood pressure and keep it down. For others, these lifestyle changes may not be enough to control hypertension, but they may reduce the number and doses of medications needed to control high blood pressure.

BLOOD PRESSURE CONDITIONS

Condition	Systolic	Diastolic	What to do
Normal	< 130	< 85	Recheck in 2 years
High- Normal	130-139	85-89	Recheck in 1 year
Hypertension
Stage 1	140-159	90-99	Confirm in 2 mos.
Stage 2	160-179	100·108	See MD in 1 mo.
Stage 3	180-209	110-119	See MD in 1 wk.
Stage 4	>210	>120	See MD immediately