High Blood Pressure: Fighting the “silent killer”

Most Americans over age 60 have high blood pressure. Patients with high blood pressure have a much higher risk of heart disease and stroke. Fortunately, you can do many things to help control your blood pressure. For some people, a better diet and more exercise will be enough. For others, medications are needed. The following information can help you understand your risk and follow a plan to reduce your blood pressure to a safer level.

What is high blood pressure?

High blood pressure, also known as hypertension, means that the pressure of the blood in your arteries is higher than it should be. It is called the “silent killer” because it usually doesn’t show any symptoms or signs. In most cases, it is difficult to know what causes high blood pressure. It usually can’t be cured, but you can do many things to bring your pressure to normal levels.

Why is blood pressure important?

High blood pressure can cause heart attack and stroke, two of the most common causes of death and disability in the United States. Because you may not know that you have high blood pressure, it’s important to be checked regularly. It’s also important to follow your doctor’s instructions about how to treat high blood pressure.

What does your blood pressure mean?

Your blood pressure is written as two numbers. The top number is the “systolic” pressure. This is the force of your blood pushing against blood vessel walls when your heart beats. The lower number is the “diastolic” pressure. This is the pressure in your blood vessels between heartbeats, when your heart is at rest.

What should your blood pressure be?

Ideal blood pressure is 120/80 or lower. The chart below shows different levels of blood pressure.

Classification	Systolic blood pressure	Diastolic blood pressure
Normal	Under 120	Under 80
Pre-hypertension	120-139	80-89
Stage 1 hypertension	140-159	90-99
Stage 2 hypertension	Over 160	Over 100

Know your blood pressure level

Have your blood pressure checked regularly, and always rest for a few minutes before it is measured. It’s often helpful to have your blood pressure checked more than once. You can measure your own blood pressure, using home monitors or machines at stores.

What can you do to control high blood pressure?

The good news is that you can do many things to help control high blood pressure. Exercise, healthy eating, and weight loss are a great start. They can improve your blood pressure and reduce your risk of heart disease.

Some very useful information for patients is provided by the government’s National Institutes of Health, http://www.nih.gov/ , and the American Heart Association, http://www.americanheart.org.

Diet

You can help to reduce high blood pressure by making a few changes in the way you eat.

Limit salt. Salt (sodium) causes your body to hold extra fluid, which makes your heart work harder. To eat less sodium:

• Use less salt in cooking.
• Eat fewer processed foods, such as canned soup, boxed snacks, or frozen dinners, since they contain a great deal of salt.
• Look at sodium levels on food labels to avoid high-salt products.
• Each more fresh fruits and vegetables.

Limit alcohol. Alcohol can raise your blood pressure. If you drink more than about two drinks a day, you may need to cut back.

Do DASH! A major government study proved that a better diet can lower high blood pressure. For more information, visit the National Institutes of Health website at: www.nhlbi.nih.gov/health/public/heart/hbp/dash/new_dash.pdf.

DASH: Dietary Approaches to Stop Hypertension
HIGH IN:	LOW IN:
fruits and vegetables	red meat
low fat dairy	sugars, sweets
whole grains	saturated fats
nuts	cholesterol
poultry and fish

Exercise

Regular, moderate activity can lower blood pressure, help control weight, and reduce your risk of heart disease, diabetes, high cholesterol, and stroke.

• First, ask your doctor if you should have any limits on physical activity
• Begin slowly, and when you can, try more challenging activities.
• Set goals for yourself so you can measure your progress and celebrate your success.
• Plan an exercise schedule, and choose a time of day that works best for you.
• Do activities you like, such as walking, swimming, or riding a bike.
• Stay motivated by exercising with friends or family, doing a variety of activities, joining a gym or exercise class, and signing up for special events that involve exercise.

YOUR GOAL: Be physically active…

• at least 30 minutes a day
• most, if not all days of the week

Stop smoking

If you smoke, you should quit. Smoking increases your risk of having a heart attack or stroke (in addition to many kinds of cancer).

When are prescription drugs needed?

If lifestyle changes aren’t enough to lower your blood pressure, you may need a medication. It is very important to take your medication every day as prescribed, or it won’t work well. If you stop taking your medication for any reason, call your doctor to talk about it.

Many kinds of medications control blood pressure and reduce the risk of heart attack and stroke. National guidelines recommend that a thiazide diuretic be the first choice to treat hypertension for most patients. Very large studies have shown that thiazide diuretics are equally or more effective than other medications. They are safe, effective, and very inexpensive.

For patients with heart disease, diabetes, and kidney problems, other medications may be needed. ACE inhibitors are usually the best choices for these patients. For patients with coronary artery disease, beta-blockers are generally used.

Many patients will need more than one medication to reduce their blood pressure. If you think you have side effects related to your medication such as tiredness, coughing, or headache, tell your doctor how you are feeling. Talk with your health care professional if you think you might stop taking your medication for any reason.

Affordable medicines for blood pressure are available for most patients. Talk to your doctor if the cost of your prescriptions is a problem.