Hypertension is well known as a silent killer. If your blood pressure is high, you probably won’t know it, even if it goes dangerously high. And if your blood pressure stays high over an extended period, the consequences are serious–heart attack, stroke, heart failure and end-stage renal disease to name just a few.
Every time you visit your physician, for whatever reason, the nurse probably wraps the cuff around your arm and takes your blood pressure. That’s a major way of detecting hypertension since at least half of Americans with high blood pressure do not know they have it.
There are also blood pressure monitors in drug stores, supermarkets and other places. It’s a good idea to stop at these machines from time to time, even if you are healthy and fit. Controlling your blood pressure is one of the most important things you can do to preserve your good health.
In addition to these spot checks, there are other signs of vulnerability you can look for, even though hypertension will not give you any direct symptoms.
AGE: High blood pressure can occur at any age, but it is most prevalent among persons age 50 and over. Once you reach that anniversary, you should be more aware of your blood pressure.
Blood pressure fluctutes from moment to moment, so one high reading at the doctor’s office or the supermarket may not mean anything. But it’s reason enough to check it again in the next few days or weeks.
SMOKING: If you’re a smoker, you will probably get hypertension sooner or later. Tobacco raises your blood pressure while you are smoking, and it also has a long-term effect, damaging your arteries and causing them to narrow, making the heart work harder to push blood through.
The best thing you can do is quit, but second hand smoke can have a similar effect. So stay away.
WEIGHT: The more you weigh, the more blood you need to feed your fat cells. And the harder your heart has to work to pump this blood where it’s needed.
Putting a greater volume of blood in your vessels also increases the pressure on the vessel walls. The increased load on the heart may cause it to weaken and become less effective at pumping, causing a buildup of pressure.
SEDENTARY LIFESTYLE: While you’re taking your blood pressure, you may also want to check your pulse. If you exercise regularly and are reasonably fit, your resting heart rate should be in the 70s or 60s, or even lower. That’s good.
If you’re not very active, your heart rate is likely to be in the 80s or higher–normal but not recommended over the long term since it puts more work on your heart and more pressure on your blood vessels.
FAMILY HISTORY: Karen’s grandmother had severely swollen feet and ankles in later life and died in her early 70s from heart failure. Her grandfather died of a stroke, probably related to uncontrolled blood pressure. Her older sister has hypertension and an enlarged heart. Karen knows she is at risk too because hypertension tends to run in families.
TOO MUCH SALT: One reason that hypertension tends to run in families is the old nemesis–salt. Because of their cultural background, some families are more likely than others to be attracted to high-sodium foods–sausages, ham, bacon, olives, anchovies, smoked fish and sauerkraut.
Probably more pertinent, some individuals, and families, are salt sensitive; their bodies have an exaggerated reaction to sodium in the diet.
According to one study, persons who are salt sensitive had an increased risk of death even if their blood pressure was normal. About a quarter of Americans with normal blood pressure and 58 percent of those with hypertension are salt sensitive.
RACE: African Americans have an increased likelihood of being salt sensitive. And they also are more likely to develop hypertension and to do so at an earlier age. Strokes and heart attacks are also more common among African Americans.
WEIGHT FLUCTUATIONS: Jack was a big fan of Reuben sandwiches and would often eat an extra pickle or two at his favorite deli. He noticed that he tended to gain several pounds the next day.
Of course, he had overeaten, but weight gain from extra calories takes longer than a few hours to have its effect. Jack was gaining weight because the high-sodium foods were causing his cells to retain fluid.
In women, weight fluctuations can be associated with hormonal changes around the time of the menstrual period. In men, they are more likely caused by salt sensitivity. Jack should try to curb his passion for Reuben sandwiches, reduce the sodium in his diet and monitor his blood pressure.
DIET: Even in persons who are salt sensitive, the amount of sodium in the diet may be less crucial than the balance of sodium and potassium. Potassium helps rid the body of excess sodium, and it also makes blood vessels more flexible.
Potassium is found in apricots, bananas, winter squash and sweet potatoes. And there are other protective substances in these and other fruits and vegetables. The DASH diet (Dietary Approaches to Stop Hypertension) calls for five servings a day of fruits and five of vegetables along with whole grains and low-fat dairy products. If such foods rank low in your diet, you can pretty well count on developing hypertension at some time in your life.
STRESS will cause an almost immediate spike in your blood pressure. And uncontrolled stress over an extended period will have other negative effects–poor eating habits, weight gain, use of tobacco or alcohol.
HEAVY DRINKING: Although moderate drinking–one or two drinks a night–has a positive effect on blood pressure and other cardiovascular risk factors, heavy drinking has a negative effect on the heart, blood vessels and blood pressure.
Knowing your habits–both positive and negative– and your family history will give you a good idea of your risk for developing high blood pressure. The problem affects about half of the population. And even trained athletes who follow a well planned diet can and do get hypertension.
If your blood pressure readings have tended to be a bit high, your doctor may recommend that you get a blood pressure monitor for use at home. The only way of knowing what’s happening inside your blood vessels is to take regular readings several times every day.
REFERENCES:
Veronica Franco, M.D., and Suzanne Oparil, M.D., “Salt sensitivity, a determinant of blood pressure, cardiovascular disease and survival,” Journal of the American College of Nutrition, 2006;25(3):247S-255S.
Daniele del Fruili and the Division of Medicine, Trento, Italy, “Early signs of cardiac involvement in hypertension,” American Heart Journal, 2001;142(6).
Greg Hood, M.D., “Exercise deficiency disorder,” Weekend Call blog, July 15, 2012.
Mayo Clinic Staff, “High blood pressure (hypertension),” MayoClinic.com, August 3, 2012.
“Symptoms and types,” WebMD Hypertension/high blood pressure health center.
“Study shows new link between salt sensitivity and risk of death,” NIH News, February 15, 2001.
William M. Tierney, M.D., et al, “Quantifying risk of adverse clinical events with one set of vital signs among primary care patients with hypertension,” Annals of Family Medicine, 2004;2(3).
Amy L. Valderama, Ph.D., et al, “Vital signs: awareness and treatment of uncontrolled hypertension among adults, United States, 2003-2010,” MMWR, October 12, 2012.
Myron H. Weinberger, “Salt sensitivity of blood pressure in humans,” Hypertension, 1996;27:481-490.
01/08/2013
For more information, sample newsletters or to get on our mailing list contact:
Community Relations
West River Regional Medical Center
1000 Highway 12
Hettinger, ND 58639-753