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An Overview of High Blood Pressure Treatment
Hypertension, or high blood pressure, is dangerous because it can lead to strokes, heart attacks, heart failure, or kidney disease. The goal of hypertension treatment is to lower high blood pressure and protect important organs, like the brain, heart, and kidneys from damage. Treatment for hypertension has been associated with reductions in stroke (reduced an average of 35%-40%), heart attack (20%-25%), and heart failure (more than 50%), according to research.
High blood pressure is classified as:
Normal blood pressure: less than 120/80 mmHg
Prehypertension: 120-139/80-89 mmHg
Hypertension: greater than 140/90 mmHg
Stage 1 Hypertension:140-159/90-99 mmHg
Stage 2 Hypertension: 160 or greater/ 100 or greater mmHg
All patients with blood pressure readings greater than 120/80 should be encouraged to make lifestyle modifications, such as eating a healthier diet, quitting smoking, and getting more exercise. Treatment with medication is recommended to lower blood pressure to less than 140/90 mmHg. For patients who have diabetes or chronic kidney disease the recommended blood pressure is less than 130/80 mmHg.
Treating high blood pressure involves lifestyle changes and possibly drug therapy.
Lifestyle Changes to Treat High Blood Pressure
A critical step in preventing and treating high blood pressure is a healthy lifestyle. You can lower your blood pressure with the following lifestyle changes:
Losing weight if you are overweight or obese.
Quitting smoking.
Eating a healthy diet, including the DASH diet (eating more fruits, vegetables, and low fat dairy products, less saturated and total fat).
Reducing the amount of sodium in your diet to 2,300 milligrams (about 1 teaspoon of salt) a day or less.
Getting regular aerobic exercise (such as brisk walking at least 30 minutes a day, several days a week).
Limiting alcohol to two drinks a day for men, one drink a day for women.
In addition to lowering blood pressure, these measures enhance the effectiveness of high blood pressure drugs.
High Blood Pressure Diet
Most people know about the strong link between a healthy diet and disease prevention. But did you know that what you eat -- or don't eat -- may lower or prevent high blood pressure? Also, weight loss, if you are overweight or obese, is a safe and effective way to lower blood pressure.
By changing a few simple dietary habits, including counting calories and watching portion sizes to boost weight loss, you may be able to lower your blood pressure -- a proven risk for heart disease. Here's the latest diet information you need.
Does weight affect blood pressure?
High blood pressure is more common in people who are overweight or obese. But studies show that losing weight has benefits in lowering high blood pressure. Losing weight may also help reduce medications needed to control high blood pressure.
If you are overweight, talk to your doctor about a healthy weight loss plan. The best way to lose weight is to move around more -- burning more calories than you take in through exercise and activity. Regular exercise (at least 30 minutes most days) can also help lower blood pressure and strengthen your heart.
Some people are not aware of the calories they consume each day. They may underestimate how much they eat and wonder why they cannot lose weight. Keeping a food diary or written record of your daily food intake is the best way to know what you eat each day.
Writing down the foods you eat, including the portion sizes, can let you see "the real facts" about your food intake. You can then start cutting back -- reducing calories and portion sizes -- to lose necessary pounds and manage your weight and blood pressure.
How does diet influence blood pressure?
Many foods and dietary factors affect blood pressure. Studies show a high-sodium diet increases blood pressure in some people. In fact, some studies show that the less sodium you eat, the better blood pressure control you might have -- even if you're taking blood pressure medications.
Findings also show that potassium, magnesium, and fiber may also affect blood pressure. Fruits and vegetables are high in potassium, magnesium, and fiber and low in sodium. Also, nuts, seeds, legumes, lean meats, and poultry are good sources of magnesium.
Is the DASH Diet effective for lowering high blood pressure?
Dietary Approaches to Stop Hypertension (DASH) was a study of the effect of different dietary patterns on reducing high blood pressure. Researchers found that volunteers who followed the DASH diet had significantly lower blood pressure after just a few weeks.
They also found the lower-sodium DASH diet, which calls for reducing sodium to 1,500 milligrams a day (about 2/3 teaspoon of table salt), resulted in even greater blood-pressure-lowering benefits.
The Department of Health and Human Services and the Department of Agriculture recommend that adults should not consume more than 2,300 milligrams of sodium a day; the recommendations also say that African-Americans, people with hypertension, and people who are middle-aged and older, should not consume more than 1,500 milligrams of sodium a day.
Research has shown reduced risk of coronary artery disease and stroke in women who followed the DASH diet for several years.
What is the DASH diet eating plan?
The DASH diet's eating plan is rich in fruits, vegetables, whole grains, fish, poultry, nuts and legumes, and low-fat dairy. These foods are high in key nutrients such as potassium, magnesium, calcium, fiber, and protein.
Unlike the "typical American" diet, the DASH diet has less sodium (salt), sugar, desserts, sweetened beverages, fats, and red and processed meats.
To start the DASH diet, follow these food groups and serving amounts (based on 2,000-calories a day):
Grains: 7-8 daily servings (serving sizes: 1 slice of bread, 1/2 cup cooked rice/pasta, 1 ounce dry cereal)
Vegetables: 4-5 daily servings (serving sizes: 1 cup raw leafy greens, 1/2 cup cooked vegetable)
Fruits: 4-5 daily servings (serving sizes: 1 medium fruit, 1/2 cup fresh or frozen fruit, 1/4 cup dried fruit, 6 ounces fruit juice)
Low-fat or fat-free dairy products: 2-3 daily servings (serving sizes: 8 ounces milk, 1 cup yogurt, 1.5 ounces cheese)
Lean meat, poultry, and fish: 2 or fewer servings a day (serving sizes: 3 ounces cooked meat, poultry, or fish)
Nuts, seeds, and legumes: 4-5 servings per week (serving sizes: 1/3 cup nuts, 2 tablespoon seeds, 1/2 cup cooked dry beans or peas)
Fats and oils: 2-3 daily servings (serving sizes: 1 teaspoon vegetable oil or soft margarine, 1 tablespoon low-fat mayonnaise, 2 tablespoons light salad dressing)
Sweets: try to limit to less than 5 servings per week. (serving sizes: 1 tablespoon sugar or jelly/jam)
Salt: Aim to cut back to 2,300 milligrams of sodium per day (about 1 teaspoon of table salt). Once your body adjusts to the lower-sodium diet, you can lower your salt intake even further to 1,500 milligrams per day (about 2/3 teaspoon table salt).
Of course, first talk to your doctor or a registered dietitian before starting the DASH diet. They can give you more information on food choices and serving sizes.
Also, even on the DASH diet, calories still count, if you need to lose weight. Your doctor or dietitian can explain how to count calories and portion sizes for weight loss.
Which fruits and vegetables are natural sources of potassium, magnesium, and fibre?
To increase your intake of potassium, magnesium, and fibre naturally, select from the following:
apples
apricots
bananas
beet greens
broccoli
carrots
collards
green beans
dates
grapefruit
grapefruit juice
grapes
green peas
kale
lima beans
mangoes
melons
oranges
peaches
pineapples
potatoes
raisins
spinach
squash
strawberries
sweet potatoes
tangerines
tomatoes
tuna
yogurt (fat-free)
How can I lower sodium in my diet?
To lower the sodium in your diet, try these easy suggestions:
Keep track of the sodium content in the foods you eat. Use a food diary to write down the food, serving size, and amount of sodium.
Aim for less than 2,300 milligrams of sodium each day (about 1 teaspoon of salt per day). Ask your doctor if you should go lower to 1,500 milligrams of sodium each day.
Read the nutritional facts label on every food package. The amount of sodium is listed on the label.
Select foods that have 5% or less of the Daily Value of sodium (this percentage is listed on the nutritional facts label)
Avoid foods that have 20% or more Daily Value of sodium.
Avoid canned foods, processed foods and lunch meats, and fast foods
Use salt-free seasonings in food preparation.
Exercise Tips for Those With High Blood Pressure
Lowering high blood pressure can be a benefit of regular exercise. A sedentary (inactive) lifestyle is one of the top risk factors for heart disease. Fortunately, it's a risk factor that you can do something about. It can also:
Strengthen your heart and cardiovascular system.
Improve your circulation and help your body use oxygen better.
Improve heart failure symptoms.
Increase energy levels so you can do more activities without becoming tired or short of breath.
Increase endurance.
Improve muscle tone and strength.
Improve balance and joint flexibility.
Strengthen bones.
Help reduce body fat and help you reach a healthy weight.
Help reduce stress, tension, anxiety, and depression.
Boost self-image and self-esteem.
Improve sleep.
Make you feel more relaxed and rested.
Make you look fit and feel healthy.
How Do I Start Exercising?
Always check with your doctor first before starting an exercise program. Your doctor can help you find a program that matches your level of fitness and physical condition.
Here are some questions to ask:
How much exercise can I do each day?
How often can I exercise each week?
What type of exercise should I do?
What type of activities should I avoid?
Should I take my medication(s) at a certain time around my exercise schedule?
Do I have to take my pulse while exercising?
What Type of Exercise Is Best?
Exercise can be divided into three basic types:
Stretching or the slow lengthening of the muscles. Stretching the arms and legs before and after exercising helps prepare the muscles for activity and helps prevent injury and muscle strain. Regular stretching also increases your range of motion and flexibility.
Cardiovascular or aerobic exercise is steady physical activity using large muscle groups. This type of exercise strengthens the heart and lungs and improves the body's ability to use oxygen. Aerobic exercise has the most benefits for your heart. Over time, aerobic exercise can help decrease your heart rate and blood pressure and improve your breathing.
Strengthening exercises are repeated muscle contractions (tightening) until the muscle becomes tired.
What Are Examples of Aerobic Exercises?
Aerobic exercises include: walking, jogging, jumping rope, bicycling (stationary or outdoor), cross-country skiing, skating, rowing, high or low-impact aerobics, swimming, and water aerobics.
How Often Should I Exercise?
In general, to achieve maximum benefits, you should gradually work up to an aerobic session lasting 20 to 30 minutes, at least three to four times a week. Exercising at least every other day will help you keep a regular aerobic exercise schedule.
What Should I Include in My Exercise Program?
Every exercise session should include a warm-up, conditioning phase, and a cool-down.
Warm-up. This helps your body adjust slowly from rest to exercise. A warm-up reduces the stress on your heart and muscles, slowly increases your breathing, heart rate, and body temperature. It also helps improve flexibility and reduce muscle soreness. The best warm-up includes stretching, range of motion activities, and the beginning of the activity at a low intensity level.
Conditioning. This follows the warm-up. During the conditioning phase, the benefits of exercise are gained and calories are burned. Be sure to monitor the intensity of the activity by checking your heart rate. Don't overdo it.
Cooldown. This is the last phase of your exercise session. It allows your body to gradually recover from the conditioning phase. Your heart rate and blood pressure will return to near resting values. Cooldown does not mean to sit down! In fact, do not sit, stand still, or lie down right after exercise. This may cause you to feel dizzy or lightheaded or have heart palpitations (fluttering in your chest). The best cooldown is to slowly decrease the intensity of your activity. You may also do some of the same stretching activities you did in the warm-up phase.
How Can I Avoid Overdoing It During Exercise?
Here are a few guidelines to keep in mind for exercise:
Gradually increase your activity level, especially if you have not been exercising regularly.
Wait at least one and a half hours after eating a meal before exercising.
Take time to include a five-minute warm-up, including stretching exercises, before any aerobic activity and include a five- to 10-minute cooldown after the activity. Stretching can be done while standing or sitting.
Exercise at a steady pace. Keep a pace that allows you to still talk during the activity.
Keep an exercise record.
How Can I Stick With Exercise?
Have fun! Choose an activity that you enjoy. You'll be more likely to stick with an exercise program if you enjoy the activity. Here are some questions you can think about before choosing a routine:
What physical activities do I enjoy?
Do I prefer group or individual activities?
What programs best fit my schedule?
Do I have physical conditions that limit my choice of exercise?
What goals do I have in mind? (For example, losing weight, strengthening muscles, or improving flexibility)
Schedule exercise into your daily routine. Plan to exercise at the same time every day, such as in the mornings when you have more energy. Add a variety of exercises so that you do not get bored. If you exercise regularly, it will soon become part of your lifestyle.
Find an exercise "buddy." This will help you stay motivated.
Also, exercise does not have to put a strain on your wallet. Avoid buying expensive equipment or health club memberships unless you are certain you will use them regularly.
Exercise Precautions for People With Heart Disease
Discuss your exercise plans with your doctor.
Review your exercise routine with your doctor regularly. This is particularly important if changes have been made in your medications. Ask your doctor about how any medication changes may affect you and your body's response to exercise before continuing your regular exercise program. New medications can greatly affect your response to activity.
If you are too tired and are not sure if it is related to overexertion, ask yourself, "What did I do yesterday?" Try to change your activities by starting out at a lower level today (but do not exercise if you are feeling very overtired). Pace yourself and balance your activities with rest.
Avoid heavy lifting, pushing heavy objects, and chores such as raking, shoveling, mowing, and scrubbing. Chores around the house may sometimes be tiring, so ask for help.
Ask your doctor what aerobic and strengthening exercises are appropriate for you and which exercises you should avoid.
Avoid even short periods of bed rest after exercise since it reduces exercise tolerance. If you become overly fatigued or short of breath with exercise, take a rest period in a comfortable chair.
Avoid exercising outdoors when it is too cold, hot, or humid. High humidity may cause you to become fatigued more quickly and extreme temperatures can interfere with your circulation and make breathing difficult. Instead, try indoor activities such as mall walking.
Avoid extremely hot and cold showers or sauna baths after exercise.
Do not go up steep hills during your activity, whenever possible. If you must walk on a hilly area, slow your walking pace when going uphill to avoid working too hard. Watch your heart rate closely and change the activity as needed.
Reduce your activity level if your exercise program has been interrupted for a few days (for example, due to illness, vacation, or bad weather). Then, gradually increase to your regular activity level as tolerated.
Do not exercise if you are not feeling well or have a fever. Wait a few days after all symptoms disappear before starting your exercise program, unless your doctor gives you other directions.
If you are short of breath during any activity or have increased fatigue, slow down your activity level or rest. If you continue to have shortness of breath, call your doctor. Your doctor may make changes in your medications, diet, or fluid restrictions.
If you develop a rapid or irregular heartbeat or have heart palpitations, rest. Check your pulse after you rest for a few minutes -- if your pulse is still irregular or above 100 beats per minute, call your doctor for further instructions.
Do not ignore pain. If you have chest pain or pain anywhere else in your body, do not continue the activity. If you perform an activity while you are in pain, you may be doing more harm than good. Ask your doctor or physical therapist for specific guidelines. Learn to "read" your body and know when you need to stop an activity.
Exercise Warning
Stop exercising and rest if you have any of the following symptoms:
Chest pain
Weakness
Dizziness or lightheadedness
Unexplained weight gain or swelling
Pressure or pain in your chest, neck, arm, jaw, or shoulder or any other symptoms that cause concern.
Call your doctor or seek emergency treatment immediately if these symptoms do not go away quickly, or if such symptoms continue to recur.
Stress and High Blood Pressure
Reducing stress can help lower high blood pressure. Stress is a normal part of life. But too much stress can lead to emotional, psychological, and even physical problems -- including heart disease, high blood pressure, chest pains, or irregular heart beats.
How Does Stress Contribute to Heart Disease?
Medical researchers aren't sure exactly how stress increases the risk of heart disease. Stress itself might be a risk factor, or it could be that high levels of stress make other risk factors (such as high cholesterol or high blood pressure) worse. For example, if you are under stress, your blood pressure goes up, you may overeat, you may exercise less, and you may be more likely to smoke.
If stress itself is a risk factor for heart disease, it could be because chronic stress exposes your body to unhealthy, persistently elevated levels of stress hormones like adrenaline and cortisol. Studies also link stress to changes in the way blood clots, which increases the risk of heart attack.
What Are the Warning Signs of Stress?
When you are exposed to long periods of stress, your body gives warning signs that something is wrong. These physical, cognitive, emotional, and behavioral signs of stress should not be ignored. They tell you that you need to slow down. If you continue to be stressed and you don't give your body a break, you are likely to develop health problems. You could also worsen an existing illness.
Below are some common warning signs of stress.
Physical signs
Dizziness, general aches and pains, grinding teeth, clenched jaws, headaches, indigestion, muscle tension, difficulty sleeping, racing heart, ringing in the ears, stooped posture, sweaty palms, tiredness, exhaustion, trembling, weight gain or loss, upset stomach
Mental signs
Constant worry, difficulty making decisions, forgetfulness, inability to concentrate, lack of creativity, loss of sense of humor
Emotional signs
Anger, anxiety, crying, depression, feeling powerless, frequent mood swings, irritability, loneliness, negative thinking, nervousness, sadness
Behavioral signs Bossiness, compulsive eating, critical attitude of others, explosive actions, frequent job changes, impulsive actions, increased use of alcohol or drugs, withdrawal from relationships or social situations
How Can I Cope With Stress?
Here are some tips for coping with stress:
Eat and drink sensibly. Abusing alcohol and food may seem to reduce stress, but it actually adds to it.
Assert yourself. You do not have to meet others' expectations or demands. It's OK to say "no." Remember, being assertive allows you to stand up for your rights and beliefs while respecting those of others.
Stop smoking. Aside from the obvious health risks of cigarettes, nicotine acts as a stimulant and brings on more stress symptoms.
Exercise regularly. Choose non-competitive exercise and set reasonable goals. Aerobic exercise has been shown to release endorphins (natural substances that help you feel better and maintain a positive attitude.)
Relax every day. Choose from a variety of different techniques (see below).
Take responsibility. Control what you can and leave behind what you cannot control.
Reduce causes of stress. Many people find life is filled with too many demands and too little time. For the most part, these demands are ones we have chosen. Effective time-management skills involve asking for help when appropriate, setting priorities, pacing yourself, and taking time out for yourself.
Examine your values and live by them. The more your actions reflect your beliefs, the better you will feel, no matter how busy your life is.
Set realistic goals and expectations. It's OK, and healthy, to realize you cannot be 100% successful at everything all at once.
Sell yourself to yourself. When you are feeling overwhelmed, remind yourself of what you do well. Have a healthy sense of self-esteem.
Get enough rest. Even with proper diet and exercise, you can't fight stress effectively without rest. You need time to recover from exercise and stressful events. The time you spend resting should be long enough to relax your mind as well as your body. Some people find that taking a nap in the middle of the day helps them reduce stress.
How Can I Keep a Positive Attitude When Stressed?
A positive attitude and self-esteem are good defenses against stress because they help you view stress as a challenge rather than a problem. A positive attitude keeps you in control when there are inevitable changes in your life. A positive attitude means telling yourself there are things you can do to improve certain situations and admitting that sometimes there's nothing you can do. To maintain a positive attitude during a stressful situation (or to prepare yourself for a potentially stressful situation), keep these tips in mind:
Stay calm. Stop what you're doing. Breathe deeply. Reflect on your choices.
Always tell yourself you can get through the situation.
Try to be objective, realistic, and flexible.
Try to keep the situation in perspective. Think about the possible solutions. Choose one that is the most acceptable and feasible.
Think about the outcome: Ask yourself, what is the worst possible thing that can happen? (Chances are that won't happen)
Tell yourself that you can learn something from every situation.
How Can I Reduce My Stressors?
While it is impossible to live your life completely stress-free, it is possible to reduce the harmful effects of certain stressors. Here are some suggestions:
First identify the stressor. What's causing you to feel stressed?
Avoid hassles and minor irritations if possible. If traffic jams cause you stress, try taking a different route, riding the train or bus, or car-pooling.
When you experience a change in your life, try to continue doing the things that you enjoyed before the change occurred.
Learn how to manage your time effectively, but be realistic and flexible when you plan your schedule.
Do one thing at a time; concentrate on each task as it comes.
Take a break when your stressors compile to an uncontrollable level.
Ask for help if you feel that you are unable to deal with stress on your own.
How Can I Learn How to Relax?
In order to cope with stress, you need to learn how to relax. Relaxing is a learned skill -- it takes commitment and practice. Relaxation is more than sitting back and being quiet. Rather, it's an active process involving techniques that calm your body and mind. True relaxation requires becoming sensitive to your basic needs for peace, self-awareness, and thoughtful reflection. The challenge is being willing to meet these needs rather than dismissing them.
There are a number of methods you can use to relax, including:
Deep breathing.
Imagine a spot just below your navel. Breathe into that spot, filling your abdomen with air. Let the air fill you from the abdomen up, then let it out, like deflating a balloon. With every long, slow exhalation, you should feel more relaxed.
Progressive muscle relaxation.
Switch your thoughts to yourself and your breathing. Take a few deep breaths, exhaling slowly. Mentally scan your body. Notice areas that feel tense or cramped. Quickly loosen up these areas. Let go of as much tension as you can. Rotate your head in a smooth, circular motion once or twice. (Stop any movements that cause pain!) Roll your shoulders forward and backward several times. Let all of your muscles completely relax. Recall a pleasant thought for a few seconds. Take another deep breath and exhale slowly. You should feel relaxed.
Mental imagery relaxation.
Mental imagery relaxation, or guided imagery, is a proven form of focused relaxation that helps create harmony between the mind and body. Guided imagery coaches you in creating calm, peaceful images in your mind -- a "mental escape." Identify your self-talk, that is, what you are saying to yourself about what is going on with your illness or situation. It is important to identify negative self-talk and develop healthy, positive self-talk. By making affirmations, you can counteract negative thoughts and emotions.
Relax to music.
Combine relaxation exercises with your favorite music. Select the type of music that lifts your mood or that you find soothing or calming. Some people find it easier to relax while listening to specially designed relaxation audio tapes, which provide music and relaxation instructions.
Biofeedback.
Biofeedback helps a person learn stress-reduction skills by using various instruments to measure temperature, heart rate, muscle tension, and other vital signs as a person attempts to relax. The goal of biofeedback is to teach you to monitor your own body as you relax. It is used to gain control over certain bodily functions that cause tension and physical pain. If a headache, such as a migraine, begins slowly, many people can use biofeedback to stop the attack before it becomes full blown.
Once you find a relaxation method that works for you, practice it every day for at least 30 minutes. Taking the time to practice simple relaxation techniques gives you the chance to unwind and get ready for life's next challenge.
Can What I Eat Help Fight Stress?
Your body is able to fight stress better when you take the time to eat well-balanced meals. Eat a variety of foods each day, including lean meats, fish or poultry, whole grain breads and cereals, fruits and vegetables, and low-fat dairy products.
Guidelines for Healthy Eating to Fight Stress
Eat a wide variety of healthy foods to counteract stress.
Eat in moderation -- control the portions of the foods you eat.
Reach a healthy weight and maintain it.
Eat lots of fruits and vegetables per day.
Eat food that is high in dietary fiber such as whole grain cereals, legumes, and vegetables.
Minimize your daily fat intake. Choose foods low in saturated fat and cholesterol.
Limit your consumption of sugar and salt.
Limit the amount of alcohol and caffeine that you drink.
Make small changes in your diet over time.
Combine healthy eating habits with a regular exercise program.
Sleep and Stress
Lack of sleep can contribute to stress. On the other hand, if you are stressed, you may not be able to get good sleep. Either way, if sleep is a problem, try these tips:
Establish a regular sleep schedule. Go to bed and get up at the same time every day.
Make sure your bed and surroundings are comfortable. Arrange the pillows so you can maintain a comfortable position.
Keep your bedroom dark and quiet.
Use your bedroom for sleeping only; don't work or watch TV in your bedroom.
Avoid napping too much during the day. At the same time, remember to balance activity with rest and recovery.
If you feel nervous or anxious, talk to your spouse, partner, or a trusted friend. Get your troubles off your mind.
Listen to relaxing music.
Do not take sleeping pills before talking to your doctor.
Take diuretics or "water pills" earlier, if possible, so you don't have to get up in the middle of the night to use the bathroom.
If you can't sleep, get up and do something relaxing until you feel tired. Don't stay in bed worrying about when you're going to fall asleep.
Avoid caffeine.
Maintain a regular exercise routine but don't exercise within two to three hours of bedtime.