Hypertension by Dr. A. R. Scopelliti

Hypertension affects about 1 in 4 American adults and is one of the most common worldwide problems afflicting humans. It increases the chance of heart disease and stroke for those affected, so it’s important to understand how to lower hypertension. High blood pressure, aka hypertension risk factors include obesity, drinking too much alcohol, smoking, and family history of high blood pressure. High blood pressure is the most important modifiable risk factor for coronary heart disease (the leading cause of death in North America), stroke (the third leading cause), congestive heart failure, end-stage renal disease, and peripheral vascular disease.

Normal blood pressure with respect to cardiovascular risk is less than 120/80 mm Hg, (however, unusually low readings should be evaluated for clinical significance as well). Prehypertension is a new category emphasizing that individuals with prehypertension are at risk for progression to hypertension and that lifestyle modifications are important preventive strategies. Home blood pressure predicts cardiovascular events much better than do office readings and can be a useful clinical tool. Anyone with hypertension should be monitoring their own BP at home. BP kits are available everywhere, and they are inexpensive. If your blood pressure readings suddenly become low, you should tell your doctor to titrate downwards your medication so that you do not become syncopal, (passing out). The following are the ranges of BP:

Normal – Systolic, (top number) lower than 120, diastolic, (bottom number) lower than 80.

Prehypertension - Systolic 120-139, diastolic 80-99.

Stage 1 hypertension- Systolic 140-159, diastolic 90-99.

Stage 2 hypertension- Systolic equal to or more than 160, diastolic equal to or more than 100

Recommendations to lower blood pressure and thus decrease cardiovascular disease risk include the following:

• Lose weight if overweight. Even a few extra pounds will raise blood pressure.

• Google DASH (Dietary Approaches to Stop Hypertension) for a reasonable diet, which is rich in fruits and vegetables.

• Limit alcohol intake to no more than 1-2 drinks/day.

• Increase aerobic activity (30-45 min most days of the week).

• Reduce sodium intake, learn to read nutritional information labels on products you purchase.

• Maintain adequate intake of dietary potassium, calcium and magnesium for general health.

• Stop smoking and reduce intake of dietary saturated fat and cholesterol for overall cardiovascular health.