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August 15, 2018

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Hypertension: How to Prevent and (Truly) Treat It—Part 1

November 18, 2018

Hypertension is a leading cause of death and disability throughout the Westernized world. In the US, 1 in 3 adults suffers with persistently elevated blood pressure. (1) Systolic blood pressure is the pressure in your vessels when your heart contracts, and diastolic blood pressure is the pressure in your vessels when you heart relaxes. A systolic pressure of 130 or above, or a diastolic pressure of 80 or above is considered diagnostic of hypertension. Many people look at hypertension as an inevitable consequence of aging but this is simply not the case. Researchers have known for decades that people in cultures with different eating and lifestyle habits than our own tend not to develop high blood pressure in old age (2). So, what’s the big deal about having high blood pressure? Over time chronically elevated blood pressure causes damage to your organs leading to complications like kidney disease, blindness, dementia, and of course heart disease and heart failure. You are also at risk for more acute and catastrophic conditions like aneurysms, heart attacks, and strokes. The good news is that your blood pressure is largely under your control, which means you can actively decrease your risk of these dreaded conditions by making a few, impactful behavioral changes.

 

A couple side notes before we dive in, this discussion is in reference to primary or essential hypertension only. Secondary hypertension is a separate entity in which high blood pressure is being directly caused by another disease and is thus treated differently. In addition, this post does not serve as medical advice and any medication change or major lifestyle modification should be made under the individualized guidance of a qualified health care provider.

 

Hypertension is a lifestyle disease so treating it at a core level means addressing each lifestyle factor known to increase one’s risk. Some of these risk factors are obvious, such as smoking. Smoking causes significant damage to your blood vessels and thereby increases your risk of hypertension (3). If you currently smoke, know that there are several modalities available to help you quit in the form of nicotine replacement, support groups, hotlines, and prescription medications. Furthermore, it’s never too late to get healthier by quitting.

 

Other lifestyle factors to consider include alcohol intake, activity level, and sleep. Three or more alcoholic drinks per day has been shown to increase your risk of hypertension (4), as has being sedentary and sleep deprived (5). Regarding exercise, shoot for 150 minutes per week (or about 30 minutes, 5 days per week) of moderate to vigorous intensity activity. However, don’t assume that if you can’t hit this goal it’s not worth trying. Even small amounts of exercise have been shown to be beneficial. In the end, some is always better than none. Also try to minimize prolonged sedentary time. If you have a desk job make a point of getting up regularly to move your body. And cultivate active hobbies like gardening and hiking.

 

Many people wear their chronic sleep deprivation as a badge of honor these days. However, by not valuing adequate, high-quality sleep they are increasing their risk for multiple diseases, including hypertension (6). Shoot for 7-8 hours of uninterrupted sleep per night. This may require making some changes to improve the quality and duration of your sleep, such as keeping consistent bed and wake-up times, avoiding caffeine in the afternoon, and avoiding screens for a couple hours before bed. Know that if you are not making time for sleep now, you are making time to be sick later.

 

Obesity is a leading risk factor for hypertension. Therefore, attaining and maintaining a healthy weight is crucial to having a healthy blood pressure. Obesity is thought to increase risk of hypertension in multiple ways including by chronically stimulating the sympathetic nervous system (which has a “fight or flight” effect), increasing sodium retention, increasing systemic inflammation, and increasing insulin levels. (7) The previously discussed alcohol, sleep, and exercise recommendations help promote a healthy weight, as do the very same foods known to promote a healthy blood pressure, which will be discussed in the next post.

 

Keep an eye out for the second part of this post which will focus on nutrition and dietary tips to achieve and maintain a healthy blood pressure.

 

References

 

1. Merai R, Siegel C, Rakotz M, Basch P, Wright J, Wong B; DHSc.,

Thorpe P. CDC Grand Rounds: A Public Health Approach to Detect and Control Hypertension. MMWR Morb Mortal Wkly Rep. 2016 Nov 18;65(45):1261-1264

 

2. Greger, M. (2016, October 17). How not to die from high blood pressure [Video file]. Retrieved from https://nutritionfacts.org/video/how-not-to-die-from-high-blood-pressure/

 

3. Messner, B., & Bernhard, D. B. (2014). Smoking and cardiovascular disease: Mechanisms of endothelial dysfunction and early atherogenesis. Arteriosclerosis, Thrombosis, and Vascular Biology, 34, 509-515.

 

4. Husain, K., Ansari, R. A., & Ferder, L. (2014). Alcohol-induced hypertension: Mechanism and prevention. World Journal of Cardiology, 6, 245-252.

 

5. Behaviors that increase risk for high blood pressure. (n.d.). Retrieved October 27, 2018, from cdc.gov website: https://www.cdc.gov/bloodpressure/behavior.htm

 

6. Sleep and chronic disease. (2018, August 8). Retrieved November 13,2018, from www.cdc.gov website: https://www.cdc.gov/sleep/about_sleep/chronic_disease.html

 

7. Jiang, S.-Z., Lu, W., Zong, X.-F., Ruan, H.-Y., & Liu, Y. (2016). Obesity and hypertension. Experimental and Therapeutic Medicine, 12, 2395-2399.

 

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