High Blood Pressure: An Update
Chester J. Zelasko, Ph.D. | May 20, 2003

Many of us discovered this week that the blood pressure we thought was just fine is now considered prehypertensive. The U.S. government announced new guidelines for determining what is considered high blood pressure (also called hypertension) in adults over 18 years of age (1). For years, a blood pressure of 120/80 mm Hg (systolic blood pressure over diastolic blood pressure measured in millimeters of mercury) was considered normal. Now that's going to be a benchmark for beginning treatment. Should you be concerned about these new guidelines? Heck, yes!

Why change the blood pressure recommendations? The long-term goal is to reduce the rate of cardiovascular and kidney disease. We're living longer, with life expectancy close to 80 years in the U.S. and Canada. While that's good news, it also means that there are more years for heart and kidney disease to develop. Waiting until blood pressure exceeds the old guidelines for treatment of 145/90--usually after age 40 or 50--means that more people will develop heart disease that might have been prevented. To you, that means that although you may live a long time, the quality of your life may be impaired by heart disease. Certainly nothing to look forward to, is it?

Why is hypertension so bad? The Committee stated it succinctly: "The higher the blood pressure, the greater the chance of myocardial infarction (heart attack), heart failure, stroke, and kidney disease."

Why does blood pressure go up? Several reasons:

  • If someone is overweight, each extra pound of fat requires blood vessels, and that significantly increases the amount of pressure required by the heart to carry blood to more vessels.
  • The build-up of plaque in arteries can make arteries stiff; that restricts blood flow and causes the heart to increase the force with which it must beat, which raises blood pressure.
  • High sodium intake and high alcohol consumption pull more water into the blood, creating higher blood volume, which requires more pressure to keep blood circulating.
  • Lack of exercise lets the heart become weaker and less effective so it has to push harder to move the blood. It's like putting a smaller engine in your car--you can still drive fast, but the engine will have to work harder.
  • Stress also contributes to hypertension because of the stress hormones released into the blood.
So what can you do if you are now considered prehypertensive? At Better Life Unlimited, we don't focus on problems, we focus on solutions. In other words, if your systolic blood pressure is between 120-139 mm Hg and/or your diastolic blood pressure is between 80-89 mm Hg, it's time to change your lifestyle. There are five things that you can do to get your blood pressure to optimal levels as recommended by the report:

  • Lose weight. Even a reduction of 10% in body weight can reduce blood pressure by 5-20 mm Hg. That's a great beginning to move into the Optimal Blood Pressure category.
  • Adopt the Dietary Approach to Stop Hypertension (DASH) Diet. This is essentially the same as the Mediterranean diet and includes eating more fruits and vegetables, using low-fat dairy products, and reducing the intake of saturated fats. This approach can reduce blood pressure between 8-14 mm Hg.
  • Reduce sodium intake to no more than 2.4 grams per day or 6 grams of salt. This can reduce blood pressure 2-8 mm Hg.
  • Increase physical activity, especially aerobic exercise. Moderate aerobic exercise, such as walking for 30 minutes per day most days of the week, can lower blood pressure 4-9 mm Hg.
  • Consume alcohol moderately, if at all. Limiting consumption to no more than two drinks per day can lower blood pressure 2-4 mm Hg.
As you can see, the Recommendations Committee gave specific examples of how much a person's blood pressure could be reduced for each lifestyle change an individual might make. That allows a person to set reasonable goals for lifestyle changes one at a time, instead of trying to do everything at once, and that greatly increases the odds of succeeding.

Some skeptical people will think that these new guidelines are nothing more than an attempt to promote more medications. I don't think so--what these new guidelines really mean is that as a society, we've done a lousy job of adopting lifestyles that are conducive to healthy blood pressures. One thing is for sure: you can pay the price of a healthy lifestyle to get your blood pressure under control or you can pay for the drugs later. Either way, you will pay. The choice is yours.

Reference:

  1. Chobanian AV et al. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. The JNC 7 Report. JAMA. 2003;289:2560-2572.
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