Blood
Pressure Matters
About
1 in 3 adults in the U.S. has high blood pressure, but many don’t realize it.
High blood pressure is sometimes called a “silent killer,” because it usually
has no warning signs, yet it can lead to life-threatening conditions like heart
attack or stroke. The good news is that high blood pressure, or hypertension,
can often be prevented or treated. Early diagnosis and simple, healthy changes
can keep high blood pressure from seriously damaging your health.
Normal
blood flow delivers nutrients and oxygen to all parts of your body, including
important organs like your heart, brain, and kidneys. Your beating heart helps
to push blood through your vast network of blood vessels, both large and small.
Your blood vessels, in turn, constantly adjust. They become narrower or wider
to maintain your blood pressure and keep blood flowing at a healthy rate.
It’s
normal for your blood pressure to go up and down throughout each day. Blood
pressure is affected by time of day, exercise, the foods you eat, stress, and
other factors. Problems can arise, though, if your blood pressure stays too
high for too long.
High
blood pressure can make your heart work too hard and lose strength. The high
force of blood flow can damage your blood vessels, making them weak, stiff, or
narrower. Over time, hypertension can harm several important organs, including
your heart, kidneys, brain, and eyes.
“Hypertension
is a leading risk factor for death and disability worldwide,” says Dr. Paul
Whelton, an expert in hypertension and kidney disease at Tulane University.
“High blood pressure raises the risk of having a heart attack, heart failure,
stroke, or kidney disease.”
Anyone,
even children, can develop high blood pressure. But the risk for hypertension
rises with age. “Once people are in their 60s, about two-thirds of the
population is affected by hypertension,” Whelton says.
Excess
weight or having a family history of high blood pressure also raises your risk
for hypertension.
African
Americans are especially likely to get hypertension. Compared to Caucasian or
Hispanic American adults, African Americans tend to develop hypertension at a
younger age and to have a higher blood pressure on average.
Because
it usually has no symptoms, the only way to know for sure that you have
hypertension is to have a blood pressure test. This easy, painless test
involves placing an inflated cuff with a pressure gauge around your upper arm
to squeeze the blood vessels. A health care provider may then use a stethoscope
to listen to your pulse as air is released from the cuff, or an automatic
device may measure the pressure.
Blood
pressure is given as 2 numbers. The first number represents the pressure in
your blood vessels as the heart beats (called systolic pressure). The second is
the pressure as your heart relaxes and fills with blood (diastolic pressure).
Experts generally agree that the safest blood pressure—or “normal” blood
pressure—is 120/80 or lower, meaning systolic blood pressure is 120 or less and
diastolic pressure is 80 or less.
“Hypertension
is defined as having an average blood pressure of above 140/90,” says NIH’s Dr.
Lawrence Fine, who oversees research on the treatment and prevention of
hypertension. Since blood pressure can vary widely from day to day, a diagnosis
of hypertension is usually based on an average of 2 or more readings taken on 2
or more occasions.
If
your blood pressure falls between “normal” and “hypertension,” it’s sometimes
called prehypertension. People with prehypertension are more likely to end up
with high blood pressure if they don’t take steps to prevent it.
“We
know we can prevent high blood pressure through diet, weight loss, and physical
activity,” Whelton says. “We can also treat it, and we can treat it
effectively.”
If
you’re diagnosed with high blood pressure, your doctor will prescribe a
treatment plan. You’ll likely be advised to make healthy lifestyle changes (see
the Wise Choices box). You may also need to take medications. The goal of
treatment is to reduce your blood pressure enough to avoid more serious
problems.
How
low should you aim when reducing your blood pressure? The answer depends on
many factors, which is why it’s important to work with your doctor on blood
pressure goals. Most current guidelines recommend aiming for a systolic
pressure below 140. These medical guidelines are sometimes adjusted as new
research is reported.
A
large NIH-funded study recently found there may be benefits to aiming for a
much lower systolic pressure—120 or less, instead of 140—at least for some
people. The study looked at adults ages 50 and up who had increased risk for
cardiovascular disease but didn’t have diabetes. Half aimed for a systolic
pressure of 120. The rest aimed for a pressure of 140.
NIH-funded
studies have clearly shown that healthy lifestyle changes can improve your
blood pressure. “Making even small changes over time can really add up,” says
Kathryn McMurry, a nutrition science expert at NIH. “In terms of diet, our best
advice is to follow the DASH eating plan.”
DASH
stands for Dietary Approaches to Stop Hypertension. “It’s not a diet to go on
for a short period of time, but one that’s meant to be part of a healthy
lifestyle and enjoyed for life,” McMurry says.
The
DASH eating plan requires no special foods. Instead, it provides daily and
weekly nutritional goals. It’s high in vegetables, fruit, whole grains, and
low-fat dairy foods but low in saturated fat and added sugar.
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