One of the most common problems in medicine today is high blood pressure, also called “hypertension.”
Hypertension is a serious medical condition, which occurs when the force of the blood pumping through your arteries is too strong. Having higher blood pressure for short amounts of time is normal. However, when your blood pressure remains high most of the time, that can cause serious health problems.
Hypertension becomes more common for both men and women as they age, but more women have hypertension by the time they reach 65. And about 60% of people with diabetes have high blood pressure.
Hypertension is quantitatively a major modifiable risk factor for premature cardiovascular disease, even more prevalent than cigarette smoking, abnormal lipids, or diabetes, which are the other major risk factors.
So what are some of the potential complications of high blood pressure?
Left ventricular hypertrophy (LVH, which is enlargement of the pumping chamber on the left side of the heart) is a common and early finding in patients with hypertension. LVH is associated with a higher incidence of subsequent heart failure, myocardial infarction, sudden death, and stroke.
Patients have an increased risk of heart failure.
Hypertension is the most important risk factor for the development of intra-cerebral hemorrhage, which is bleeding into the brain.
High blood pressure (HBP) itself usually has no signs or symptoms for years – headaches occur rarely – which is why it is sometimes referred to as “the silent killer,” as it can quietly damage the heart, blood vessels, brain, and kidneys if left untreated.
What can precipitate hypertension?
Genetics, obesity, or even being overweight, a sedentary lifestyle, excessive alcohol consumption, pre-existing kidney or renal disease, excessive salt intake, and potentially stress can contribute to hypertension. We can exacerbate the complications of high blood pressure by having elevated blood lipids, smoking, a diet with excessive saturated fat, and diabetes.
What steps should all of us should take to avoid and treat hypertension?
● Weight loss – Weight loss in overweight or obese individuals can lead to a significant fall in blood pressure independent of exercise. The decline in blood pressure induced by weight loss can also occur in the absence of dietary sodium restriction, but even modest sodium restriction may produce an additive blood pressure lowering effect. Weight loss-induced decline in blood pressure may be in a range of 1 mmHg for every 1 pound lost, but this can vary.
● Dietary salt restriction – In well-controlled randomized trials, the overall impact of moderate sodium reduction is a fall in blood pressure in hypertensive and normotensive individuals.
● Dietary Approaches to Stop Hypertension (DASH) diet – This diet is very similar to a Mediterranean diet. The DASH dietary pattern is high in vegetables, fruits, low-fat dairy products, whole grains, poultry, fish, and nuts; and low in sweets, sugar-sweetened beverages, and red meats. The DASH dietary pattern is consequently rich in potassium, magnesium, calcium, protein, and fiber, but low in saturated fat, total fat, and cholesterol. Spices are fine, but added salt should be restricted. Simple sugars added to a diet should be restricted to no more than 100 calories per day for a woman and 150 calories per day for a man.
● Exercise – Aerobic exercise, and possibly resistance training, can decrease systolic and diastolic pressure.
● Limited alcohol intake – Women who consume two or more alcoholic beverages per day and men who have three or more drinks per day have a significantly increased incidence of hypertension compared with nondrinkers.
An integral part of the Mediterranean or DASH diet is a diet heavy in fruits and vegetables. An added benefit of some of these vegetables is the presence of dietary nitrates that can help lower the blood pressure. The nitrates in many vegetables may keep blood vessels healthy and lower blood pressure. Foods that have a significant amount of nitrates include: cabbage, dill, turnip, savoy cabbage, Chinese cabbage, endive, fennel, kohlrabi, leek, parsley, celery, cress, chervil, lettuce, red beetroot, spinach, and arugula.
If do plan to go on medications for high blood pressure, which are often needed, make sure you understand all the potential side effects and also explore the lifestyle changes above.