LivingWell: Tips for keeping your blood pressure in control High blood pressure, known in “medical-speak” as hypertension, measures two numbers. The top number is the systolic pressure and is taken when the heart contracts and pushes the blood out into the arteries with force. The bottom number, called the diastolic pressure, is when the heart is relaxed and the blood is flowing more slowly. Both numbers are important and, when elevated, can lead to stroke, heart attack, kidney failure and blindness, among other problems. A normal blood pressure is below 120/80. A pressure above 130/80 is considered elevated and is where the risk of organ damage starts to increase. A pressure above 140/90 is the beginning of hypertension.
High blood pressure is so common that over half of us will have it by the age of 60, yet most of us won’t even know. That’s why it’s often referred to as a “silent killer” and why prevention is so important. If you already have high blood pressure, don’t despair. The same lifestyle changes that prevent hypertension can also be used to reverse it. So, what can you do to prevent, and if you already have it, reverse hypertension? One of the biggest factors contributing to high blood pressure is excess body fat. Check out a future article where I’ll talk more about ways to tell if you’re overweight, but, for most of us, it’s not usually a secret. Maintaining a normal body weight will prevent almost all, and will actually cure, most cases of high blood pressure. Even if you don’t reach your ideal weight you can expect to see an improvement of about one point in the systolic pressure for every two pounds of weight loss. Eating a healthy diet can make a huge difference in your blood pressure. The DASH diet, which stands for Dietary Approach to Stop Hypertension, can reduce the systolic by 11 points and the diastolic by 3 points. That’s as effective as most of the blood pressure medications we use. You can read a lot more about the DASH diet on the web, but in short, it emphasizes whole, unprocessed foods like fruits, veggies, beans, nuts and seeds while limiting meat and dairy. Be warned, however, that this type of eating comes with some significant side effects which can include weight loss, reversing diabetes and improving cholesterol. So, be careful! Being physically active is also important to preventing and reversing hypertension. Aerobic activity, such as walking, biking, swimming, racquet sports, jogging or rowing, for an hour and a half to three hours a week has been shown to decrease systolic pressure by 8 points and diastolic by 4 points. Again, this is comparable to what we’d expect to see with a blood pressure medication. Dynamic exercises, like weightlifting, squats, push-ups and sit-ups, can also reduce blood pressure by almost 5 and 2 points for systolic and diastolic pressures. Add on top of that isometric exercises and you may see an additional 5 and 4 points drop for the top and bottom numbers for blood pressure. Isometric resistance exercises are those where you flex a muscle without moving the joint. This type of resistance is often referred to as “holding” a position. Examples include planks, wall sits, or holding a squat or lunge position. This might seem like a lot of exercising and make you wonder if you have the time. One way to get more bang-for-the-buck is to do an activity that combines more than one type of exercise. For example, while going for a brisk walk, stop every 10 or 15 minutes and do some lunges or squats. A brisk walk is aerobic exercise while squats are a form of dynamic exercise. Add in some planks or hold some squats for 30 seconds and you’ve added isometrics, and just like that, bada-boom-bada-bing, you’ve got all three! Can you think of any other activities that may combine two or three types of exercise? One of my favorites is yoga. Obstructive sleep apnea (OSA) is one of the primary causes of high blood pressure. OSA is also more common in those who are overweight, so, as you can see, being overweight contributes to high blood pressure in more ways than one. OSA is when the air flow into the lung is blocked by excess tissue, usually fat at the base of the tongue and back of the throat. This can cause loud snoring and interrupted breathing. Blockage of air into the lungs results in low oxygen levels, causing strain on the heart and vascular systems which contributes to high blood pressure, poor sleep and fatigue, and can increase the risk of heart failure and stroke. Treating sleep apnea can help with both weight loss and also directly to lower blood pressure. If you are concerned that you may have OSA you can do a quick screening online. Look up the STOP-BANG questionnaire to answer a few simple questions. In the past, testing required an overnight stay at a sleep lab. In many cases it can now be done in your home from the comfort of your own bed. So, if you suspect you may have sleep apnea talk to your provider about getting tested. Lack of sleep also contributes to hypertension. Our blood pressure should naturally dip lower when sleeping, and those whose blood pressure does not dip have a much higher risk of a heart attack. Several studies have shown that high blood pressure when we’re asleep may be more risky than high blood pressure measured while awake. Most of us do best with between 7 and 9 hours of sleep per night. Several studies have shown that lack of sleep, especially less than 5 hours, is associated with higher blood pressure, as is sleeping more than 9 hours. There are other lifestyle changes that can have a dramatic effect on blood pressure as well including sodium (salt) intake, alcohol, and stress. Certain foods can also be just as effective, or more so, than the blood pressure medications we frequently prescribe. I’ll write more about these in the next article, so stay tuned. Until then, keep Living Well!
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