What Is Hypertension?


Hypertension is one of the most common chronic conditions in the world and the United States. The Centers for Disease Control and Prevention (CDC) estimates that about 1 in 3, or 76 million, American adults have hypertension. [1] But what is hypertension, why should you care about it, and how can you manage it if you have it?

Hypertension is the official term for high blood pressure. Blood pressure is the force of the blood as it pushes against the walls of your blood vessels. Chronically higher-than-normal blood pressure can raise risk for heart disease, stroke, and other health concerns. The good news is that you can work to manage it and lower your risk for complications.

 

Diagnosis: Blood Pressure Levels in Hypertension


The National Heart, Lung, and Blood Institute (NHLBI) of the National Institutes of Health (NIH) suggest getting your blood pressure checked each year so you can catch it early and begin to treat it. [2].You will probably get it tested at your routine doctor visits.

Blood pressure measurements come with 2 values.

  • Systolic. This is the higher value. It reflects the blood pressure when your heart contracts.

  • Diastolic. This is the lower value. It reflects the blood pressure when your heart relaxes.

The American Heart Association (AHA) and American College of Cardiologists (ACC) give the following values for normal and elevated blood pressure and for stage 1 and 2 hypertension. [3]

Systolic Diastolic
Normal Blood Pressure
120 mm Hg
and
80 mm Hg
Elevated Blood Pressure
120 129 mm Hg
and
80 mm Hg
Stage 1 Hypertension
130-139 mm Hg
or
80-89 mm Hg
Stage 2 Hypertension
140 mm Hg
or
90 mm Hg
 

Who Gets Hypertension?


Why does hypertension happen? Who are the 75 million Americans with hypertension? Some of the risk factors are genetic or non-modifiable. Your risk is higher, for example, if you have a family history of hypertension or are African-American. Risk also increases with age as blood vessels become less responsive and more rigid.

There are many other risk factors that are modifiable, which means you can do something to lower them. Uncontrolled blood sugar with diabetes and high cholesterol are both risk factors for hypertension. Being overweight or obese, having a high-sodium or poor diet, and being physically inactive are additional risk factors for hypertension. Your risk for hypertension also increases if you smoke or are exposed to secondhand smoke

 

Symptoms and Effects of Hypertension


High blood pressure could cause headaches or nausea, but symptoms are not common. In fact, hypertension is known as the “silent killer” because it rarely has noticeable signs, and it can lead to heart disease and stroke, which are the first and fourth leading causes of death in the U.S. That is one reason why you should it tested each year even if you do not have symptoms.

Uncontrolled hypertension puts you at risk for many complications.

  • Stroke

  • Heart attack and heart failure

  • Kidney disease

  • Peripheral arterial disease (PAD) and vascular dementia

These potentially devastating complications can develop without warning, since you may not know that you have high blood pressure unless you measure it. That is why it is important to check your blood pressure regularly.

 

Managing Hypertension with Weight Loss


Do you need another reason to lose weight? How about lowering blood pressure? If you have high blood pressure and are carrying around extra pounds, losing weight can help. At least, that is what dozens of clinical trials have shown. 

You do not need to lose 50 or 100 lb. to get benefits. The research shows that for each pound you lose, you can expect to average a decrease in systolic blood pressure of about 0.5 mm Hg. [5] Each pound counts, and aiming for one or a few pounds at a time can be more motivating than feeling the pressure to lose 50 or 100.

Everyone can use a little help with weight control, especially when the goal is to keep off the extra weight for the long term. Lark Hypertension Pro helps make weight management a habit without it being burdensome. Your coach helps you set goals and track progress towards them, and gives you information and encouragement.

Smart Weight Loss Habits

  • Enjoy real foods instead of bars, shakes, and other diet products.
  • Choose more filling versions, such as fresh, whole fruit instead of dried fruit and juices.
  • Take bigger portions of low-calorie and filling foods, such as vegetables and fish.
  • Take smaller portions of high-calorie, less filling foods, such as desserts, processed snack foods, fatty meats, and fried foods.
  • Eat slowly and savor every bite.
 

Managing Hypertension with Physical Activity


Remember that gym membership you purchased in January as a New Year’s Resolution? It’s time to use it! Exercise and other forms of physical activity – movements as simple as taking the stairs while at work or sweeping the floor at home – can lower your blood pressure.

Type of Exercise (Approximate Decrease in Systolic Blood Pressure): Recommendation Examples Remember…
Aerobic Exercise (5 mm Hg): 150 minutes per week of moderate-intensity
Swimming, brisk walking, hiking, cycling, swimming, aerobics, dancing, rowing, elliptical machine, gardening
You should be able to talk but not sing during aerobic activity.
Dynamic Resistance (5 mm Hg): Each major muscle group at least twice per week
Weight machines, resistance bands, weighted balls, body weight, dumbbells, barbells
You can tone up without looking like a body builder.
Isometric Resistance (5 mm Hg): 3 sessions per week
Planks, wall sits, glute bridge, overhead hold, hand grip. Hold for 1-2 minutes, rest for 30-60 seconds. Repeat.
Building muscle increases your metabolism so you burn more calories all day.

Getting active can get your blood pressure down almost immediately. The effects last for 24 to 48 hours, so it is important to get active most days.

 

Managing Hypertension with Healthy Eating


The foods and nutrients you eat can affect your blood pressure regardless of your weight or any weight loss. Sodium may be the best-known nutrient with a great impact on your blood pressure – and it is a harmful impact! Lowering your intake by 1,000 mg per day or achieving a goal of less than 1,500 mg per day can lower high systolic blood pressure by as much as 6 mm Hg.

On the other side of sodium is potassium. Potassium is a mineral that counteracts the effects of sodium and has a blood pressure-lowering effect. Most Americans get too little, and achieving 3,500 to 5,000 mg per day can lower high systolic blood pressure by up to 5 mm Hg.

Less Sodium! Limit…

  • Pickles, sauerkraut, and olives
  • Cold cuts, other processed meats, and cheese
  • Soy sauce, salad dressings, marinades, and other salty condiments
  • Fast food, such as pizza, burgers, fries, burritos, and Chinese food
  • Processed foods, such as frozen meals, chips, pretzels and other snack foods, and baked goods including bread and cake.
  • Canned soups and broths
  • Other salty canned goods, such as canned vegetables, tomato sauce, and chili

More Potassium! Choose…

  • Leafy green vegetables
  • Vegetables such as tomatoes, broccoli, and mushrooms
  • Beans (dried or low-sodium canned), lentils, soy products, and dried peas
  • Fish, such as salmon, tuna, and cod
  • Fruit, including cantaloupe, orange, banana, pear, mango, and kiwi
  • Whole grains, such as bran cereal, brown rice, and whole wheat pasta
  • Avocados
  • Milk and yogurt
  • Starchy vegetables, such as acorn, butternut, and other winter squash, sweet potatoes, and potatoes
  • Nuts, peanuts, and seeds

It is not only sodium and potassium that count. A generally healthy diet can lower systolic blood pressure by as much as 11 mm Hg. A simple pattern to follow is the Dietary Approaches to Stop Hypertension (DASH) diet. It includes more vegetables, fruit, and dairy products than the average American consumes, and fewer added sugars and unhealthy fats[6]. The stunning clinical trial that originally investigated DASH found that it lowered blood pressure within two weeks!

DASH Diet Made Simple

To go from a typical American diet to a DASH-style pattern of eating…

Increase certain nutrient-dense foods:

  • Have more vegetables and fruit.
  • Choose whole grains, such as whole-grain bread, cereal, and pasta, and brown rice.
  • Include reduced-fat dairy products, such as milk and yogurt.
  • Eat more seafood.
  • Include nuts, peanuts, and legumes.

Limit certain less-nutritious foods:

  • Limit refined grains, such as white bread, pasta, rice, and crackers.
  • Eat less fried food.
  • Save sugar-sweetened foods for occasional treats.
  • Trim fat and skin from meat and poultry.

The nutrition coaching in Lark Hypertension Care is based on healthy eating to lower blood pressure. It can help you make better decisions, one by one, to support lower blood pressure without stress.

 

Medications for Hypertension


Your doctor is likely to prescribe blood pressure-lowering medications if lifestyle changes do not get your blood pressure down to goal levels. There are several types that act in different ways to lower blood pressure. The medication or medications your doctor recommends depend on your individual factors.

These are some of the main classes of medications to lower blood pressure.

  • Angiotensin-converting enzyme (ACE) inhibitors: They block the production of angiotensin II, which is a hormone that narrows blood vessels and raises blood pressure.

  • Angiotensin II receptor blockers (ARBs): These prevent the hormone angiotensin II from binding to its receptors in the blood vessels, so they don’t narrow.

  • Calcium channel blockers: These let blood vessels relax and lower blood pressure because they prevent calcium from entering muscle cells of your heart and blood vessels, which is what allows them to contract.

  • Diuretics (water or fluid pills): These help your body eliminate excess sodium, which helps your body eliminate excess water, and lowers blood pressure.

These and other classes of antihypertensive medications can help get your blood pressure under control, but there is a catch: you have to use them if you want them to work! Only about half of adults take their meds properly all the time[7]. Lark can help with some of the common barriers by reminding you and tracking your use.

 

Help with Hypertension


If you have high blood pressure, you can help yourself in a big way by taking charge. Your healthcare team can support your blood pressure management, but self-management may be the most effective tool you have to lower blood pressure. By eating better, getting active, monitoring your blood pressure at home, and taking your medications as prescribed, you can do your part in controlling blood pressure and improving health.

These lifestyle changes can be challenging, but you do not have to make them alone. Lark can coach you through these and more strategies for controlling blood pressure, and be your guide as you manage your blood pressure.


Reference

  1.  Centers for Disease Control and Prevention. About High Blood Pressure. Reviewed July 18, 2018. https://www.cdc.gov/bloodpressure/about.htm

  2.  National Heart, Lung, and Blood Institute. High Blood Pressure. National Institutes of Health. https://www.nhlbi.nih.gov/health-topics/high-blood-pressure

  3.  2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol 2018;71:e127-e248 http://www.onlinejacc.org/content/71/19/e127?_ga=2.204312528.1948270614.1550184802-608566656.1548798866

  4.  Neter JI, Stam BE, Kok FJ, Grobbee DE, Geleijnse JM. Influence of weight reduction on blood pressure: A meta-analysis of randomized controlled trials. Hypertension. November 2003. Vol 42, Issue 5. https://www.ahajournals.org/doi/full/10.1161/01.HYP.0000094221.86888.AE

  5.  2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol 2018;71:e127-e248 http://www.onlinejacc.org/content/71/19/e127?_ga=2.204312528.1948270614.1550184802-608566656.1548798866

  6.  National Heart, Lung, and Blood Institute. DASH Eating Plan. National Institutes of Health. https://www.nhlbi.nih.gov/health-topics/dash-eating-plan

  7.  Health and Human Services. Improving medication adherence among patients with hypertension: A tip sheet for health care professionals. Updated February 2017. https://millionhearts.hhs.gov/files/TipSheet_HCP_MedAdherence.pdf