It is a common occurrence to see your doctor for your annual physical exam, which I hope you are doing, and be told that your blood pressure is up. It is estimated that 1 billion people, or 26 percent of the world population suffers from high blood pressure. Rates vary and are as low as less than 10 percent in both men and women in India and as high as more than 65 percent in men and women in Poland. Prevalence rates are rising in the U.S. and expected to surpass 30percent in the next 10years.
High blood pressure, technically known as hypertension, is more common in African Americans and Native Americans. The incidence is lower in Caucasians and Mexican Americans. Rates increase with age and are more common among men, though menopause tends to even out the rates in later life for women.
There are two types of hypertension: primary and secondary. 90-95 percent of cases are primary, or essential hypertension, which means there is no obvious medical cause for the condition. The remainder, 5-10 percent of cases, are secondary, meaning they are caused from a distinct condition, such as kidney, arterial, heart or endocrine disease. The most common cause of secondary hypertension is caused by primary aldosteronism, a disorder whereby the kidney releases too much of a hormone called aldosterone.
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The diagnosis of hypertension is made by measuring the systolic and diastolic blood pressure. The “systolic” is the top number and reflects the blood pressure in the vessels during the heartbeat and the “diastolic” is the bottom number and reflects the blood pressure at rest. The first stage of hypertension is diagnosed when the systolic reading rises above 140-159 or the diastolic reading is 90-99.
The diagnosis is generally confirmed by three separate elevated blood pressure readings one week apart each at a physician’s office. I commonly see patients with “white coat” hypertension whereby their blood pressure rises just by walking into a doctor’s office. It is imperative to have the patient take their blood pressure outside the office setting either at home or a pharmacy to confirm.
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Although there is no one identifiable cause of hypertension, several factors and conditions are associated with high blood pressure; sedentary lifestyle, smoking, stress, obesity, salt sensitivity, alcohol and Vitamin D deficiency. Genetic factors do have a place in the development of hypertension as high blood pressure will run in families.
Treatment begins with diet, exercise and weight loss. Dietary changes should include limiting salt intake, increasing consumption of nuts, fruits, vegetables, fish and poultry while decreasing consumption of red meat, sugar and sweets. Regular intake of magnesium, calcium, potassium and protein helps contribute to blood pressure control.
Alcohol consumption should be limited to no more than one drink daily. Weight loss has a dramatic effect on lowering blood pressure and just taking off a few pounds will drop readings anywhere from 5-10mm.
When traditional treatment is unsuccessful then medications known as antihypertensives are used to control the blood pressure. A simple 5mm drop in blood pressure reduces one’s risk for stroke by 34 percent, coronary heart disease by 21 percent and reduces the likelihood of dementia, heart failure and mortality from cardiovascular disease.
Next time someone tells you to calm down because they think you are going to have a stroke, listen to them!
Dr. Ballard is a Board Certified Internist and Geriatrician with a special interest in Women’s Health. She practices in Enumclaw, 360-825-1389. Dr. Ballard’s comments are informational only and not to be construed as medical advice. Consult your personal physician for any medical issues.
