Managing High Blood Pressure: Let’s Change the Equation

Nearly half of all American adults have high blood pressure (also known as hypertension), a chronic condition that puts strain on the heart, arteries, kidneys and brain and can lead to many serious threats to health, including heart disease and stroke — as well as the chance of having an untimely death. The good news is that in many cases, with careful management and lifestyle modifications, high blood pressure can be kept at healthier levels.

May is National High Blood Pressure Education Month, a good time to remember what causes high blood pressure, what the risks are, and how it can best be managed. When blood pressure is too high, the heart has to work harder than normal to get blood to all parts of the body, and there is also increased pressure on all of the blood vessels. Blood pressure readings that are regularly above 130/80 are considered high (stage 1 hypertension) — and unhealthy.

Home care nurses at Partners in Care, where I work, and its affiliate, the Visiting Nurse Service of New York, often play a key role in making sure that patients and family caregivers understand and can manage their medical conditions, including high blood pressure, beyond the doctor’s office. To manage hypertension, our nurse-led teams work with patients and caregivers to establish a plan of care at home, help them understand the risks and red flags, and make sure patients and their caregivers know the next steps to take should their condition worsen. Our Partners in Care home health aides are also trained to prepare healthy low-sodium meals that help lower high blood pressure.

First, people need to make sure they have their blood pressure checked regularly. The Centers for Disease Control and Prevention estimates that some 13 million Americans have hypertension but don’t know it. The dangers of untreated hypertension are enormous: High blood pressure is implicated in almost half of all strokes (May is Stroke Awareness Month as well), and is a leading factor contributing to a number of heart conditions.

Some of the risk factors for high blood pressure are unavoidable. These include age — our blood vessels naturally stiffen over time — family history and genetics, gender, and ethnicity. High blood pressure is more common in African American adults than adults of other ethnicities, and statistics vary by gender. Before age 55, men are more likely than women to have high blood pressure. After 55, the situation is reversed, with women more likely than men to develop the condition.

On the other hand, many of the risk factors for high blood pressure are tied to lifestyle — and this is where individuals who are at risk, along with the family members and friends who care for them, can make a great difference. Here are a few important things you can do to help reduce risk of hypertension in yourself or a loved one:

Say no to salt

As with most healthy diets, a nutrition plan for high blood pressure is rich in fruits and vegetables, low in saturated fats and — most especially — low in salt. Packaged foods such as canned soups and canned items in general are loaded with sodium, so be sure to read food labels to check the amount of sodium in packaged foods (in fact, you should avoid packaged foods completely whenever you can). Keeping a food journal is a simple way to hold yourself accountable to your healthy eating goals. Writing down the content on your food labels — such as salt or sugar content levels, or how many servings of fruits and vegetables you have each day — helps you see, manage and plan your diet more effectively.

Get yourself moving

Exercising is important in controlling blood pressure and preventing complications related to hypertension. In addition, getting regular exercise can help you reduce excessive body weight, which is another risk factor for high blood pressure. Just 15 to 30 minutes of light physical activity, three to five days a week, can help reduce your risk for stroke and heart disease. Once you get started, small steps can lead to big progress — so look for ways to build activity into your daily routine: If you live in the city, walk to the mailbox or the corner bodega every day, or get off one stop early and walk a few extra blocks if you ride the bus or subway. If you can’t get outdoors, walk the halls of your apartment building. And if you live in the suburbs or out in a rural environment, try to walk rather than take the car when doing errands.

Mind your medications

If lifestyle changes don’t adequately reduce your blood pressure, your healthcare provider may prescribe medications to improve your blood flow, including diuretics, beta-blockers, ACE inhibitors, or angiotensin II receptor blockers. It is critically important to take the medication you are prescribed, how and when you are supposed to. It’s been reported that nearly 3 out of 4 Americans do not always take their medication as directed. Let your doctor know if a medication disagrees with you — if you face side-effects such as dizziness or swelling — rather than just deciding to stop taking it. Also, you should always bring a list of all your medications to each doctor’s appointment and have your physician update the list.

Stop (or at least reduce) smoking and drinking

Smoking raises blood pressure and can cause strokes — so try to cut back or, better still, stop smoking entirely. Limiting your alcohol consumption is important too, as alcohol can adversely affect some heart medications and is also linked to increased stroke risk. Each person is different, but moderation is crucial.

For more: The National Cancer Institute is one of many health organizations with a plan to help you quit smoking.

Connect to care

It is especially important for those at high risk of hypertension to stay in communication with their physicians and to be aware of high blood pressure and related health risks. As always, it is important to consult your health provider before making significant changes in your diet or fitness routine.

I still remember during Superstorm Sandy in late October/early November 2012, which stranded thousands of vulnerable New Yorkers, our corps of visiting nurses and other frontline caregivers racing around the city to visit homebound seniors who were unable to get their medicines. More often than not, these included hypertension medication — which isn’t surprising, since about 3 in 10 New Yorkers, and 62% of Americans age 65+ — have the condition.

Fortunately, you can begin changing the equation today. Get your blood pressure checked regularly, and then follow up with these healthy steps towards better blood flow, and better health.

Managing High Blood Pressure: Let’s Change the Equation

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