The Healthy Heartbeat - Volume 1

Redefining Hypertension

High blood pressure, also called hypertension, is the most common risk factor for stroke and heart disease. Blood pressure measures the force blood exerts on the walls of your blood vessels. If you have high blood pressure, your heart has to work extra hard to pump your blood. Over time, this puts you at risk for heart disease and stroke. High blood pressure is also linked to kidney disease, aneurysms, eye damage, sexual dysfunction, and other conditions. Because high blood pressure does not cause symptoms, it is known as a “silent killer,” second only to smoking as a cause of preventable heart disease and stroke deaths.

In 2017, the American College of Cardiology and the American Heart Association released new guidelines for hypertension, or high blood pressure. High blood pressure is not a normal part of aging and the new guidelines are the same for all adults, regardless of age. By lowering the threshold for high blood pressure, the guidelines emphasize the need for earlier intervention to keep blood pressure under control.

Blood pressure is measured with two numbers. Systolic pressure is the first number, and it indicates the maximum pressure your heart exerts when it beats. The second number is diastolic pressure, which measures the maximum pressure in your arteries between heartbeats. The guidelines are as follows:

• Normal is 120/80 mmHg or less
• Elevated blood pressure is 120-129 mmHg systolic and diastolic < 80 mmHg
• Stage 1 high blood pressure is 130-139 mmHg systolic or 80-89 mmHg diastolic
• Stage 2 high blood pressure is greater than 140 mmHg systolic or greater than 90 mmHg diastolic

Monitoring Your Blood Pressure

The guidelines stress the importance of monitoring your blood pressure at home. Blood pressure levels should be based on an average of 2-3 readings on different occasions. In addition to providing an average blood pressure number, combining home readings with readings from your doctor’s office can help healthcare providers identify the following:

• White coat hypertension, in which blood pressure is elevated in a medical setting but not in everyday life. People with white coat hypertension feel stressed during their doctor visit, which temporarily raises their blood pressure. They do not have as elevated a heart disease risk as those with sustained high blood pressure.
• Masked hypertension, in which blood pressure is normal at the doctor’s office but elevated at home. People with masked hypertension may have stressors at home or at work that they don’t experience in the doctor’s office. They have a similar heart disease risk as people with sustained high blood pressure.

What the Guidelines Mean

The guidelines for high blood pressure have resulted in both diagnostic and prescriptive changes:

• Before these guidelines were established, 32 percent of the U.S. adult population was considered to have high blood pressure. The new numbers push this up to 46% — nearly half the population.
• This means that 14% more people are now diagnosed with high blood pressure and counseled about lifestyle changes.
• By lowering the definition of high blood pressure, the guidelines call for earlier intervention to keep hypertension from progressing.
• Medication is not recommended for Stage I hypertension unless a patient has already had a cardiovascular event or is at high risk of heart attack or stroke based on age and other health factors.
• Socioeconomic status and psychosocial stress are risk factors for high blood pressure that should factor into a patient’s care plan.

If your blood pressure is higher than the normal range, talk to your doctor. Depending on your numbers, you may need medication, or you may be able to manage it with diet and lifestyle changes, such as eating more fruits and vegetables, reducing your consumption of bad fats and sodium, increasing your level of activity, and losing weight if necessary.

Small Changes for a Healthier Heart

Are you ready to lose fifty pounds and enter a triathlon? Most of us aren’t. Dramatic lifestyle changes can be daunting to undertake and hard to maintain. But making many small changes can become second nature and add up to a big difference in your overall health. Below are some simple modifications that you can start right now. Your heart will thank you!

• Drink more water. When you don't drink enough water, your body can confuse hunger with thirst. Beyond keeping you well-hydrated, drinking more water helps you feel full, which means you’ll be less likely to snack between meals.
• Get a pedometer. Tracking your steps can be very motivating once you realize how many you can get in without even thinking about it! Aim for at least 10,000 steps a day. Find easy ways to get in a few extra steps — park further from the store or take the stairs instead of the elevator.
• Be fat-conscious. Some fats are healthier than others. Increase your consumption of polyunsaturated and monounsaturated fats by eating more avocados, olives, nuts, and fatty fish such as salmon. Limit how much red meat, whole milk, and butter you eat.
• Get chewing. Ever gone through a pint of ice cream in one sitting? It’s easy to overindulge in soft foods like ice cream or mashed potatoes because there’s no chewing to slow you down. Serve yourself a single portion and don’t go for seconds. And never eat ice cream straight out of the carton!
• Make plans that don’t involve food. Instead of going to lunch with a friend, go for a hike or bike ride instead.
• Fill up on fiber. Toss the salty snacks and nibble on nuts, fruits, and raw veggies instead. Replace white rice with cauliflower rice and spaghetti with zucchini noodles. Stuff your omelets with broccoli and peppers instead of ham and cheese.
• Don’t just sit there. Research has linked sitting for long periods of time with obesity, high blood pressure, high blood sugar, high cholesterol, and an increased risk of death from cardiovascular disease. If you have a sedentary job, try to take a standing break at least every hour. Stand while talking on the phone, watching TV, or even doing your work at a high table or counter. Download Break Pal, a program that pops up on your monitor every 30 minutes with a three-minute routine.
• Cut back on alcohol. Not only are those cocktails full of empty calories, but over time, excess alcohol consumption puts you at risk for high blood pressure.
• Eat mindfully. If you’re working through lunch, it’s easy to eat on autopilot. Before you know it, you’ve gone through a bag of salty snacks — which is bad for your waistline and your blood pressure. Instead, take a short break to eat and enjoy your lunch. Sit down to dinner in your home dining area rather than in front of the TV where it’s easy to slip into mindless eating mode. Try stretching or lifting weights during your favorite show rather than reaching for the cookies.
• Find a workout that works for you. Just because your bestie swears by Peloton doesn’t mean it’s right for you. Before you commit to an exercise routine, see what you like. Try swimming, yoga, speed walking… there are so many different ways to get your heart rate going and burn some calories. If you find you crave variety, make mixing it up your routine. Try fitting in a brisk 30-minute walk after lunch and/or dinner.
• Caffeinate without the calories. Replace those two teaspoons of sugar you put in your coffee with a sprinkling of Stevia, a natural sweetener that may help regulate blood sugar. Skip your afternoon trip to the coffee shop to cut back on calories and save a little money too.
• Make your dog happy. Remember, every dog walk is an opportunity for both you and Fido to get some steps in. Find new places to explore with your pup and get walking.
• Take time to decompress. In addition to being a known risk factor for heart disease, stress promotes inflammation and increases a person’s risk of developing type 2 diabetes. When you’re feeling stressed, take a break. Do something that relaxes you, such as meditating, taking slow deep breaths, stretching, or listening to music.