Hypertension: Making Sense of the Numbers and Tips to Control

Lori Rancik, RN BSN, Case Manager, The Women’s Health Center

Hypertension. What exactly does this word mean? It affects 65 million Americans – about one-in-three – and it is estimated that of these, almost one-third don’t even know they have it.

Additionally, it recently was addressed that many people have been told they have “hypertension;” however, they do not understand what this term actually means. In one scenario, a gentleman had been taking medication for hypertension for five years.

When questioned by a new provider as to why he was taking this medication, he stated, “I have been hyper ever since I was little, and I guess my doctor thought I was just too uptight so he gave me those pills.” As there are many health risks associated with the diagnosis of hypertension, it is important that one understands the meaning, the measurement of numbers as well as the lifestyle choices that can make a difference in the prevention and treatment of this condition called hypertension.

Hypertension is the medical term for high blood pressure. The heart is the pump that forces blood throughout the body by way of blood vessels. Blood pressure is the measurement of force of the blood pushing through and against the blood vessels as the heart beats.

Blood pressure is recorded as two numbers -one over the other – such as 116/64. The top number, which in the medical world is referred to as the “systolic pressure” indicates the amount of pressure when the heart squeezes to pump blood to the rest of the body. The bottom number, “diastolic pressure,” is the force on the blood vessels when the heart relaxes.

Normal blood pressure, according to the American Heart Association is any reading of 120/80 or less. If a blood pressure reading is 120-139/80-89, a diagnosis of pre-hypertension is made. Hypertension is an elevated blood pressure that is recorded as 140-159/90-99 or higher.

When one has his or her blood pressure taken, it is important to know the numbers. In the past, it was acceptable to simply know blood pressure as “good” or “up.” As health care changes, with more emphasis on prevention and wellness, it is necessary that patients have a discussion with their provider so they know exactly what their numbers are and what they mean in relation to overall health.

When a person has high blood pressure, the heart is forced to work harder to pump blood throughout the body. As a result, the blood vessels weaken over time and can lead to damage in major organs such as the heart, brain and kidneys. If left untreated, high blood pressure can lead to life-threatening issues such as stroke, heart attack or kidney failure. High blood pressure has been called “the silent killer” because a person can have it for years and not know.

It is nearly impossible to pinpoint exact causes of high blood pressure; however, some people do have risk factors that increase their chances of having or developing high blood pressure. These risk factors include:

  • Someone in your family has high blood pressure
  • Men over the age of 45
  • Women over the age of 55
  • If you have been told you have pre-hypertension
  • If you are a woman and have had hypertension in pregnancy
  • Diabetes
  • Overweight
  • Diet high in salt
  • Lack of exercise
  • Smoking
  • Excessive alcohol consumption

High blood pressure can be prevented—and lowered—when the following steps are taken:

  • Follow a healthy eating plan, such as DASH (which is explained below), that includes foods lower in salt and sodium.
  • Maintain a healthy weight.
  • Be moderately physically active for at least 30 minutes on most days of the week.
  • Stop smoking.
  • If you drink alcoholic beverages, do so in moderation.

To further explore these steps, it is first important to understand the DASH meal plan. The word dash typically leads one to believe something fast or quick. DASH is a much different meal plan than one that is obtained in the drive-through as you are “dashing” from one place to another. In the context as written, DASH stands for Dietary Approaches to Stop Hypertension.

The DASH eating plan requires no special foods and has no hard-to-follow recipes. It simply calls for a certain number of daily servings from various food groups. The National Heart, Lung & Blood Institute (NHLBI) advises less than 2.4 grams (2,400 mg), or 1 teaspoon, of table salt a day.

A key goal of the DASH diet is reducing how much sodium (salt), you eat, since sodium can dramatically increase blood pressure. It is important to learn to read food labels to identify the amount of sodium. The NHLBI advises less than 2,400 mg per day, or about 1 teaspoon.

The DASH diet is rich in fruits, vegetables, nuts/beans/seeds, low-fat and nonfat dairy, and includes whole grains, heart healthy fats, and moderate amounts of lean meat/fish/poultry. Based on a daily diet of 2000 calories, the recommendation is:

  • 7 – 8 servings of grains (include at least 3 whole grain foods each day)
  • 4 – 5 servings of fruits
  • 4 – 5 servings of vegetables
  • 2 – 3 serving of low fat dairy
  • 2 or less servings of lean meats
  • 4 – 5 (per week) servings of nuts, seeds and legumes
  • Limited fats and sweets

Another important step is to maintain an ideal body weight. Combining DASH with a regular physical activity program, such as walking or swimming, will help you shed pounds and stay trim for the long term. By limiting calories, even 100 at a time, one is able to reach a healthy weight. Suggestions such as eating one cup of cereal instead of two, adding lettuce and tomato instead of cheese to your sandwich and ordering thin crust rather than thick crust pizza can be helpful in reaching one’s goal.

Physical activity can start with a simple 15-minute walk during your favorite time of day and gradually increase the amount of time you are active. Get active any way that you find pleasurable and fun. The recommendation is 30 – 60 minutes of physical activity on most days of the week.

The final steps are healthy choices about smoking and alcohol use. The nicotine in tobacco causes blood vessels to constrict, or narrow, limiting blood flow and raising blood pressure. Partner with your provider to discuss options to help you stop smoking. Alcohol consumption should be limited to no more than two drinks a day for men and one drink per day for women.

One last note is the use of medications in the treatment of hypertension. There are many medications that lower blood pressure. They all work in different ways. There are some necessary things to do if you are prescribed medications:

  • Know the name of each medication
  • Carry a list of medications with you at all times
  • Know how and when to take medications
  • Talk to your provider about herbs, supplements and vitamins you are taking
  • Do not stop medications without calling your provider

You have the power to lower your blood pressure and live a full and healthy life. Knowing your numbers, following a meal plan such as DASH, monitoring your weight, maintaining an active lifestyle, limiting alcohol and tobacco and taking medications as prescribed can all prove beneficial in the prevention and treatment of hypertension.

The Women’s Health Task Force is a small group volunteering their time to educate women and families on important health issues. If you have an interest in health, work in a caring profession, or just want to volunteer with other sincere women, consider attending our monthly planning meetings.

These meetings are held the first Thursday of the month beginning at 12 p.m. All interested persons are encouraged to attend. Additional information is available by calling Robin Kuleck, Penn State Extension, at 814-765-7878.

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