HEALTH CONDITIONS -
High Blood Pressure (Hypertension)

Two of the major risk factors for cardiovascular disease are high blood pressure (hypertension) and high blood cholesterol. Nine out of ten Americans will develop high blood pressure during their lifetime, and nearly 70% of people with hypertension do not have it under control.

"High blood pressure is a time bomb in your blood vessels, just waiting to explode in a stroke or heart attack," says Pat Kendall, Ph.D., R.D., a nutrition specialist at Colorado State University Cooperative Extension. "It just keeps ticking away, speeding the artery-clogging process until the blood vessels finally burst."

What is High Blood Pressure?

Blood pressure is the force that circulates blood through our body and is generated by the pumping action of the heart and is regulated by a complex interaction of nerve signals and chemicals from the kidneys and several glands in our bodies.

Our blood pressure is constantly changing – increasing with exercise, excitement and stress; decreasing with rest and relaxation. When blood pressure increases, the small blood vessels that branch off from the arteries become constricted, making it more difficult for blood to pass through them (just like a kinked garden hose, the water flow is decreased) and causes the pressure against the artery walls to increase. This causes the heart to pump harder and over time the effects can be extremely harmful.

Blood pressure is measured by two numbers, one displayed over the other. The top number (systolic) measures the pressure during the heartbeat (or when the heart contracts and pumps blood through the body). The bottom number (diastolic) measures the pressure between heartbeats (or when the heart is resting).

Effects of Hypertension

Hypertension tends to speed up the process of hardening of the arteries (atherosclerosis). Atherosclerosisis the build up of plaque – fatty deposits, cholesterol and other substances – on the walls of the arteries and occurs gradually in all people.

As the arteries harden or narrow, the blood supply to the organs is decreased. When plaque ruptures, the debris, or clot, moves through the arteries and may lodge against other plaque build up, further interfering with blood flow. The clot may also block an artery, posing added danger if it breaks off and travels to the heart, lungs, or brain.

High blood pressure is a leading cause of strokes, heart disease, congestive heart failure and kidney disease. Research suggests it may also be a factor in some cases of blindness and Alzheimer's.

Symptoms

Hypertension has no noticeable symptoms and can develop over many years as it silently and painlessly damages tissues and blood vessels. Once warning signs occur, the disease is usually severely advanced:

• Nose bleeds
• Headaches
  Buzzing in the ears
• Dizziness
  Anxiety
• Excessive perspiration
  
• Confusion
• Nausea, vomiting
  
• Loss of vision
• Tiredness
  
• Chest pain
• Muscle tremors
  
• Racing or irregular heartbeats  

NOTE: Even if you do not have any symptoms, you still may have hypertension.

What Can Raise Blood Pressure?

There are two types of hypertension, essential and secondary. Less common is secondary hypertension (5-10% of all cases) and is caused by a pre-existing condition such as a thyroid condition or kidney disease. The vast majority (90-95%) of people with high blood pressure have essential hypertension which has a number of factors associated with its development:

• Generic Factors – a family history of hypertension puts a person at greater risk for developing it
  
• Gender and Age – Males between 35-50, post-menopausal women and people over 70 have a greater risk of high blood pressure
  
• Race – African Americans are more likely to develop hypertension
  
• Lifestyle – overweight, sedentary lifestyle, smoking and stress (causes the walls of the arteries to constrict which raises blood pressure)
  
• Diet –too much salt or fat (salt promotes water retention which makes your heart work harder; fat is linked to plaque buildup in the arteries which can raise blood pressure); excess alcohol (more than 1 glass of wine or 24 oz of beer); softened water (households treated with softened water have salt added to the water); white sugar (can increase sodium retention and stimulate adrenaline production which can cause blood vessel constriction - sugars and simple carbohydrates that convert to sugar in the body may cause high insulin levels, long-term consumption can lead to a rise in blood pressure); caffeine (may temporarily increase blood pressure)
  
• Medical Conditions – Diabetes, Kidney Disease, Sleep Apnea, Pregnancy, Cirrhosis, Cushing's Disease, Thyroid Disease
  
• Medications – Cold and cough remedies (decongestants such as, pseudoephedrine, phenylpropanolamine, dextromethorphan); appetite suppressants with diethylpopion; medications that contain ibuporfen (such as Advil and Nuprin) and antacids (like Rolaids, Alka-Seltzer and Bromo-Seltzer) that contain sodium; contraceptive pills (occurs in some women)
  

Controlling Hypertension

Even small reductions in blood pressure can have vast effects, significantly reducing your risk of stroke and heart disease. The American Heart Association estimates that a reduction in diastolic pressure (bottom number) of just 2 points could lower a person's stroke risk by as much as 15 percent and lower heart disease risk by 6 percent.

• Lose weight if overweight
  
• Exercise regularly
  
• Eat healthy - follow a low-fat, low-salt diet with lots of fresh fruits and vegetables (see DASH Diet)
  
• Manage stress
  
• Limit alcohol intake
  
• Stop smoking
  
• Take medications if prescribed
  
• Check your blood pressure regularly - most pharmacies have a free blood pressure monitoring devices or you can purchase an inexpensive cuff to use at home
  

Research has shown that potassium also lowers blood pressure. Good sources of potassium (in mg) include (1 cup unless noted otherwise):

• Raisins 1089
• Potato, baked w/skin, med 1081
• Lima beans 955
• Tomatoes, canned w/ sauce 909
• Winter squash 896
• Spinach, cooked 839
• Prunes, dried 828
• Prune juice 707
• Bananas 594
• Yogurt, plain, skim milk 579
• Beets, cooked 519
• Brussels sprouts, cooked 504
• Orange juice 496
• Cantaloupe 494
• Melons, honeydew 461
• Apricots, dried 407
• Milk, fat free/skim 407
• Nectarine, 1 med 288
• Dates, 5 dried 271
• Figs, 2 dried, 271

Additional Information

• High Blood Pressure — American Heart Association
• Medlineplus — a service of the U.S. National Library of Medicine and the National Institutes of Health
• Your Guide to Lowering High Blood Pressure — National Heart, Lung and Blood Institute