When blood pressure begins to rise, the advice always seems to start with reduce salt intake. While this can be good advice, it fails to consider the complexity and possible other causes of elevated blood pressure. Risk factors for high blood pressure, also known as hypertension, includes:
- Sedentary lifestyle
- Excessive sodium intake from processed and fatty foods
- Low potassium intake
- Being overweight or obese
- Excessive alcohol intake
- Age greater than 60
- Race – African American adults are at greater risk than Hispanic or Caucasian adults.
- Certain diseases or medications
If high blood pressure is caused by another disease or condition, it is termed secondary hypertension. If there is no identifiable cause found, it is termed primary hypertension. Primary hypertension is the most common form and can be related to the risk factors above.
To understand the risk for hypertension, we must understand the physiology of blood vessels. The pressure inside the blood vessel is regulated by hormones that control the blood volume and pressure. When the blood volume increases so does the pressure. Coronary artery disease can also increase pressure inside the blood vessel due to constriction. When the diameter of the vessel wall narrows due to hardening of the arteries (loss of elasticity) or plaque build-up, it increases the pressure. Over time this can lead to more damage of the arteries and gradual increase in blood pressure. High blood pressure is a major risk factor for stroke and heart disease. Unfortunately, there are approximately 75 million people in the U.S. living with high blood pressure.
So, how do we treat high blood pressure? Lifestyle factors should be the first consideration unless blood pressure is dangerously high. If this is the case, medications and/or hospitalization may be required. But for slightly elevated blood pressure, making a few lifestyle changes can go a long way. Weight loss will help if you are overweight or obese. Exercise can also improve blood pressure over time. But be cautious about exercising if blood pressure is very elevated as exercise will make it go up. Avoid tobacco and excessive alcohol intake since these will make hypertension worse. Stress reduction can also help. Dietary changes include reducing intake of processed foods that are high in sodium and fat and eating more fruits and vegetables rich in potassium. Potassium seems to be protective against the effects of excess sodium. Diets such as the Mediterranean or DASH diet are known to reduce blood pressure and heart disease risk. Some studies also found that getting adequate magnesium and calcium can improve blood pressure. Supplements may be beneficial but nutrients from food is always best.
The question remains however, how much sodium is too much? Americans consume 3,400 mg of sodium per day on average. Current guidelines recommend no more than 2,300 mg of sodium per day. The American Heart Association has lowered the guideline to no more than 1,500 mg of sodium per day for those at risk of heart disease. Some researchers argue that recent studies show limiting sodium too much may do more harm than good. According to them, a very low sodium diet increased the risk for heart disease. Several studies confirm reducing sodium intake improves cardiac risk factors, however the question remains how much should sodium be reduced? We know sodium is necessary for the body to work properly. We do not know for certain how much sodium is needed. Until we can determine this for certain, my advice is “sodium in moderation”. And remember, there is no “one-size-fits-all” when it comes to nutrition. You are an individual so listen to your body and stay healthy!
Cool as a Cucumber
When it comes to handling stress, are you cool as a cucumber or hot as a hot pepper? Stress is present every day but how we choose to handle that stress can impact our physical and emotional well being. So how does stress contribute to heart disease? Stress can increase blood pressure. If you already have hypertension, the increase in blood pressure is more dangerous. Stress can also lead to some unhealthy habits. Habits such as overeating, smoking or drinking too much alcohol can all increase our chances for heart disease. When we are under excessive stress, it is hard for us to take care of ourselves properly. We may not feel like eating healthy, exercising and avoiding those things that are bad for us. If you find yourself always in a hurry to get stuff done, eating to make yourself feel better, working too much or procrastinating to do things, sleeping too little or too much, feeling drained of energy, smoking or drinking alcohol to calm down; you may need some help to handle stress. Here are a few ideas that may help:
- Talk it out. Sometimes it helps to discuss what you are experiencing with a close friend or family member. If you don’t feel comfortable discussing it with someone else, then talk to yourself. Talking out loud may help you work through a decision or emotion with which you are dealing. Prayer is another great way to seek help. Just remember to stay focused on the positives.
- Work it out. When you find yourself in the middle of a stressful situation, find ways to deal with it in the moment. This may include taking several deep breaths, slowly counting to 10, walking away, giving someone a hug or a smile, or slowing down and tackling one thing at a time. Finding a distraction that is appropriate for the situation can help you refocus.
- Reward yourself. This can be a huge motivator to help you get through tough times. Stress can make you feel bad so counteract that with something that brings you pleasure. Be careful with this one. Rewarding yourself with things like food or alcohol is not going to help you in the long run. Try a fun hobby, read a book, spend time with friends, play a sport, take a walk, listen to music or get a massage. This can put you in a better frame of mind to handle stress.
- Practice Relaxation! We forget how to relax when we stay uptight too long. Find ways to help yourself unwind in a healthy way. True relaxation takes practice. Try yoga, tai chi, meditation, prayer or visual imagery. Find a comfortable position. Take slow deep breaths to slow your heartrate. Focus on an object, word or verse. Imagine yourself in a beautiful location while closing your eyes. Play soft relaxing music in the background. After doing this a few times, you will find it easier to relax.
Do you feel relaxed yet?
For more information and tips, check out this page at the American Heart Association.
What works to help you relax? Feel free to share your tips with others in the comments below. If you found this series on heart health useful, please let us know and share with others.
Where does your state fall?
With over one-third (36.5%) of U.S. adults being obese, weight has become a hot topic. Obesity is defined as excess body fat and a body mass index (BMI) of 30 or greater as calculated based on your weight for height. We know excess body weight can be a risk factor for several diseases including heart disease, diabetes and cancer. But for those struggling to attain or maintain a healthy weight, what are some useful strategies that will help. First, you should know your weight and BMI. Here is a helpful online BMI calculator. Second, you should know what weight is realistic for you. Not everyone is healthy at the ideal bodyweight for their height. Take into consideration your body build and muscle mass. If you look like a football player, then a BMI of 30 might be okay for you. Consider having your body fat percentage measured to see if you are indeed obese. BMI is only a calculation and does not take into consideration if you are male, female, young, elderly, athletic or sedentary. Your body fat percentage will give you a better idea of your true body proportion. Third, give thought to why you may be obese. Do you tend to overeat? Are your meals high in calories? Do you stress eat? Are you sedentary most of the time? Do you have a health problem that restricts your ability to exercise? Are you taking medication that makes you gain weight? Are you taking insulin? These are the most common factors we see in weight gain. Fourth, what small changes can you make today in order to promote gradual weight loss. Do you consume too many calories from sugary beverages? Are your portion sizes too large? Do you tend to eat high fat, high calorie foods? Do you snack frequently on sweets or junk food? Do you skip meals during the day and then overeat at night because you are famished? Fifth, remember, you do not gain weight overnight and you cannot lose it overnight. Weight loss is more of a marathon than a sprint. Losing weight too quickly can be harmful to your health and usually leads to regaining the weight later. Slow is better with weight loss so as long as you are making steady progress each month, you are on the right track. A 1-2 pound weight loss each week is considered a healthy weight loss. This equals 4-8 pounds per month or 50-100 pounds per year. Small changes can add up to big rewards over time. Sixth, weight loss is a journey. Having support and inspiration along the way makes a big difference. Surround yourself by people that are living a healthy lifestyle. Find encouragement from others that are at a weight you would like to be. Stay away from those that tempt you with food or activities that do not promote your goals. Seventh, find an activity that you enjoy doing. Exercise does not have to be an intense hour of aerobics or kickboxing. It can be walking the dog, dancing, roller skating, swimming, taking a bike ride or anything else that gets you moving. Staying active does not require an expensive gym membership, a fancy pair of walking shoes or workout equipment. But it must be fun and convenient for you. Sustained weight loss results from lifestyle changes not dieting. Find what works for you and ask for help from your healthcare provider if you are not successful on your own. There are several good resources available that can help you get to your healthy weight. Your heart will thank you.
February is American Heart Month so I thought it would be appropriate to discuss how to keep our hearts healthy. Some tips will not surprise anyone such as don’t smoke, maintain a healthy weight and exercise. But I want to get more specific with what can either prevent or contribute to heart problems. Let’s begin by looking at the top risk factors for heart disease. According to the National Heart, Lung and Blood Institute (NHLBI) (a division of the National Institutes for Health (NIH)), these include high blood pressure, high cholesterol, diabetes or pre-diabetes, smoking, being overweight or obese, sedentary lifestyle, family history of heart disease, unhealthy diet, having preeclampsia during pregnancy and age (greater than 55 for women). Some risk factors we cannot control such as our age, family history or developing preeclampsia during pregnancy. The good news is we can control the other risk factors in most cases by making some diet and lifestyle changes. The first thing we need to know is whether we have any risk factors. Do you have a family history of heart disease? Is your blood pressure normal? What are your blood cholesterol levels? Do you have pre-diabetes or diabetes? Do you smoke? Are you considered overweight or obese? Do you get at least 30 minutes of exercise (in addition to your normal daily activity) most days of the week? Do you get 5 servings of fruits and vegetables most days of the week? Do you limit your sodium and saturated and trans fat intake? How about your stress level? Do you have a healthy outlet for managing stress? How you answer these questions determines what areas need focus for making changes. We are going to look at each modifiable risk factor in a series of posts during the month of February. Look for more information on your risk factor(s).
Other articles in this series:
A Healthy Weight for Heart Health
Blood Pressure and Heart Health
Cholesterol and Heart Disease
Diabetes and Heart Health
Diet and Heart Health
Exercise for Heart Health
Stress Management and Heart Health
For more information, you can find a free 127-page book “The Healthy Heart Handbook for Women” from the NHLBI website. There are other resources for men as well but this one is particularly geared to create awareness of heart disease in women. Heart disease is still the #1 killer of both men and women in the United States. Let’s work on making our heart happy and healthy this February.