World Hypertension Day is a time to consider the importance of understanding high blood pressure (HBP or hypertension) along with its serious medical complications. This condition affects over 30% of the adult population worldwide – that is more than one billion people around the world.  In a continuing effort to educate the public on the prevention, detection, and treatment of hypertension, the theme of World Hypertension Day 2022 is “Know Your Numbers!”

Blood pressure has been referred to as a “silent killer” because symptoms are often overlooked or misunderstood, while quietly damaging blood vessels. In a stealth manner, it is a leading cause of premature death worldwide. It may be present in those who appear healthy for years before complications occur. The seriousness of high blood pressure cannot be understated since it puts someone at increased risk for numerous conditions including heart disease, stroke, metabolic syndrome, dementia, among others. However, unlike cholesterol, high blood pressure may have visible signs (headaches, fatigue, chest pain, etc) and it is something that can easily be measured and monitored. 

What is blood pressure and how do I know if I am in a healthy range? 

Blood pressure refers to the pressure of circulating blood on the walls of arteries. This measurement is taken using two measurements: systolic blood pressure measures the force the heart exerts on the arteries each time it beats, while diastolic blood pressure measures the force the heart exerts on the walls of the arteries in-between beats. When written and separated by a line, the top number represents systolic blood pressure and the bottom number represents the diastolic pressure. 

According to the American Heart Association, there are five blood pressure categories ranging from normal to hypertensive crisis. 

The only way to know if you have high blood pressure is to test your blood pressure. Fortunately, this testing is not limited to a doctor’s office. Blood pressure can be monitored at home. A recent study highlights the “superiority of unattended clinic BP and out-of-office ambulatory BP measurements” indicating that this data may improve risk stratification and lead to more tailored interventions. While blood pressure may rise and fall over the day, concerns arise when it stays elevated over time because this causes the heart to pump harder and work overtime. 

Benefits of monitoring blood pressure include:

• Early diagnosis of hypertension (especially with diabetes or kidney problems)
• Tracking treatment
• Sense of responsibility and control
• Reduced health care costs from reduced need for clinic visits
• Reconciling readings at doctor’s offices and other places.

For the most reliable readings, the American Heart Association recommends an automatic, cuff style, bicep monitor rather than a wrist or finger monitor. Tips for measuring blood pressure  include the following:

• Avoid smoking, caffeinated beverages, and exercise for 30 minutes prior to measuring
• Rest in a chair for 5 minutes with left arm resting on a flat surface for five minutes prior
• Make sure you are relaxed
• Check to make sure the cuff is placed correctly on the arm (do not put over clothes)
• Measure at the same time every day

Dietary and Lifestyle changes

Good news! There are numerous dietary and lifestyle changes that contribute to improved blood pressure control. These modest changes are practical ways to manage blood pressure and contribute to improved health and longevity. These include:

• Maintain a healthy weight and body composition
  • Gaining weight can increase blood pressure
  • Losing weight can reduce blood pressure
• Stay active and get regular exercise
  • Aim for at least 150 minutes per week (about 30 minutes most days of the week)
• Limit alcohol
• Don’t smoke
• Manage stress
• Adequate hydration
• Improve sleep factors
• Eat a healthy diet
  • Certain foods can increase blood pressure
  • Certain foods can lower blood pressure

One popular dietary plan that helps manage blood pressure is the DASH (Dietary Approaches to Stop Hypertension) plan. This eating pattern is not limited to those looking solely to manage blood pressure – those wanting to manage their weight and health may also benefit from these guidelines. Since what we eat can influence our blood pressure, a healthy eating plan can be used to reduce the risk of developing high blood pressure or lower blood pressure that is already high. It is crucial for those who already have high blood pressure to implement changes to prevent it from getting worse or causing complications.

The foundation of this plan is to increase the consumption of whole foods such as vegetables, fruits, low fat dairy foods, nuts/seeds, whole grains, poultry, and fish. These foods are inherently low in trans fat and saturated fat. Some of the benefits may also come from increased amounts of potassium, calcium, magnesium, and fiber incorporated in this plan. Sweets, added fats, and red meats may be consumed but should be done in a limited manner with controlled portions.  Some basic guidelines include:

• Eat foods lower in fat, salt, and calories
  • The DASH diet limits sodium to 2,300 mg per day (approx. 1 tsp of salt); a lower sodium version restricts sodium to 1,500 mg/day.
• Incorporate spices, herbs, lemon, or vinegar for flavoring instead of salt
• Use less oil, butter, margarine, shortening, and salad dressings

Conclusion

High blood pressure is a pervasive and harmful condition; but prevention and early detection is easy, and modifiable factors are well understood. Use World Hypertension Day 2022 to commit to a healthy diet with plenty of exercise, and “Know Your Numbers!”