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Herald Health: What to know about blood pressure

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By Deanna Duff
Special to The Herald
In response to life's challenges, it's not uncommon to hear someone say, "I could feel my blood pressure rising!"
Unfortunately, they may be more correct than they realize. High blood pressure, also known as hypertension, affects an estimated 30 percent of Washington adults 18 years and older.
"Blood pressure control has been identified by the Centers for Disease Control as the main thing in terms of improving one's health and preventing death," says Colette Rush, registered nurse and a coordinator for Washington State Department of Health's Heart Disease and Stroke Prevention program.
Washington is nationally recognized for its efforts in blood pressure education.
Hypertension is a contributor to heart and kidney disease, stroke and peripheral vascular disease (circulatory system issues other than the brain and heart).
Even though it's the most significant, preventable cause of premature death, the prevalence of high blood pressure hasn't improved nationally or statewide in the past 20 years.
"Most people have no idea they have blood pressure because they don't feel sick," Rush said. "They need to be screened and told."
The positive news is that even moderately lowering blood pressure yields tremendous results. Every 5-point decrease reduces the risk of stroke by 34 percent and heart attack by 21 percent. That can be easily accomplished through simple and affordable lifestyle changes.
Accurate reading
It's especially important to be screened if you are 50 years or older, have a family history of hypertension, are obese or already diagnosed with diabetes or chronic kidney disease. However, even those without typical risk factors should be occasionally checked.
Start with a general-care doctor who can follow up with questions and offer a plan if needed.
"With the increasing obesity, I'm definitely seeing more hypertension at younger ages. It's also more emergent in children over the last years," says Dr. Deb Nalty, who practices at the Monroe Clinic.
Regardless of where you go, be your own advocate to ensure precise readings.
"In pretty much every setting across health care, we've found that blood pressure measurements are frequently not taken accurately," Rush says.
There is currently a state and nationwide effort to retrain providers.
The salty truth
Good weight management is beneficial to overall health, including blood pressure. Additionally, limiting salt intake is critical to preventing and reducing hypertension.
"Sodium reduction is fairly easy compared to other, major lifestyle choices," Rush said. "It has a tremendous impact and sometimes blood pressure lowers even within a few weeks."
The average American consumes more than 4,500 mg of salt daily. The recommended amount is less than 2,300 mg -- approximately a teaspoon -- and 1,500 mg for those at risk or already diagnosed with hypertension.
Studies show that the dinner-table saltshaker isn't the main culprit. The CDC estimates 77 percent of salt intake is from fast food, restaurant dining and processed foods.
You don't need to eliminate a food altogether, but read labels and look for low-sodium options. Cooking at home is a great option, but be cautious that you're not ingesting more salt than you think.
"We're not cooking from scratch like we used to. We often start with processed foods to begin with, such as using rice mixes, which have tremendous added sodium compared to the natural version," says Sara Eve Sarliker, manager of DOH's Heart, Stroke and Diabetes Program.
A diet rich in potassium (potatoes, spinach, bananas), magnesium (whole grains, green leafy vegetables and legumes) and calcium (skim or low-fat milk and yogurt) also helps balance and counteract sodium.
If it initially seems daunting, make small adjustments. Salt is an acquired taste, and the palate typically adjusts to lesser amounts within a few weeks.
Nalty's patient Eric Cundy, 48, lost more than 40 pounds in eight months. He lowered his blood pressure enough to avoid taking medication.
"I didn't make actually make huge changes to my diet," says Cundy, who also regularly exercises. "Now I walk past the chip aisle and go straight for fruit. It's a progression."
Sweat, stress, sleep
Get a move on; 30 minutes of moderate walking five times weekly can decrease blood pressure by 10 points. That can be accomplished by walking the dog or parking farther away from the store.
Everett resident Dick Jones began volunteering with the American Heart Association after his mother passed away from a heart attack. He has raised money through numerous walks and half-marathons.
"I started running three to four times a week," Jones says. "When I went back to the doctor, my blood pressure was down. I kept running and was able to go off my blood pressure medication entirely."
Jones inspired his son, who also had hypertension and ultimately suspended medication through exercise.
"I realized it's a better way to go (get off pills)," Jones says. "It's one less thing to worry about in life."
In the majority of cases, healthier decisions can result in either not needing prescriptions at all or at least reducing dosages.
"Many patients are shocked to discover that it can take four to five drugs to get blood pressure under control," Nalty says.
"Typically, one medication lowers it maybe 10 points, a few points more with another. Pills are modestly effective and often have to be used in combinations. They also have side effects."
Ultimately, a cumulative approach is best: diet, exercise and quitting smoking are primary factors.
Reducing long-term stress is beneficial, and so is ensuring quality rest. Sleep deprivation is linked to hypertension and difficulty losing weight.
"We too often take shortcuts with our lifestyles," Nalty says, "but we need to treat these precious bodies of ours the way they deserve."
Story tags » Health

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