Doctor’s Tip: Check your blood pressure regularly
Your heart pumps blood through your arteries to your organs and tissues, and blood returns passively to the heart through your veins. The higher blood pressure number (systolic) is the pressure in your arteries when your heart is contracting. The diastolic or lower number is the pressure in your arteries when your heart is in the relaxation phase of each beat.
In countries on the Western diet, which is high in salt, sugar, fat and animal products, hypertension is common as we age, so that eventually 90 percent of Americans have it. However, this scenario is not normal, because in societies on a total plant-based, whole (unprocessed) food, no-added-oil diet without sugar or added salt, blood pressure does not increase as people age — it remains around 105/65 throughout life.
The heart contracts billions of times in a person with average life expectancy. If the heart has to pump against the added resistance caused by hypertension, eventually the myocardium (heart muscle) is damaged, leading to heart failure. Hypertension also damages the delicate organ (endothelium) that lines the arteries, which leads to the following complications: heart attacks, the most common cause of death in the U.S.; strokes, a common cause of death and the most common cause of disability and poor quality of life in America; loss of vision; chronic kidney disease, which can lead to kidney failure; and dementia, including Alzheimer’s.
We have known for decades that when large human populations are studied, the people with blood pressures greater than 115/75 have a higher risk of heart attacks and strokes, particularly if blood pressures are greater than 140/90. The national guidelines in the U.S. used to recommend blood pressures of less than 140/90, and recently the recommended maximum was lowered to 130/80. The problem with these guidelines is that thousands of people still suffer the complications of hypertension if doctors practice guideline-based standard of care.
Brad Bale, M.D. and Amy Doneen, Ph.D., are internationally recognized experts in heart attack prevention and have an amazing track record of preventing heart attacks and strokes in their patients. In their book “Beat The Heart Attack Gene,” they point out that in order to prevent heart attacks and strokes doctors need to practice “optimal care,” rather than standard of care, so that means getting their patients’ blood pressures to less than 120/80, with the caveat that some frail, elderly people do better with somewhat higher blood pressures.
Everyone should check their blood pressure at least a few times a year, and the easiest way to do that is with your own, automatic cuff, available at most pharmacies for around $40 (Omron is a good brand, but buy an arm cuff, not a wrist cuff). Blood pressure machines for public use are available at Glenwood Medical and in some pharmacies. Check your blood pressure at different times of the day, including when you first get up in the morning. Blood pressure goes up during exercise, so wait a few minutes after exercise before checking it.
If your blood pressure is greater than 120/80 more than occasionally, see your doctor. If you have hypertension, request an overnight oximetry to screen for sleep apnea, even if you don’t snore or have other symptoms of apnea. Sleep apnea is a common cause of hypertension.
If your blood pressure is high, you should first make sure you aren’t on medications that can elevate it, such as NSAIDS (e.g. Advil/ibuprofen, Aleve/naproxen); cortisone; and certain anti-depressants such as Effexor and Wellbutrin. If you are overweight, attaining your ideal body weight often resolves hypertension or at least improves it. Mindfulness meditation, regular aerobic exercise and switching to a plant-based, low-salt (sodium chloride) diet helps lower blood pressure and can prevent hypertension from occurring in the first place. The maximum safe dose of sodium per day is 1,500 mg., and most Americans have an intake of well over twice that, so check food labels. Big Food has Americans hooked on salt, sugar and fat, and is shameless about adding salt to virtually everything, including food for children.
These days there are many medications for treatment of hypertension, and your provider can work with you to find one (sometimes more than one is needed) that doesn’t cause side effects. It often takes at least a few weeks if not a few months for lifestyle modification to lower your blood pressure, whereas medication should lower it within days. So consider taking medication while you are working on your lifestyle, and hopefully in time you can back off the pill(s).
Bottom line: High blood pressure can be prevented through optimal lifestyle. If it occurs, it can cause serious and even fatal complications. So it needs to be treated aggressively, through lifestyle modification and/or medications.
Dr. Feinsinger, who retired from Glenwood Medical Associates after 42 years as a family physician, now has a nonprofit Center For Prevention and Treatment of Disease Through Nutrition. He is available for free consultations about heart attack prevention and any other medical concerns. Call 970-379-5718 for an appointment. For questions about his columns, email him at email@example.com.