HEALTH and WELLNESS
 

Blood Pressure

~submitted March 2008

Hypertension

Definition:

Defining blood pressure can be a very complex.  It is the mechanism behind how our bodies maintain homeostasis, or balance.  Simply put it is the pressure on the arterial walls created by the contraction of our heart (systole) and the pressure during the relaxation of the heart (diastole).  When these pressures exceed what in considered normal (120 systolic / 80 diastolic) it is referred to as hypertension (140 systolic / 90 diastolic).  Hypertension can be classified into two categories, essential (or primary) and secondary.  Essential hypertension is typically what is seen, accounting for 95% of cases.  Causes of essential hypertension are not always known, but certain traits are identifiable.  For example, essential hypertension is prevalent in societies with a high salt intake and a sedentary lifestyle.  Secondary hypertension only accounts for 5% of cases and is due to a defect in a body organ or system (e.g. Kidney). 

Causes:                      

There are many ways one can arrive face to face with a Physician and be confronted with what is referred to as the “silent killer”, or hypertension.  Genetics, diet (high salt intake), excessive alcohol consumption, stress and a sedentary lifestyle are risk factors.  For many of these the body has combative mechanisms (e.g. baroreceptors, kidneys).  However, with over stimulation and increasing age they will eventually fail and become more, unfavorably, apparent in blood pressure. 

·        Genetics

o       Having a family history of hypertension does put one at a higher risk of developing hypertension.  Suggestion: If a family member has diabetes, had stroke, a heart attack or kidney failure see your physician regularly for a screening.

·        Diet

o       Excess salt may be involved in the hypertension that is associated with advancing age, African American background, obesity, hereditary (genetic) susceptibility, and kidney failure (renal insufficiency). 

o       High cholesterol foods are correlated with high blood pressure.  Cholesterol is necessary in ones diet, but in moderation.  Suggestion: Try using turkey in your burgers instead of red meat, limit the number of eggs you eat each week, eat low fat cheese or simply go without the cheese, try skim milk.

·        Alcohol

o       Although regular alcohol consumption seems to reduce the incidence of atherothrombotic cardiovascular events, excessive alcohol intake increases the risk of many medical problems, including hypertension. Suggestion: A maximum alcohol intake of one drink per day in women and two drinks per day in men is a reasonable goal, if drinking is not otherwise contraindicated.

·        Stress

o       Chronic stress exposes your body to unhealthy, persistently elevated levels of stress hormones like adrenaline and cortisol. Chronic stress can also lead to poor eating habits, alcohol consumption, smoking, and lack of exercise – all of which are risk factors for hypertension.  Suggestions: Regular sleeping and eating habits can make a major contribution to stress reduction. Try taking a short nap during the day.  Use your bedroom for sleeping only; do not work or watch TV there.  Whenever you feel anxious - get things off your chest. Talk to someone you trust.  Avoid caffeine.  Maintain a regular exercise routine, but do not exercise within two to three hours of bedtime.

·        Sedentary lifestyle

o       A sedentary lifestyle increases the risk of many diseases, including diabetes and cardiovascular disease.  These are not the only two, but both of these can result in hypertension.  Suggestions: Make walking a part of your daily routine.  

Effects:

Systemic hypertension has been firmly established as a risk factor for cardiovascular diseases. Stroke, heart attack, kidney failure, and congestive heart failure have all been related to elevated blood pressure, and treatment of hypertension generally has been shown to have a favorable effect on these conditions. 

Medication (Drugs):

There is no ‘magic bullet’ drug.  That is, drugs cannot simply work on the hypertension.  Once they are in the blood stream they are free to act on any part of the body that will allow it.  This results in a wide range of potential side effects.  Typically physicians will prescribe a number of medications to lessen each of these effects.  For example, some drugs may cause lightheadedness while others may cause chest pain.  If a physician gave a patient a higher dose of just one drug that patient would be more likely to see the side effect.  Another reason for multiple drugs is because there are usually multiple mechanisms causing the hypertension.  For example, diuretic drugs are often prescribed in combination with a long-acting calcium channel blocker.  The diuretic works by forcing the kidney to move more water and sodium to the urine.  Whereas long-acting calcium channel blockers slow the heart’s rate of contraction, thus reducing the stress it and on the arterial walls.

There are cases where drugs are necessary and will be the most effective treatment for hypertension.  Usually these medications will be needed for the rest of a person’s life.  It is very important to keep in touch with your physician regarding any and all medications you may think of taking while on antihypertensive drugs (including over the counter and herbal medicine).

Exercise:

If exercising is not a part of your daily routine then you should not start with the intensions of running a marathon.  Exercise should become a part of your lifestyle and training for a marathon is not something you will be doing for the rest of your life. So be realistic and start with activities that interest you.  For example, if you enjoy being outside go for a hike or simply walk throughout your neighborhood.  If you don’t care for the outdoors but love shopping, head for the mall and make sure you cover it twice.

People who exercise regularly have a 25-50% lower chance of developing hypertension.  As well, within 4 weeks exercise can lower your blood pressure 5-15mm Hg.  Suggestions: Use stairs instead of elevators. Get off the bus one or two stops early and walk the rest of the stretch.  Park your car at the far end of the parking lot at work.  Find someone to exercise with - it will help you stay motivated!

Remember, exercise does not need to be a painful experience.  Start out slow and gradually increase your activity level.  Always consult your physician before beginning any exercise program.  Consult a physical therapist for an appropriate medically based exercise program to safely target your goals.

If you have an area of interest, please email it to support@airphysicaltherapy.com
 

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