Paging Dr. Frischer - High blood pressure

High blood pressure, also known as hypertension, affects roughly one third of all adults in the United States. It is a condition in which the force of the blood against the walls of the arteries is so strong that it can cause serious health problems, such as heart disease. It costs about $47 billion per year, and sadly, only about one-half of those afflicted have it under control. How do we get high blood pressure, and what can be done about it? Roughly 5% of those with hypertension suffer from secondary hypertension. This is high blood pressure caused by an underlying condition, such as kidney disease, thyroid disease, obstructive sleep apnea, alcohol abuse, and some medications. It tends to appear suddenly, and to cause higher blood pressure than does primary hypertension. We won’t address this type of hypertension specifically any further in today’s column.

The overwhelming majority, about 95% of those identified as hypertensive, suffers from primary, or essential hypertension, which has no direct cause. There are, however, a number of risk factors associated with it. The more of them you have, the greater the risk.

Some risk factors are impossible to control:

Genetics. Having a family history of hypertension puts you at a high risk.

Age. Men are more likely to develop high blood pressure around age 45, and women after age 65. Eventually, as we age, most of us will have high blood pressure.

Race. High blood pressure is more common among black people, and may develop at a younger age. This means that complications of high blood pressure (such as stroke, heart attack, and kidney failure) may also strike black people at a younger age.

Other risk factors, however, can be controlled by the lifestyle choices we make:

Risk factor: Being overweight. The higher the weight, the more blood is needed to supply oxygen and nutrients to the tissues. As the blood volume increases, so does pressure on the artery walls. Lifestyle choice: Any weight loss will lower blood pressure. Eat healthful foods including more fruit, vegetables, whole grains, and low fat dairy, and consume less saturated fat.

Risk factor: A sedentary lifestyle. Inactivity leads to a higher heart rate, resulting in more work for the heart and stronger contractions. This increases the force put on the arteries, which increases blood pressure. Lifestyle choice: Increase your physical activity to help lower blood pressure and keep your weight under control.

Risk factor: High salt intake. Too much sodium causes the body to retain fluid, which increases blood volume and consequently increases blood pressure. Lifestyle choice: Limit salt intake. A goal of 1,500 to 2,000 milligrams per day is ideal. Start by avoiding the obvious culprits like fast food, snack foods, and many canned and frozen foods. The majority of people with high blood pressure are “salt sensitive,” meaning that anything more than minimal salt intake increases blood pressure.

Risk factor: Low potassium, calcium, or magnesium. These minerals help to balance the amount of sodium in our cells. Too little can lead to the accumulation of too much sodium. Lifestyle choice: Incorporate sources of these minerals into the diet, or take supplements if necessary.

Risk factor: Tobacco use. Whether it is smoked, chewed, or secondhand, tobacco immediately causes a temporary rise in blood pressure. The chemicals in cigarettes also damage the lining of artery walls, resulting in the hardening of the arteries, which increases blood pressure. Lifestyle choice: You guessed it. Quit smoking.

Risk factor: Too much alcohol. Over time, heavy alcohol consumption can cause heart damage (among other things) and lead to high blood pressure. Lifestyle choice: Add high blood pressure to a host of reasons to drink in moderation (one or two drinks per day at the most). Those who can’t control their alcohol intake must eliminate alcohol altogether.

Risk factor: Stress. What can I say? Stress affects every aspect of our health. Our body’s fight or flight mechanism leads to temporary increases in blood pressure. Lifestyle choice: Discover a method of stress management that works for you. Practice healthful coping behaviors, such as deep breathing, yoga, exercise, massage, meditation, music, and hobbies.

Along with these critical lifestyle changes, there are safe and effective prescription medications that can control elevated blood pressure with very minimal side effects. Some non-prescription alternatives include fiber, cocoa, coenzyme Q10, garlic, omega 3 fatty acids, and probiotics.


Dr. Alan Frischer is former chief of staff and former chief of medicine at Downey Regional Medical Center. Write to him in care of this newspaper at 8301 E. Florence Ave., Suite 100, Downey, CA 90240.



Published: Nov. 27, 2014 - Volume 13 - Issue 33