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Illness prevention and treatment

November 15, 2015

Do you have high blood pressure and not know it?

High blood pressure (or hypertension) is called the silent killer. But there’s a lot you can do to manage this potentially deadly condition.

Maybe you’ve passed the blood pressure monitor at your local pharmacy and thought about testing your blood pressure. Or worried a little about those dizzy spells or nosebleeds you’ve been having.

Given that six million Canadian adults have high blood pressure (also called hypertension), it might be a good idea to check yours.

“High blood pressure is often referred to as the ‘silent killer’ because there are often no symptoms or warning signs,” says Christine LeGrand, a spokesperson for the Heart and Stroke Foundation of Canada. “It is important to know that while you may not be experiencing symptoms, uncontrolled or undiagnosed high blood pressure causes damage to your heart, brain, kidneys and blood vessels.”

And that damage can be deadly.

“Hypertension is the major cause of heart disease, and the number-one cause of stroke,” says Dr. Ernesto Schiffrin, president of Hypertension Canada in Montreal and Canada Research Chair in Hypertension and Vascular Research, Lady Davis Institute for Medical Research. “There is no doubt that it is a major problem for the healthcare system.”

Risk factors for hypertension

Blood pressure is a measure of the pressure of blood against the walls of the arteries. The systolic (top) number is the measure of the pressure when your heart contracts and pushes out the blood. The diastolic (bottom) number is the measure of when your heart relaxes between beats, according to the Heart and Stroke Foundation of Canada.

Your blood pressure is high when it’s over 140/90 if you’re a healthy adult; over 130/80 if you have diabetes; and over 150 (systolic) if you’re over age 80. Genetics, increasing age and your ethnic background may play a part in the development of high blood pressure. As well, certain medications, such as oral steroids, contraceptives, weight-loss drugs, anti-inflammatories and cold and flu medications may contribute to high blood pressure.

But there are a number of lifestyle changes you can make to control it:

  • Eat less salt. Salt raises blood pressure, so minimize canned, smoked, processed and restaurant foods and keep your salt intake to 5 g per day, suggests Schiffrin.
  • Maintain a healthy body weight. If you’re overweight or obese, you’re more at risk of high blood pressure. Losing even 5% to 10% of excess weight can help to reduce your blood pressure as well as dramatically decrease your chances of having a stroke or heart attack, says LeGrand.
  • Stay fit. Be physically active for at least 150 minutes per week, doing moderate-to-vigorous-intensity aerobic physical activity, in bouts of 10 minutes or more. Speak to your healthcare provider before starting a physical activity program.
  • Quit smoking. Smoking increases your risk of a heart attack.
  • Eat less fat. Particularly, avoid saturated and trans fats. Choose healthy fats like the omega 3s found in fatty fish such as salmon.
  • Eat foods high in potassium. Low potassium levels raise blood pressure, so choose foods such as dark leafy greens and bananas.
  • Drink less alcohol. If you’re a woman, limit yourself to no more than two drinks a day, to a weekly maximum of 10; if you’re a man, no more than three drinks a day to a weekly maximum of 15.
  • Minimize stress. Stress can raise blood pressure, so find ways to relax with friends, do some fitness and avoid excessive TV watching, snacking and drinking alcohol to unwind.

If you’ve been diagnosed with hypertension, there’s a high likelihood you’ll be prescribed a medication to manage it, says Schiffrin. “Most patients with even mildly elevated blood pressure won’t be controlled with just lifestyle -- they will need blood pressure-lowering drugs.”

These might include:

  • Diuretics. These are also known as water pills. They flush excess salt from your body.
  • ACE (angiontensin-converting enzyme) inhibitors. These help relax blood vessels.
  • Angiotensin receptor blockers. These can treat heart failure and protect the kidneys from failing.
  • Calcium channel blockers. These drugs relax the blood vessels and increase the flow of oxygen to the heart.
  • Mineralcorticoid receptor blockers. Often used in hard-to-treat cases, these are a form of diuretic.
  • Beta blockers. Often used in younger people, these regulate the beating of the heart.
  • Alpha-andrenergic blockers. These medications dilate blood vessels and capillaries.

Schiffrin says these drugs are often used in combination with each other until optimal blood pressure readings are achieved.

Managing high blood pressure

Keeping a careful watch on your systolic and diastolic readings means at least annual visits to your GP, says Schiffrin. He suggests that your doctor measure your level of blood pressure several times during the visit to ensure an accurate reading. Due to the “white coat effect,” many people tense up around doctors and end up with higher-than-normal blood pressure readings. Schiffrin says that to avoid this, many doctors are now using machines that take the blood pressure of patients without GP intervention -- the doctor can even be out of the room.

Schiffrin also recommends that people with high blood pressure invest in home machines to ensure they monitor their blood pressure levels regularly. He suggests taking readings every day for one week per month, to determine an average reading -- and to watch for fluctuations.

As for those pharmacy monitors, Schriffrin says they’re not ideal in terms of accuracy, but they can signal a problem for a doctor to investigate.

Three ways to cope with high blood pressure:

1. Don’t eat anything that comes from a can or box (except albacore tuna), to keep your sodium levels in check.
2. Take your own blood pressure properly. Hold your arm level with your heart, and make sure the cuff fits snugly.
3. Track your average readings in a log, as they can change dramatically in a single day.

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