High Blood Pressure
High Blood Pressure
High blood pressure is the most common chronic illness in the United States and is so rampant among older people that it is often accepted as a normal part of aging. But our bodies are only designed to handle so much sodium, so much extra weight, so much of a subpar diet, believes Paul Whelton, M.D., dean of the school of public health at Tulane University in New Orleans. When you go over those preset limits, you develop high blood pressure. “The genes cock the gun and the environment pulls the trigger,” Dr. Whelton says.
High blood pressure goes by the medical name hypertension. That’s apt because the condition literally creates too much tension throughout your circulatory system. The condition gets started when your heart begins to work harder either because of stress or because your arteries have been narrowed by fat deposits. It now takes more effort to get blood through the vessels. Pressure increases on the walls of the blood vessels and the heart. Over time, this extra exertion makes your heart stiff and weak, which can cause heart failure.
The two numbers that express the measurement of blood pressure in millimeters of mercury (mm Hg), such as 130/85, represent systolic pressure and diastolic pressure. Systolic, the top number, is measured when your heart contracts or beats. Diastolic, the bottom number, is the minimum pressure and happens when your heart is relaxed between beats. Normal blood pressure is a systolic under 130 mm Hg and a diastolic under 85 mm Hg. William Elliott, M.D., Ph.D., director of the section of clinical research at Rush-Presbyterian–St. Luke’s Medical Center in Chicago, recommends an optimal blood pressure less than 120/80 mm Hg.
Simple lifestyle changes can make a big difference, suggests Dr. Whelton. In one study, he found that simply by reducing salt intake and losing some weight, older people with hypertension were often able to go completely off high blood pressure medication. “A lot of people could come off their medication safely and they continued to keep their blood pressures down even off the medication,” he says.
Make these changes yourself, and you might be able to prevent high blood pressure before it gets a real foothold. And even if you’re already taking medications for hypertension, these changes can make the medication work better and increase your chances of beating this silent disease, says Dr. Whelton.
Try This First
Silence your salt shaker. In Dr. Whelton’s study, some people could go completely off high blood pressure medications if they reduced sodium and lost weight. For some people, salt or sodium causes their blood pressures to soar.
There’s sodium in many canned and packaged foods. You can be better informed about its presence by reading labels and learning to avoid anything with a high sodium content. But the salt we shake on our food is also significant. So ban the salt shaker from your table and your cooking, says Dr. Elliott.
You should limit your sodium content to 2,400 milligrams a day, advises the American Heart Association. Think you’ll miss the taste? Don’t worry. “After a few weeks, you get pretty used to a low-salt diet,” says Lawrence Z. Feigenbaum, M.D., founder and director of the Goldman Institute on Aging in San Francisco.
Other Wise Ways
Stock up on naturally low-salt foods. If you fill your pantry with low-sodium foods, you’re bound to cut salt from your diet. Always be sure to have on hand some of the following suggestions from the American Heart Association: fruits, vegetables, fresh or frozen lean meats, poultry, fish, shellfish, unsalted lean pork, eggs for egg whites, water-packed tuna, dried peas, beans, lentils, skim or reduced-fat milk, low-fat yogurt, and whole grains.
Spice up your life. Salt is usually added for taste, but there are a plethora of spices that can add taste without adding blood pressure points, says May M. Harter, R.D., coordinator of nutrition and weight management programs at New Britain General Hospital in Connecticut. Reach for your spice rack the next time you need to add a little flavor. For instance, use basil for fish, lamb, lean ground meats, stews, salads, and sauces. Try bay leaves with lean meats, stews, poultry, soups, and tomatoes. Dash some rosemary on chicken, veal, lean meat loaf, lean beef, lean pork, sauces, stuffings, potatoes, peas, and lima beans. Use dill on fish sauces, soups, tomatoes, cabbages, carrots, cauliflower, green beans, cucumbers, potatoes, salads, macaroni, lean beef, lamb, and chicken.
Read the labels. When buying products, look for the amount of sodium, Harter says. The red flag should go up if a product has more than 400 milligrams of sodium per serving, she says. If you are eating something that has more than that, make sure the other foods you eat throughout the day are lower in sodium. You don’t want to go over 2,000 milligrams a day.
Stalk the produce aisle. Fruits and vegetables are more than just salt-free. They are potassium-rich. “Potassium seems to be an important element in controlling blood pressure. The more potassium one takes in, the lower blood pressure tends to be,” Dr. Whelton says. The best way to get the Daily Value of 3,500 milligrams is through fruits and vegetables, adds Dr. Whelton. Food sources include dried apricots, baked potatoes, dried prunes, cantaloupe, spinach, citrus fruits, and most raw vegetables. Don’t overdo the dried fruits, however, since they are high in calories.
Be a little lighter. In his study, Dr. Whelton found that older people who reduced the salt in their diets and lost weight reduced their blood pressures so much that about half of them were able to stay off their blood pressure medication. Even obese people who lost as little as eight pounds saw health benefits in regard to blood pressure, he says. His subjects didn’t have to go through a brutal regimen either. They were told to do small amounts of exercise like taking the stairs instead of the elevator as well as daily brisk walks. And they were told to make dietary changes like eating more fruits and vegetables and changing a few things in their diets, like switching from whole milk to low-fat or drinking diet soda in place of regular. “Little things can have a big impact. Just cutting out 100 to 150 calories a day will likely result in about a one-pound weight loss in one month,” he adds.
| Managing Your Meds There are several classes of drugs commonly used to treat high blood pressure, says William Elliott, M.D., Ph.D., director of the section of clinical research at Rush-Presbyterian–St. Luke’s Medical Center in Chicago. Diuretics such as hydrochlorothiazide (HydroDIURIL ), amiloride (Midamor), and spironolactone (Aldactone) are often used when high blood pressure is your only medical condition. These are very effective in reducing heart attack and stroke in older individuals. A doctor may prescribe beta-blockers like atenolol (Tenormin) and propranolol (Inderal) if you have high blood pressure and other health problems such as a previous heart attack and angina. Angiotensin-converting enzyme (ACE) inhibitors such as captopril (Capoten) may be used if the person also has heart failure or diabetes and kidney problems. Another possible treatment is with calcium channel blockers such as amlodipine (Norvasc). If you are being treated for high blood pressure, check with your doctor before taking the following: • Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen. These may interfere with high blood pressure medication. Also, most contain sodium. • Over-the-counter and prescription decongestants like pseudoephedrine (Sudafed). They may raise blood pressure. • Those over-the-counter and prescription antihistamines that contain decongestants such as diphenhydramine (Bena-D) or chlorphen iramine (Coricidin-D). (The brand name may have a D, but decongestant should appear on the package label.) They may raise blood pressure. |
Take a walk. Just a brisk walk about a half-hour a day keeps your blood pressure down. You should walk at a pace that will make you a little short of breath but still able to talk to a companion. “When you look at clinical trials, the evidence is very strong that increasing physical activity is overall beneficial. It seems to lower blood pressure and reduce weight,” Dr. Whelton says. It is always a good idea to start slowly and increase your activity level over time. Aerobic exercise may keep your blood pressure down by keeping your blood vessels more flexible.
Max out on magnesium. Along with potassium, magnesium is another mineral that may help keep your blood pressure down. The research isn’t as conclusive with magnesium as it is with potassium, Dr. Whelton notes. But it is good enough to recommend that you get the Daily Value of 400 milligrams a day. You’ll find magnesium in meats, green leafy vegetables, brown rice, legumes, nuts, and whole grains. People with heart or kidney problems should not take supplemental magnesium.
Milk it. Getting adequate calcium in conjunction with standard medication has been shown to be of some benefit in lowering blood pressure for some people, says Ruth Kava, R.D., Ph.D., director of nutrition at the American Council on Science and Health in New York City. Through food or supplements, try to get 1,200 milligrams a day, she advises. The best sources are usually dairy: low-fat and nonfat cheeses, milk, and yogurt.
Along with your 1,200 milligrams of calcium, make sure you also get 400 international units of vitamin D, which can be found in fortified milk; fatty fish like herring, mackerel, salmon, or sardines; and, if necessary, multivitamins. Without vitamin D, calcium can’t be absorbed by your body. Your body also makes vitamin D itself with the help of sunlight. Although about 15 minutes of the summer sun gets you a day’s worth, older adults may have a decreased ability to produce vitamin D, and sunscreen will interfere with your skin’s ability to make vitamin D. This means it may be best to rely on food sources for your daily vitamin D.
