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Hypertension: The Silent Killer


Kevin Russell, Natasha Larivee, Cameron Ashe, and Matt Stewart, LIC Clerks, Dalhousie Medicine New Brunswick, Horizon's Miramichi Regional Hospital

Hypertension, also known as high blood pressure, is a popular topic of conversation in the doctor's office. Most people have probably had their blood pressure taken at some point, either at the pharmacy, by a family doctor, or maybe with a machine at home. Even so, many people may not completely understand what blood pressure is and why it matters.

What is blood pressure?

Blood pressure (BP) is exactly what it sounds like - the pressure of blood against the vessel walls when it is pumped by the heart to the rest of the body. Two numbers are recorded with blood pressure (i.e.: 120/80).The top one (systolic) is the maximum pressure attained after the heart contracts. The bottom one (diastolic) is when the heart rests and fills between beats. Even though high blood pressure may not make you feel sick, these two numbers are a very important indicator of your health overall.

What are some causes of high blood pressure?

One of the most common and unavoidable causes of high blood pressure is age. As we get older, our vessels and arteries naturally get a little more stiff, causing increases in our blood pressure. But, there are several othermodifiablerisk factors, which are things thatyoucan change. These include: poor diet, smoking, too much alcohol use, obesity, stress and sleep apnea.

What happens if my blood pressure is high for a long time?

Having high blood pressure can damage your blood vessels, by causing little knicks and tears. Eventually, if left untreated, this can lead to many complications, including heart disease, stroke and kidney damage.

How do I know if I have high blood pressure?

The only way to know for sure is to check. Your family doctor is always able to measure it. If your blood pressure is raised at one visit, it is not a reason to panic because more testing will be done to make sure it wasn't a one-off thing. For example, you might be asked to go to the hospital and have a 24-hour blood pressure monitor put on, or to take measurements at home. If your blood pressure is high for a long time, it may cause some symptoms including headaches, dizziness and feeling short of breath. However, high blood pressure usually has no symptoms, which is why we call it the "silent killer." Once it is confirmed you have hypertension, you can start to look at ways to lower it. 

How can I lower my blood pressure?

In order to get your ideal blood pressure, there are several ways that most people can begin to lower it. First, there are dietary changes that you can make. You can start by limiting your salt intake (be mindful of fast foods and processed dinners) and keeping a diet high in vegetables. You can also try adding more potassium (bananas, citrus, avocado, sweet potato and spinach) to your diet. Another recommendation is limiting your alcohol intake; a good rule of thumb is to have 1 drink/day or less for women and 2 drinks/day or less for men. Other big lifestyle changes that will make a difference in blood pressure include quitting smoking and exercising at a moderate intensity for at least 30 minutes 5 to 7 days a week. 

I've tried some lifestyle changes and I'm not seeing changes I want to in my BP readings. What now?

Don't be discouraged - this is the case for many people. This is because everyone's blood pressure tends to go up as we get older. You may need medication. You and your doctor can have a discussion and find out which one is for you.

I'm on medication, now what?

Figuring out what medication is right for you can take some time and a few trials with different medications. The biggest thing is to monitor your pressure and how you're feeling. You really want to make sure the medication doesn't lower your BP too much. You can often feel this if you stand up suddenly and get dizzy or feel faint. Your doctor will lower the chance of this happening by starting on a low dose medication and increasing the dose slowly. Remember to always tell your doctor if you start feeling like you have a low BP. They want to know!

Bottom line: don't ignore your blood pressure. 

That's a lot of information to digest, so here are the key takeaway points:

Change your lifestyle! Visit these links for more information.

Know your target blood pressure.

  • Heart disease or chronic kidney disease: 120/xx
  • Diabetes: 130/80
  • Low or moderate risk for heart disease: 140/90

Debunked Myths

Myth #1: High blood pressure runs in my family so there's nothing I can do to prevent it. This is somewhat true. When people in your close family have high blood pressure, you are more likely to develop it too, but most cases of high blood pressure aremultifactorial. This means that quitting smoking, healthy eating and exercise can all help too.

Myth #2: I feel fine, so I don't need to worry about high blood pressure. This is FALSE. Most times, high blood pressure does not give you any symptoms.

Myth #3: I don't add salt to my meals, so I am in control of my salt intake. This is FALSE. Putting down the salt shaker is a good first step, but canned and processed foods also have a lot of hidden salt. It's important to check labels! One rule of thumb is to shop the perimeter of the grocery store.

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