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  Tuesday, October 21, 2014
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TLC and HTN
By Brianne R. Fitzgerald RN, MPH

     Total lifestyle change (TLC) and hypertension (HTN), high blood pressure is the topic for discussion.  Blood pressure is determined by the amount of blood that the heart pumps out which is systole (the higher number) and the resistance that the blood meets as it flows through the arteries which is called diastole (the lower number).  The more blood that your heart pumps (the harder it works) and the narrower your arteries the higher your blood pressure will be.

     HTN has few if any symptoms.  Headaches, nosebleeds, fatigue and dizzy spells are signs of advanced high blood pressure.  Most cases of HTN have no cause, and are called essential/primary HTN. A small percentage of hypertension cases are from another underlying condition (secondary HTN).  Drugs (cocaine and amphetamine), some medicines (cold remedies, birth control pills and some over the counter pain relievers) and conditions including kidneys, adrenal glands and congenital heart defects can lead to secondary HTN.

     Age, race and family history are risk factors that we are unable to change, but there are others that are in our power to modify in order to lessen our chances of HTN.  Excess weight, inactivity, tobacco use, too much salt and too little potassium in your diet, excessive alcohol use and stress are all lifestyle choices that we can intact in order to reduce blood pressure. 

Blood pressure guidelines issued in 2003 by The National Heart, Lung and Blood Institute divide blood pressure into four categories:

    Normal. Blood pressure below 120/80.  Some data suggests that 115/75 should be the gold standard.

    Pre-hypertension. 120-129/80-89 is the limits set for this stage.  Pre-hypertension tends to worsen over time.  Within 4 years of being diagnosed with pre-hypertension nearly 1:3 adults 35-64 and 1:2 adults over 65 progress to definite high blood pressure.

    Stage 1 hypertension.  This is systolic pressure ranging from140-159 and diastolic pressure ranging from 90-99.

     Stage 2 hypertension is the most severe hypertension and the numbers that indicate this type is equal to and greater than 160/equal to and greater than 100.

     Complication from untreated HTN include damage to arteries, heart failure, aneurysm (ruptured blood vessel in brain), which can lead to stroke, kidney problems and metabolic syndrome.  Untreated HTN can affect your ability to think, remember and learn.

     TLC is the first treatment, the most cost effective and least dangerous treatment for pre-hypertension. Daily exercise, weight loss, diet changes and managing stress levels differently can improve many areas of one’s life, not just blood pressure. Sometimes lifestyle changes are not enough and medications are recommended.  The medications offered for HTN include several categories and would necessitate an entire column to explain.  Diuretics (water pills), beta blockers (block adrenaline), ACE inhibitors (relax blood vessels), calcium channel blockers (relax muscles of blood vessels and slow heart rate) are the major classes of drugs used to manage HTN.  There are others and many physicians and nurse practitioners advise a daily baby aspirin also.  Talk to your provider and learn about the medications that are prescribed.  If prescribed medications recognize that it will be for a lifetime.  Remember to take medications properly and speak to your provider if side effects or costs pose problems.

     Eat a diet that includes fruits, vegetables, whole grains and low fat dairy products.  Eat potassium rich foods (soy, raisins, sardines) and eat fewer fats.  Limit your sodium intake to 1,500 mgs.  Weight loss of even 5 pounds can dramatically lower blood pressure.  Add 30 minutes a day, every day of some physical activity.  Limit alcohol intake, and stop smoking.  Smoking speeds up the process of artery hardening.  Stress is a part of life.  The management of stress includes, enough time to rest, relaxation activities, minimizing situations that you involve yourself in that result in anger and unhappiness.  One needs not go to every fight that they are invited to!  Remain patient and optimistic.  Laugh and love.



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