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Dr. David Lipschitz
High blood pressure is a major risk factor for heart disease, stroke,
and peripheral vascular and kidney disease. In the United States, 30 percent
of the entire population over the age of 18 has hypertension as defined
by a top or systolic pressure above 140 or a bottom or diastolic pressure
The prevalence rises with advancing age. The disease affects 50 percent of the
population over 65 and 66 percent of those over 75. As many as 40 percent of
individuals have significant hypertension that is not being treated, and for
those over the age of 75, only 25 percent with systolic pressures of 180 are
The benefits of treatment are proved, and medications used for over a half a
century are highly effective in returning blood pressure to normal and reducing
the risk of life threatening and debilitating illnesses by 50 percent or more.
Because hypertension is a silent killer, adults must measure their blood pressure
a few times every year. A visit to the doctor is not needed as every drugstore
has a machine that can accurately measure blood pressure and identify a problem
at its very earliest stages.
Just as important is a public-health strategy to prevent hypertension that can
be achieved by lifestyle changes that include exercise, weight control, diet
and stress management.
First and foremost is controlling stress — perhaps the most critical risk
factor in developing hypertension. Although a natural part of life and the way
we respond to challenges, stress causes acute and chronic hormonal changes that
lead to high blood pressure.
Acute stress stimulates the release of noradrenalin and adrenalin that increases
the heart rate and causes constriction of arteries that raise blood pressure.
Chronic stress raises blood pressure by increasing hormones that cause sodium
retention, alteration in appetite and weight gain.
More and more evidence shows that, as a nation, we are not dealing with stress
well. According to a recent survey of the American Psychological Association,
78 percent of Americans admit to using poor coping skills when it comes to stress.
Learning to unwind and seek true and inner peace saves lives. Dealing with stress
requires education, time and commitment. There are many relaxation techniques
available, including medication, prayer, yoga, tai chi, breathing exercises and
an approach called guided imagery. Books, tapes and even smart phone applications
can teach relaxation techniques that suit everyone’s personality and schedule.
Eating a prudent diet that limits salt intake reduces the risk of hypertension.
The average American consumes 10.5 grams of salt daily, twice as much as the
Simply being a savvy shopper can reduce salt intake while simultaneously providing
a more healthful diet. Try and buy fresh or frozen foods over canned, and always
read the salt content of any food bought. Wherever possible, buy food with the
lowest salt content and avoid adding too much salt, particularly if suffering
The best diet for our health and blood pressure is the Dietary Approaches to
Stop Hypertension diet. Developed by the National Institutes of Health and the
American Heart Association, this diet includes fruit and vegetables, lower fat
foods, more whole grain products and foods rich in magnesium, potassium and calcium.
Of course, no healthy lifestyle is complete without exercise, and it is not surprising
that increasing exercise and being physically fit lowers blood pressure.
Using these approaches will reduce the prevalence of hypertension within the
community, but according to many health experts, they should also be the initial
effort to treating mild to moderate elevation of blood pressure. Lifestyle changes
should always be recommended for anyone whose blood pressure is consistently
above 120 over 80. Referred to as “prehypertension,” these minimal
elevations are risk factors for major diseases. And even for those with blood
pressures as high as 145, lifestyle changes can be attempted before resorting
to lifelong medication use.
Preventive care makes so much sense. And for every common illness the approach
is the same. Although hard to achieve, lifestyle changes are the best, safest
and most predictable approach to living a long, healthy life.
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