Let’s talk about the new blood pressure guidelines that the American College of Cardiology and the American Heart Association released recently concerning high blood pressure. These guidelines are recommendations for treating blood pressure that’s considered higher than normal.  This is the first time the guidelines have changed since 2003. They’ve now lowered the numbers  for what we consider high blood pressure.  In the past you were considered to have high blood pressure when your numbers reached 140/90.  Now, a blood pressure of 130/ 80 is considered elevated.

More People With High Blood Pressure

There are a few reasons the experts made this decision –  and it is not a conspiracy for everybody in the country to be put on blood pressure medication!  However this does triple the number of men, especially those in their forties, who have high blood pressure and doubles the number of women in their forties that have high blood pressure.

So why do we care? Why did the AHA make this change and what’s really the big deal about high blood pressure?

High Blood Pressure – The Silent Killer

Most people don’t even know they have high blood pressure.  Here’s the problem – high blood pressure over decades will lead to problems and when we talk about the problems, it’s a list as long as my arm!  Some of these are big bad problems, but the good news is we can prevent many, if not all of them if we can identify and treat high blood pressure early.

Everybody knows somebody with one of these problems – strokes, TIAs, dementia, coronary artery disease, congestive heart failure can happen, kidney problems or even kidney failure that can lead to dialysis, vision problems and erectile dysfunction are just a few of the major health problems that can result from long term untreated high blood pressure.

If we, as a medical community, recognize people with high blood pressure earlier, we can probably help decrease the rate of some of these bad outcomes.  So we’re saying to our patients, “hey look your blood pressure is 130/80 and it’s not normal (normal is 120/80) and that means we need to talk about what to do to get you back into the normal range.”  This is a good thing!

Behavior Modification to Fight High Blood Pressure

The guidelines are great because they don’t suggest that when you hit 130/80 you have to go on medication immediately – in fact, just the opposite! The recommendation from this panel is that you actually start with behavior modification to help lower your blood pressure, and there are many things you can do to lower your blood pressure.

Unfortunately, it’s not easy.  If you’ve ever been my patient you’ve heard me say that staying healthy is hard work and getting healthy is even harder. So what do we do when you have high blood pressure?  You need to start thinking about behavior modifications:

Lose Weight

Lose some weight.  If you can lose that excess weight that’s forming a spare tire around your waist you will make a difference in your blood pressure.  Even ten pounds of weight loss may have a significant effect.

One of the best ways to lose and keep the weight off is regular exercise.  The American Heart Association agrees regular exercise keeps you healthy and will help keep your blood pressure lower.

Eat A Healthy Diet

Eat a healthy diet, high in vegetables, fruits, lean meats, and low fat dairy and decrease saturated fats. The Dash Diet is recommended by the American Heart Association.

Limit Alcohol Intake

Decrease your alcohol intake.  Alcohol can be a factor, over years, in raising blood pressure, so be smart about your intake.  Like many things in life, moderation is key.  The AHA recommends no more than one drink a day for women and two drinks a day for men.

Don’t Smoke

Don’t smoke.  Smoking is bad for you.  It’s bad for your lungs. It’s bad for your blood vessels. It’s bad for your heart. It’s bad for everything.  Don’t smoke!  There are so many resources to help you quit.  Check out the Colorado QuitLine for help with smoking cessation.  There are so many online resources if this doesn’t have what you are looking for.

Coffee May Not Be A Problem But…

This next one is a little bit controversial for me as a physician. I make my way through almost every day, as a physician mom, with a cup of coffee in hand, so I spent some time reviewing this behavioral intervention.  The cause/effect of added caffeine isn’t all that clear. You might get an increase in blood pressure after drinking a cup of coffee. if you do get a bump in your blood pressure, it probably goes back down quickly or it’s not a big bump.  

However, if you do check your blood pressure 20 to 30 minutes after drinking, a cup of coffee and it increases significantly you might be one of those who needs to cut back just a little bit on your caffeine to help keep your blood pressure in check.  In the long term, I think we will find that the weight loss, diet, exercise and decreased alcohol intake will have more of an impact on long term blood pressure control than caffeine (I’ll keep my fingers crossed, at any rate).

Stress Levels Can Be A Factor In High Blood Pressure

Your stress level will affect your blood pressure and there are myriad ways of dealing with stress.  Managing expectations, time management, getting enough sleep, and expressing gratitude are methods shown to reduce stress and help maintain lower blood pressure.

Genetics May Play A Part

Unfortunately, some people are genetically predisposed to high blood pressure and following all the guidelines will not change that. If you do need medication to control high blood pressure, you are probably going need two to three medications as you progress in age to control your blood pressure.  Work with your primary care physician to obtain optimal control.  They are your best ally in the medical community for long term medical optimization.

Multiple Changes Can Make Big Improvements

I know with a little bit of behavior modification, some weight loss perhaps some medications, if needed,  you’re going to make a big difference in your life, not only now, but in the years to come.  Stay healthy!


(c) Can Stock Photo / Goodluz

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