High Blood Pressure – Canyon View Medical

The heart is a magnificent pump! It is only the size of a fist, weighs less than a pound and beats about 100,000 times every day. It is responsible for pumping 2000 gallons of blood per day (or about 5 quarts per minute) through 60,000 miles of arteries, capillaries, and veins. The average life expectancy for a woman in the United States is approximately 80 years, which means it is vital to take care of this incredible organ!

This pump lasts longer, runs smoother and more effectively when there is less pressure in the system. Numerous clinical trials have proven that tighter control of blood pressure in adults decreases heart failure, cardiovascular events (such as a heart attack or stroke), and death. Taking care of the heart also improves mental and physical health (according to self-reporting techniques). A thorough evaluation of these data and findings has led the American College of Cardiology (ACC) and the American Heart Association (AHA) to redefine a normal blood pressure of 120/80 mm Hg or less. Hence, clinicians may be more direct to patients regarding lifestyle modifications in order to decrease blood pressure readings and be more apt to start medical therapy.

Here are the new definitions of hypertension:

A normal blood pressure (BP) means the top number (systolic) should be less than 120 mm Hg and the bottom number (diastolic) should be less than 80 mm Hg.
Elevated blood pressure is defined as the top number being between120 to 129 mm Hg with the bottom number still being less than 80 mm Hg.
Stage 1 hypertension is when the top number is between 130 and139 mm Hg or the bottom number is elevated, between 80 to 89 mm Hg.
Stage 2 hypertension is having the top number at 140 mm Hg or higher or the lower number at 90 mm Hg or higher.

Definition	Measured in mm Hg
Normal BP	<120/<80
Elevated BP	120-129/<80
Stage 1 hypertension	130-139 (top number)OR 80-89 (bottom number)
Stage 2 hypertension	≥140 (top number)OR ≥90 (bottom number)

Treating blood pressure doesn’t always mean starting a daily medication. For people at low risk for heart disease, nutrition and activity modifications are often sufficient. Combining the Dietary Approaches to Stop Hypertension (DASH) eating plan with a diet low in sodium is highly effective in decreasing blood pressure. The DASH eating plan emphasizes the consumption of vegetables and fruits, includes low-fat dairy, whole-grains, fish, poultry, and nuts. Red meats, saturated and trans fats, sodium, sweets, and sugary drinks are limited. Every 1 to 2 pounds of weight loss can decrease blood pressure by approximately 1 mm Hg. Stress reduction and decreased alcohol consumption can also decrease blood pressure.

LIFESTYLE MODIFICATION	APPROXIMATE REDUCTION (mm Hg)
DASH eating plan	8-14
weight loss	5-20 (per10 kg weight loss)
↓ sodium	2-8
alcohol in moderation	2-4
↓ stress	5
smoking cessation	2-4
physical activity	4-9

Regular physical activity has a plethora of benefits, including a reduction in blood pressure. Exercising for 40 minutes 3 to 4 times per week is associated with a reduction of 3 to 5 mm Hg. Even meditation may decrease blood pressure by 2 to 4 points. If lifestyle changes are not enough to decrease the pressure in the cardiovascular system and the blood pressure is 140/90 mm Hg or higher, the medication should be initiated. Pressures even lower than this may require medical intervention if there are other coexisting conditions. There are many types of medications available and two or more medications may be required to get pressures to a goal of less than 130/80 mm Hg.

SOME OF THE BENEFITS ASSOCIATED WITH REGULAR PHYSICAL ACTIVITY:

Weight control & reduced body fat

Longer lifespan & improved quality of life

Better management of chronic pain

Stronger immune system

Reduced risk of diabetes and cancer

Stronger bones & muscles

Improved oxygenation of tissue & improvement in organ function

Enhanced flexibility, balance & coordination, therefore increased mobility & independence with age

Decrease in stress

Improved mood & management of symptoms of depression or anxiety

Unfortunately, sometimes an individual can do everything right and still end up with hypertension or high blood pressure. Even though this is frustrating, diagnosis and treatment can help control long-term complications and disabilities or possible death that are associated with this disorder. Throughout the world, it is estimated that a billion adults have a blood pressure of 140 mm Hg or greater. Identification and appropriate treatment will not only help to control health care costs but are also likely to improve the quality and quantity of life.

Ask your provider about your blood pressure.

High blood pressure is something you know may affect you as an adult, but did you know that it can also affect children? Childhood hypertension (high blood pressure) is now one of the most common health concerns in children and adolescents. Being that there are usually no symptoms, measuring your child’s blood pressure at routine well-child visits is crucial for diagnosing and treating high blood pressure early.

How Does High Blood Pressure Affect My Child?

High blood pressure is a serious condition in childhood. A consistently high force of blood pushing against the walls of the blood vessels quietly causes damage to the cells of the arteries’ inner lining. High blood pressure can also damage the heart by causing it to work harder to pump blood to the body. Over time, the strain on the heart can cause heart muscles to weaken and work less efficiently. Numerous studies have shown that elevated blood pressure in childhood increases the risks in adulthood for even higher blood pressure, heart disease, and stroke.

Who Is At Risk?

Certain diseases, as well as some medications, can cause high blood pressure in children. Unfortunately, for a growing number of children and adolescents, poor lifestyle habits, lack of exercise, and obesity are the primary contributors. Obesity not only puts your child at risk for high blood pressure, but it also has a role to play in other health issues, such as diabetes and heart disease. Other risk factors include a family history of high blood pressure, type 2 diabetes, and high cholesterol or triglycerides.

Can it Cause Problems Now?

Some children and adolescents have high blood pressure as a result of other illnesses. Although uncommon, blood pressure can reach dangerous levels in youth and cause heart failure, pulmonary edema (fluid in the lungs) or hypertensive encephalopathy (brain blood flow abnormalities leading to brain swelling or decreased blood supply). High blood pressure detected at routine well visit screenings can lead to the diagnosis of other conditions: kidney disease, thyroid disease, adrenal abnormalities, and heart conditions such as coarctation (narrowing or tightening) of the aorta. Early detection of problems causing high blood pressure can enhance treatment and improve outcomes – sometimes preventing serious complications.

Prevention and Intervention

Lifestyle plays an important role in preventing and treating high blood pressure. A family-based approach is vital in all childhood diseases but plays a particular role in conditions that are significantly influenced by lifestyle behaviors. Families that encourage a healthy diet and physical activity can have a beneficial effect on blood pressure and heart disease, as well as preventing childhood obesity. Here is what you can do:

See your pediatrician for regular well-visits. It is important for your child to see the doctor regularly. It’s the only way to know if there is a problem. Your doctor will measure your child’s blood pressure yearly beginning at age three. Normal blood pressure for a child is not the same as an adult. Your pediatrician will measure and evaluate your child’s blood pressure based on their gender, age, and height. Blood pressure will be measured more often if the child has other risk factors such as obesity, kidney disease, diabetes, or is taking medications known to increase blood pressure.

Eat a Healthy Diet. The DASH (Dietary Approaches to Stop Hypertension) diet emphasizes fruits, vegetables, whole grains, fish, poultry, nuts, lean red meats, and low-fat dairy. It also includes a limited intake of sugar and sweets along with lower sodium intake.

Increase Physical Activity. Any type of exercise, whether it’s aerobic training, resistance training, or combined training appears to be beneficial for lowering blood pressure and keeping your weight under control. Aim for 30 to 60 minutes of moderate to vigorous physical activity at least 3 to 5 days per week. Children with high blood pressure may participate in competitive sports once they have been assessed by their doctor and their blood pressure is in a safe range.

Drop Excess Weight. Children who are overweight usually have a higher blood pressure than those who are not. If your child is overweight, losing even 5 pounds can lower their blood pressure.

Reduce Stress. Practice healthy coping techniques, such as muscle relaxation, deep breathing, or meditation. Getting regular physical activity and plenty of sleep can help, too.

Medication. If a lifestyle modification program does not lower your child’s blood pressure, medicines may be prescribed by your pediatrician.

References:

Subcommittee on Screening and Management of High Blood Pressure in Children, “Clinical Practice Guideline for Screening and Management of High Blood Pressure in Children and Adolescents” American Academy of Pediatrics, August 21, 2017

Kevin D. Hill MD, MSCI, Jennifer S. Li, MD, MHS, ”Childhood Hypertension: An Underappreciated Epidemic?” American Academy of Pediatrics November 22, 2016

“High Blood Pressure” https://www.mayoclinic.org/diseases-conditions/high-blood-pressure/diagnosis-treatment/drc20373417

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