Take Heart, Will Endure

Proper monitoring and simple lifestyle changes can help you control high blood pressure

Checking blood pressureFirst, the good news. It does not take too much of a radical sea-change for you to reduce your risk of heart attack and/or stroke, if you are diagnosed to have high blood pressure [[hypertension].

The bad news is the problem with high blood pressure is its “presentation.” The disorder has no obvious symptoms and is affecting people on a large scale. Most of the time, it is the complications of hypertension which cause symptoms – and, not hypertension itself. Hence, if you wait for symptoms before starting treatment, you have already missed the boat!

Hypertension is achieving epidemic proportions – almost one in three adults have high blood pressure. Almost one-third of people with high blood pressure, or hypertension, do not know they have it. There are, as a matter of fact, scores of people who have had high blood pressure for years without being aware of it. Even after treatment only one-third have their blood pressure properly controlled – i.e., less than 140/90 mmHg.

High blood pressure is a controllable disease. Medicines for high blood pressure need to be taken almost life long. If it is not controlled, high blood pressure can lead to stroke, heart attack, heart failure, or kidney failure. Hence, it is often called the “silent killer.”

Normal resting blood pressure in healthy individuals averages 120/80 mmHg. The first [120] represents the pressure caused against the artery walls when the heart contracts. This is called the systolic blood pressure. The second [80] is the pressure caused against the artery walls during the resting phase – i.e., between heart beats. This is called the diastolic blood pressure.

The dynamics

  • There are specialised pressure sensors in the body that regulate blood pressure. They also ensure that it does not fall too low, compromising adequate flow to the tissues. Or, it does not rise too high, increasing the work of the heart and stressing vessels
  • In general, blood pressure is regulated in such a way that it rises and falls consistently with the demands of the body. It is, in other words, a dynamic phenomenon
  • When blood pressure control mechanisms malfunction, it results in hypertension.

When to check your blood pressure

Every person should get his/her blood pressure checked at least once a year after age five. Future checks will depend on the BP reading at the first check. Avoid getting routine BP checks when you have fever, or pain, or after exercise, or immediately after a heavy meal or tea/coffee/ alcohol/smoking. It will invariably be on the higher side.

High blood pressure control plan

  • First and foremost, if you are hypertensive, try to keep your blood pressure under 140/90 mmHg. If you can’t, even with medication, speak to a specialist
  • Take your medicines, every day, preferably at a “fixed” time
  • Seek a healthy weight level, because carrying extra weight increases your risk of high blood pressure. One good way of knowing your ideal weight is to find out your body mass index or BMI. BMI is weight in kilogram divided by height in metre squared; it is a method of determining obesity. If your BMI is above the normal range [25], you would sure benefit from weight loss
  • You may include rebounding exercise, with very good effect, on a mini-trampoline.
  • You should meditate for at least 10-15 minutes a day
  • Reduce or cut down on food high in salt or sodium. Also, avoid packaged food because a majority of them contain sodium
  • If you do not want to annoy your taste buds, use spices and herbs instead of salt to season the food you prepare or eat
  • Incorporate a balanced diet. Avoid overeating, fast, junk, oily foods, and excessive meat.
  • Other additional daily measures include 4-5 servings of fruits, vegetables, grains, and low-fat dairy foods. Also, remember smoking and alcohol do your case no good. Restrict their use, or better still eliminate them from your list of choices.
  • Exercise helps lower blood pressure
  • Studies suggest that moderate-intensity activity [60-70 per cent of maximum oxygen uptake] may be effective in lowering blood pressure. It is for this reason that doctors often recommend the use of low-to-moderate-intensity exercise for hypertensive individuals.
  • It may be mentioned that regular physical activity has been shown to be effective in reducing the relative risk of developing hypertension by 20-30 per cent. A low cardio-respiratory fitness level in middle age is actually suggested to be associated with a 50 per cent greater risk of developing hypertension-related cardiac problems. Results are universal in both men and women
  • While it is important that you’d also need to maintain a consistently successful exercise programme, you should not try to go overboard too soon. Avoid conquering your blood pressure the first time around, or after. You need to exert patience, and start slowly
  • It is ideal to start first with endurance activities such as walking, swimming, cycling and low-impact aerobics. Make them the central part of your exercise programme. Most important: you need to eliminate isometric and isotonic, or resistance, exercises – they can cause extreme and adverse fluctuations in blood pressure, which isn’t good if one is hypertensive
  • It is important that you do not hold your breath during weight training, if you use light weights. Because, holding breath can lead to large fluctuations in blood pressure. It may also lead to passing out and sometimes life-threatening events [abnormal heart rhythms]
  • Most physicians advise hypertensive individuals to exercise 5-6 times a week, subject to their fitness level/standards, although improvement can be achieved with as little as 3-4 sessions a week. Experts recommend a total exercise duration lasting 20-30 minutes per session
  • Medical researchers also recommend that individuals with lower levels of fitness should ideally start with short-duration exercise for 10-15 minutes, and increase it incremently every week. You should aim to reach your 20-30 minute exercise goal over a period of 8-12 weeks.

In a Nutshell

  • Have your blood pressure checked regularly. Your primary care physician can tell you how often
  • Stop smoking
  • Avoid excessive salt intake
  • Eat more fresh fruits, vegetables, and foods high in fibre and less fat
  • Reduce stress on and off the job; master relaxation techniques
  • Be moderate in your drinking, or don’t drink at all
  • Exercise regularly, and keep your weight within normal limits.

If your doctor prescribes medication to lower your blood pressure, be sure to follow his/her directions religiously.

Dr Vijay Kumar Verma, MD, DM, is a Navi Mumbai-based cardiologist.


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