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House Call: Keeping your blood pressure in check

Like your cholesterol level, which I wrote about last time, blood pressure is another factor we measure and track to assess your risk for heart and vascular disease. High blood pressure makes your heart work too hard and contributes to hardening of the arteries. Hardening of the arteries increases blood pressure further creating a vicious circle. As your arteries harden, it becomes increasingly difficult to supply nutrients and oxygen to the organs in your body, which they all need to keep you alive. When you maintain a healthy blood pressure, you reduce the risk of having the supply of blood and oxygen to your organs stopped by a blockage in a hardened and narrowed artery.

The two most critical organs that need a constant supply of oxygen are your heart and brain. When oxygen can’t get to your heart, we generally call it a heart attack and when it can’t get to your brain, a stroke. Depending on the severity of these events, you can be left with lifelong impairments or you can die, so it is important to do all you can to maintain a healthy blood pressure. We call high blood pressure “the silent killer” because you can have it for years with no symptoms until you have a heart attack, a stroke, or some other awful thing happen.

The steps you should take to keep your blood pressure low or to get it lower are mostly the same as what I describe often to stay healthy. Maintain or lose weight and exercise every day. When I was in my 30s, I noticed my blood pressure, which had always been low, creeping up as it often does in middle age. I took up running after moving to Spokane and the upward creep reversed itself. With continued regular exercise it has stayed down. You should also drink fewer alcoholic beverages, preferably no more than one drink a day. Eat a healthy diet that includes a lot of fruits and vegetables, and eat less salt. The most obvious way to reduce the amount of salt and sodium in your diet is to put down the salt shaker, but there any other steps you can take that are pretty simple.

Look for recipes that use spices, herbs and seasonings other than salt so that you are still eating flavorful meals. Become a salt sleuth and check labels for how much salt is in the packaged foods. You’ll be surprised how much salt can be found in some flavored pasta mixes, frozen meals, and other prepared foods. When it comes to vegetables, buy fresh, plain frozen, or no-salt-added canned ones. Find a flavorful, salt-free seasoning blend that you like and keep it on the table instead of salt. It is recommended that we limit our salt to 2,400 milligrams a day. For perspective, there are 6,000 milligrams in a teaspoon of salt.

Even after making and maintaining all these changes, your doctor may recommend adding medication to lower your blood pressure. It is important to take it as directed and notify you doctor immediately if you have intolerable side effects. It is pretty common for me to see patients with high blood pressure who have stopped their medication on their own after taking it for a while because their blood pressure was normal and they thought that they didn’t need it any more. If you are prescribed blood pressure medication keep taking it and check your blood pressure occasionally to make sure that it is working. If you are having side effects, don’t just stop it. Work with your doctor to find a medication that will work for you.

Bob Riggs is a family medicine physician practicing at Kaiser Permanente’s Riverfront Medical Center. His column appears biweekly in The Spokesman-Review.


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