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Spokane, Washington  Est. May 19, 1883
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House Call: Lower blood pressure starts with lifestyle changes

Dr. Alisa Hideg

Sometimes it is normal to have slightly higher blood pressure, but when it is elevated most of the time, that’s called hypertension – a health risk for heart attacks, stroke, kidney disease and other problems.

You may not feel anything with high blood pressure, which is why I recommend checking it regularly, either with a blood pressure cuff at home or in your health care provider’s office.

People with high blood pressure are told to decrease salty foods or exercise more. Many find it easier to continue such changes by monitoring blood pressure at home, but seeing a difference can take weeks, so it is important to be patient. During National High Blood Pressure Education Month, I want to teach you what blood pressure is, what is being measured, and why it matters.

Just like water running through a hose pushes on the walls of the hose, blood in your veins and arteries presses out against the walls of your blood vessels. If the hose is narrower in one spot or along the whole hose, the pressure changes.

When checking your blood pressure there are two numbers. Systolic (the first number) is the pressure in blood vessels when your heart beats (contracts) and pushes blood out of your heart. Diastolic (the second number) is the pressure between beats when your heart relaxes and refills with blood. The American Heart Association recommends less than 120 for systolic pressure and less than 80 for diastolic. Medications are usually started if it is consistently higher than 140/90 and sometimes at lower readings if you have other health issues.

Consistently low blood pressure (less than 90 systolic and 60 diastolic) is usually only worrisome with symptoms like dizziness or weakness. Low blood pressure is sometimes a sign of serious health problems. Check with your health care provider if you are concerned. A sudden drop in blood pressure can be dangerous and may warrant a trip to urgent care or the emergency room.

Consistently high blood pressure stretches blood vessels, weakening them and causing thickening. Weakened blood vessels develop aneurysms, a widened area of the blood vessel, which can rupture. Thickened blood vessels and aneurysms are places where cholesterol, plaque and blood cells collect.

Narrow blood vessels make your heart work harder to keep pushing blood through. This can strain your heart muscle and valves.

Collected matter in blood vessels can also break off and stick in smaller blood vessels “downstream,” blocking or restricting blood flow. Imagine a water hose with something stuck inside of it. Stopped or restricted blood flow prevents tissues from getting enough oxygen and nutrients. In the brain it causes brain cell death and is called a stroke; in your heart, a heart attack when heart muscle dies.

Depending on where it happens, restricted blood flow from partial blockages and narrowing can also permanently damage your eyes and kidneys over time. Kidneys are especially sensitive to decreased blood flow, reacting by releasing hormones to increase blood pressure.

When you have high blood pressure (or even if you do not), not smoking, regular exercise, maintaining a healthy weight, consuming less than 2,300 milligrams of salt per day and limiting alcohol to two drinks per day for men and one per day for women have all been shown to improve blood pressure and heart health. Medication is recommended if lifestyle changes alone do not get your blood pressure into a healthy range. You might not be able to feel the difference right away, but your heart and the rest of your body will.

Dr. Alisa Hideg is a family medicine physician at Group Health’s Riverfront Medical Center in Spokane. Her column appears every other Tuesday in the Today section.
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