Hypertension affects a large number of individuals in Anguilla, and many of them have uncontrolled high blood pressure. We know that uncontrolled blood pressure can increase the risk of heart attacks, strokes and kidney failure. It has been shown that individuals with prehypertension can go on to develop hypertension (high blood pressure) if individuals with prehypertension do not make lifestyle changes such as to start exercising and eating healthy.
What is prehypertension?
Prehypertension is where a person’s blood pressure is elevated above normal, but not to the level considered hypertension (high blood pressure). A blood pressure reading has two numbers. The first, or upper, number measures the pressure in your arteries when your heart beats (systolic pressure). The second, or lower, number measures the pressure in your arteries between beats (diastolic pressure). Prehypertension is a systolic pressure from 120 to 139 millimeters of mercury (mm Hg) or a diastolic pressure from 80 to 89 mm Hg.
Weight loss, exercise and other healthy lifestyle changes can often control prehypertension.
What are the symptoms of prehypertension?
Prehypertension does not cause symptoms. In fact, severe high blood pressure may not cause symptoms. Many residents of Anguilla still believe that they must have symptoms to be diagnosed with hypertension or prehypertension.
The only way to detect prehypertension is to keep track of your blood pressure readings. Have your blood pressure checked at each doctor’s visit — or check it yourself at home with a home blood pressure monitoring device.
What are the risk factors for prehypertension?
A primary risk factor for prehypertension is being overweight. Other risk factors include a family history of hypertension, a sedentary lifestyle, eating high sodium(salt) foods, smoking, and excessive alcohol intake. Blood pressure levels appear to be familial, but there is no clear genetic pattern.
What can you do if you have prehypertension?
If you are overweight, or obese, losing weight can make a big difference. Losing weight can, by itself, significantly reduce your blood pressure and decrease the stiffness of your arteries. If you lose this weight you should make efforts not to put it back on. One way to keep those unwanted pounds from creeping back is to increase your physical activity — especially aerobic exercise.
Turn off the TV, shut down the computer, and get back on your feet. Aerobic exercise, including brisk walking, dancing and swimming can help you lower your weight and your blood pressure. I advise my patients to do something active everyday even if it is just gardening or washing the car.
According to the Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure (in the USA), regular aerobic physical activity most days of the week can lower your systolic (upper) blood pressure by up to nine points.
Cut back on the use of alcohol
Individuals who have more than two drinks per day are twice as likely to have prehypertension and hypertension as non-drinkers. What is considered to be one drink may be less alcohol than you think: just 12 ounces of beer, 5 ounces of wine, or 1.5 ounces of liquor. Heavy drinkers (more than nine servings of alcohol per week) are more likely to have coronary heart disease, high blood pressure and stroke than mild or moderate drinkers.
The Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure recommends no more than two drinks per day for men – and one drink per day for women – to lower your systolic blood pressure by up to four points.
Interestingly, research studies have shown that people — even those with high blood pressure — who drink alcohol moderately (one drink a day for women and two a day for men), have less disease in the coronary and leg arteries, and fewer risks of heart attacks and strokes.
Stop smoking
Smoking cigarettes triggers increased activity of nerves that raise blood pressure and heart rate, making your arteries stiffer and less flexible for as long as 10 years after your last cigarette.
Studies have shown that long-time smokers without diagnosed high blood pressure have an average rise in their systolic blood pressure of 20 points with their first morning cigarette. There is no doubt that to stop smoking can help prevent prehypertension and hypertension.
Eating a healthy diet
Avoiding fast food and changing your diet is one of the best ways to naturally lower your blood pressure. The Dietary Approaches to Stop Hypertension (DASH) trial demonstrated that a diet rich in fruits, vegetables and legumes, and low in desserts and candy, reduced blood pressure by 2.8 points over 1.1 points.
Switching to low-fat dairy products, and curbing saturated fats and total fat, lowered blood pressure by 11.4/5.5 in people with high blood pressure. Fruits and vegetables (as well as some types of tea and cocoa) contain flavonoids which significantly reduce both systolic and diastolic blood pressures.
Other helpful dietary adjustments proven to lower blood pressure include: eating more fish and soy proteins and increasing fibre intake.
Decreasing your salt intake
The DASH trial also found that reducing sodium, the active ingredient in sodium chloride, or table salt, reduced blood pressure by an average of 8.9/4.5. For people with high blood pressure, systolic values dropped an average of 11.5 points. There is no doubt that many Anguillians use a large amount of salt. The Pig tail soup is only one example of a common salty meal in Anguilla. The amount of sodium recommended for blood pressure control is between 2,300 mg to as low as 1,500 mg. This represents a very large reduction for most people, and it can take some time for your palate to adjust. One teaspoon of salt contains 2,300 mg. of sodium.
Most of the sodium in our diet comes from restaurant/fast food meals and processed foods, so cooking at home more often is a good idea. When preparing meals, try to fill up half your plate with fresh or frozen fruits/vegetables (with no added salt). Instead of seasoning with salt, try spices, no-salt-added seasonings, lemon, lime or vinegar.
If you have to use canned products, look for no-salt-added or reduced-sodium versions, or rinse the food under cold water before serving. This works well with canned beans or tuna. Common foods eaten at home that often have too much sodium include canned soups, rice and noodle mixes, ketchup and mustard, TV dinners and deli and smoked meats. If you do eat out, ask your server if you can order low-sodium meals or meals made without salt.
Medications and prehypertension
If you have prehypertension accompanied by diabetes, kidney disease or cardiovascular disease, your doctor may recommend blood pressure medication in addition to lifestyle changes. The benefits of medication for other adults with prehypertension are less clear. If you have further questions about this talk to your doctor.
Conclusion
Identifying individuals with prehypertension and then managing this condition has been shown to decrease the incidence of hypertension. Lifestyle changes have been shown to effectively treat prehypertension. Many individuals in Anguilla still do not have their blood pressure checked on a regular basis, especially men. Often many persons even ignore an abnormal blood pressure until it is too late and complications develop such as strokes, heart attacks and kidney failure. Good control of hypertension can help decrease these potentially serious complications. Talk to your doctor today.
Ask Your Doctor is a health education column and is not a substitute for medical advice from your physician. Dr Brett Hodge is an Obstetrician/Gynaecologist and Family Doctor who has over thirty years in clinical practice. Dr Hodge has a medical practice in the Johnson Building in The Valley.
