Heart Health: Blood Pressure

When it comes to heart health, one of the most important things to pay attention to is our blood pressure. As one of the vital signs that doctors check to get a baseline indicator of our health, a healthy blood pressure is indicative of much more than a healthy heart.

First, science.

Let’s start with what blood pressure is. It all starts with the heart. Our heart is the pump that circulates our blood throughout our body. Our blood pressure is a measure of the pressure on the walls of our blood vessels as our blood moves around. Blood pressure is typically measured in the arteries.

For many, myself included, it’s hard to give context to a blood pressure measurement. The typical blood pressure of a person at rest is 120/80 mmHg. What does this mean? The first number is systolic blood pressure, or the maximum pressure during one beat of the heart. The second number diastolic blood pressure, the minimum pressure between two heart beats. The final bit is a unit of pressure, in this case millimeters of mercury.

Sphygmomanometer
Traditionally, blood pressure is measured with a device called a sphygmomanometer, from the Greek word sphygmos (pulse) and the scientific instrument the manometer which measures pressure. The most basic sphygmomanometer consists of an inflatable cuff, an inflation mechanism, and a gauge to measure pressure. The cuff is inflated around the arm and above the elbow to cut off blood flow to the brachial artery. A medical professional then listens to the artery with a stethoscope as the pressure in the cuff is released. When blood is heard to reenter the artery (it makes a whooshing noise), the pressure is noted (systolic). As the pressure in the cuff continues to be released the sound from the artery will stop, which is when the pressure is noted again (diastolic).

What’s the problem?

An adult is considered to have high blood pressure (hypertension) if it’s in the range of 130/80 mmHg to 140/90 mmHg. One of the biggest problems with high blood pressure is the lack of symptoms. If we can’t feel it and it doesn’t affect our lifestyle, we tend to minimize it or ignore it. Unfortunately, by the time symptoms do show up, they can be fatal.

Some of the risks of hypertension include arterial damage from increased pressure on the arterial walls, a ruptured artery in the brain leading to a stroke, and heart failure from overworking our hearts. Problems with our blood flow are no joke. I haven’t even mentioned the risk to our kidneys, eyes, and libido.

What can we do?

Exercise and weight loss

Losing weight and exercising are at the top of most lists when it comes to managing blood pressure. Body weight and blood pressure have been known to be related for years. The relationship is simple: lose weight to lower high blood pressure.

The connection between lowering high blood pressure and exercise is pretty simple. The Mayo Clinic sums it up nicely:

How are high blood pressure and exercise connected? Regular physical activity makes your heart stronger. A stronger heart can pump more blood with less effort. If your heart can work less to pump, the force on your arteries decreases, lowering your blood pressure.

Mayo Clinic

It doesn’t matter what exercise we do. According to the Arquivos Brasileiros de Cardiologia (Brazilian Cardiology Archives), all exercise will lower our blood pressure in the time following our exercise, but jogging has the greatest effect. Exercise is an effective tool in preventing high blood pressure as well.

Diet

Reducing salt is on every list of how to manage hypertension. This is because salt (specifically sodium) interferes with our kidney’s ability to remove water, leaving extra fluid in our circulatory system, straining our heart. Salt plays such a significant role in hypertension that the journal Hypertension says:

To prevent and control the ongoing epidemic of prehypertension and hypertension, major reductions are needed in the salt content of the food supply.

Hypertension

The European Journal of Nutrition finds that upping our calcium intake can play a role in reducing blood pressure. According to the American Journal of Hypertension, eating fruits and vegetables helps lower blood pressure as well. The National Institutes of Health (NIH) has even promoted a diet designed to manage blood pressure called the DASH Diet (Dietary Approaches to Stop Hypertension).

The DASH Diet [click to expand] The DASH (Dietary Approaches to Stop Hypertension) diet was developed out of a study funded by the National Heart, Lung, and Blood Institute (NHLBI [part of the NIH]) that concluded in 1997. In response to the ongoing epidemic in hypertension, they wanted to know what role diet could play in lowering blood pressure. The study consisted of over 450 participants (67% of whom were minorities) in five sites around the US.

Participants were given one of three diets for eight weeks. The control diet was relatively low in fruits, vegetables, fiber, and nutrients but mirrored typical American fat consumption. The first experimental diet was high in fruits and vegetables but had a similar fat content to the control diet. The second experimental diet was high in fruits and vegetables as well, but limited fat intake by reducing consumption of saturated fats. The cohort that received the first experimental diet saw their systolic blood pressure drop an average of 2.8 mmHg. The cohort that received the second experimental diet saw their systolic blood pressure drop an average of 5.5 mmHg. The second experimental diet is what became the DASH diet.

What to Eat

Whole grains: Oatmeal, bread, rice, pasta. The focus should be on whole grains because they have more fiber and nutrients. Avoid instant oatmeal, white bread, and white rice.
Vegetables: Tomatoes, carrots, broccoli, greens. Avoid thinking of vegetables as a side dish. They’re full of fiber and nutrients. Don’t worry about fresh, frozen, or canned, but pay attention to salt content when buying frozen or canned.
Fruits: Apples, oranges, berries. If you can eat the skin, you should. They’re another good source of fiber. Most fruits are high in potassium and magnesium and low in fat so they’re perfect for lowering cholesterol as well as boosting our nutrient intake. Canned fruit and fruit juice is good too, just pay attention to added sugar.
Dairy: Milk, yogurt, cheese. Although dairy is high in calcium and protein, it’s also high in saturated fats. Try to limit consumption and find low-fat or non-fat sources of dairy. Add low-fat yogurt to fruit for an easy any-time snack.
Lean meat: Chicken, tuna, salmon, eggs. To limit our fat intake we should limit our meat intake as well. Like dairy, meat is usually high in saturated fats. Instead we should focus on adding more fish to our diet such as tuna and salmon which is high in polyunsaturated fats which have vital nutrients for our body.
Nuts, seeds, and beans: Almonds, walnuts, sunflower seeds, beans. Nuts are easy to add to other meals, especially salads. They are high in calories, and therefore should be moderated, but are also high in healthy fats and so shouldn’t be overlooked either.
Fats and oils: Mayonnaise, salad dressing, butter. Sometimes we need more flavor, and our bodies definitely need fats to function properly. The key here is moderation. Consume small servings a few times a day, and pay attention to the type of fat. Always avoid trans fats and limit saturated fats.
Sweets: Candy, soda, ice cream. We don’t have to eliminate sweets entirely from our diet, but they need to be limited. We should aim to be responsible with the sweets we choose as well. Look for reduced fat options such as sorbet in place of ice cream.

Temperance

As enjoyable as our vices are, they are probably contributing to raising our blood pressure. The number one contributors are cigarettes. Nicotine is the primary culprit, being responsible for increased heart rate and increased blood pressure. The journal Internal and Emergency Medicine found that quitting smoking for a sufficient time reduces blood pressure.

Drinking excessively can also lead to both short-term and long-term rises in blood pressure. Alcohol is also calorie dense so it can contribute to weight gain which won’t help us manage our blood pressure. Fortunately, most of the hypertensive effects of alcohol dissipate when intake levels are reduced to moderate levels or cut out all together.

When it comes to caffeine and marijuana, the jury is still out. The research is contradictory, therefore I don’t think it’s responsible to make a claim one way or the other on the effect these drugs have on heart health.

Chill out

Although there’s no link to stress and long-term changes in blood pressure, stress can cause short-term spikes in blood pressure and constriction to our arteries. If we react to stress by drinking or smoking, the effect can be compounded. Unfortunately there’s no catch-all solution to stress, but losing weight, eating healthy, and working out, are all known to have a beneficial effect on our stress levels. Plus, getting our blood pressure under control means we have one less thing to worry about.

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