Important Information on High Blood Pressure

Blood pressure is the force of blood against artery walls. It is measured in millimeters of mercury (mm Hg) and recorded as two numbers--systolic pressure (as the heart beats) over diastolic pressure (between heartbeats). Both numbers are important.

BLOOD PRESSURE CATEGORIES FOR ADULTS*

Systolic**

Diastolic**

Optimal

<120 mm Hg

and

<80 mm Hg

Normal

<130 mm Hg

and

<85 mm Hg

High-Normal
High

130-139 mm Hg

or

85-89 mm Hg

Stage 1

140-159 mm Hg

or

90-99 mm Hg

Stage 2

160-179 mm Hg

or

100-109 mm Hg

Stage 3

>=180 mm Hg

or

>=110 mm Hg



* Categories are for those age 18 and older and come from the National High Blood Pressure Education Program. The categories are for those not on a high blood pressure drug and who have no short-term serious illness. If your systolic and diastolic pressures fall into different categories, your overall status is the higher category. < means less than, and >= means greater than or equal to.

In the United States, hypertension is a public health problem of enormous proportions, more than 60 million individuals have been found to have elevated blood pressure or have reported taking anti-hypertensive drugs prescribed by a physician.

When blood pressure is too high, the heart is working harder than it should. Once developed, high blood pressure lasts a lifetime. It is a dangerous condition, which often has no warning signs or symptoms. If uncontrolled, it can lead to heart and kidney disease, and stroke.

Currently, three non-drug methods are recommended as part of the treatment for high blood pressure (hypertension) - weight control, alcohol restriction, and sodium restriction.

Certain nutrients are implicated in hypertension regulation as well as the mechanisms by which dietary factors are known to influence hypertension. The association between hypertension and weight reduction has been investigated in many epidemiologic studies. A significant reduction of elevated blood pressure occurs with weight loss.

Complicating the relationship of obesity to blood pressure is the role of sodium. The relationship between the intake of salt and the development of hypertension was emphasized as early as 1904 by Ambard and Beaujard. Long term studies have shown that hypertensive patients can control blood pressure by reducing sodium intake. Even small reductions in sodium intake over a long period may reduce blood pressure.

Population studies have shown both a positive relationship between sodium intake and blood pressure and an inverse relationship between potassium and blood pressure - potassium salt produces a regular decline in blood pressure.

The nutritional requirement for sodium for growth and unavoidable loses from the skin and feces is in the range of 100 - 200 mg of sodium per day (about 500 mg of salt). The average sodium chloride intake is about 10 g per day, about 20 times the nutritional requirement. There is no reason to believe that reduction of sodium chloride intake to levels of 3 g per day would be harmful for healthy persons, and it may be a preventative factor of hypertension in susceptible individuals. Achieving an intake of 3 g of salt per day would require an elimination of salt in cooking and at the table, since nondiscretionary salt intake in foods amounts to at least 3 g per day.

The consumption of 150 mg of caffeine (about 2 cups of brewed coffee) may promote an increase in blood pressure within 15 minutes that is maintained for as long as 2 hours. However prolonged use of caffeine has not been associated with increased rates of hypertension in some individuals. Thus, there appears to be adaption or tolerance to the hemodynamic effects of caffeine.

Epidemiologic studies have shown that individuals who regularly consume large amounts of alcohol have higher blood pressure than people who abstain from alcohol.

Prolonged excessive intake of vitamin D can cause anorexia, nausea, weakness, weight loss, hypertension, anemia, hypercalcemia, irreversible renal failure, and death.

In emergency situations the agents used to treat elevated blood pressure should be easily titratable with a quick onset of action but with a limited risk of excessive and sudden lowering of blood pressure. Preferred agents include low doses of intravenous labetalol or low doses of enalapril. Some investigators have also used small patches of nitropaste. More aggressive, but also easily titratable, treatment of blood pressure includes continuous intravenous infusions of nitroglycerin, nitroprusside, or esmolol. Sublingual nifedipine is one of the most commonly used agents to lower blood pressure in the emergency department. However, it should be viewed as second-line therapy since its effect may be delayed, it is more difficult to titrate as compared to the intravenous medications, and its use can be associated with precipitous drops in blood pressure. If blood pressure is lowered in this setting, serial neurological examinations should look for signs of deterioration such as increasing weakness or a reduced level of consciousness. The presence of these findings should prompt consideration of more conservative control of blood pressure.

Research has shown that diet affects the development of high blood pressure. Recently, a study found that a particular eating plan can lower elevated blood pressure (NIH Publication No. 98-4082 September 1998).

The eating plan is meant for those with elevated blood pressure. It also is a heart-healthy plan that you can share with your family.

Even slight elevations of blood pressure above the optimal level of less than 120/80 mm Hg are unhealthy. The higher the blood pressure above normal, the greater the health risk.

In the past, researchers had tested various single nutrients, such as calcium and magnesium, to find clues about what affects blood pressure. These studies were done mostly with dietary supplements and their findings were not conclusive.

Then, scientists supported by the National Heart, Lung, and Blood Institute (NHLBI) tested nutrients as they occur together in food. The results were dramatic. The clinical study, called "DASH" for Dietary Approaches to Stop Hypertension, found that elevated blood pressures can be reduced with an eating plan low in saturated fat, total fat, and cholesterol, and rich in fruits, vegetables, and lowfat dairy foods. The plan is rich in magnesium, potassium, and calcium, as well as protein and fiber.

The DASH eating plan is rich in various nutrients believed to benefit blood pressure and in other factors involved in good health. The amounts of the nutrients vary by how much you eat. If you eat about 2,000 calories a day on the plan, the nutrients you get will include:

  • 4,700 milligrams of potassium
  • 500 milligrams of magnesium
  • 1,240 milligrams of calcium

Those totals are about two to three times the amounts most Americans get.

The DASH eating plan can be found at this site - http://www.nhlbi.nih.gov/health/public/heart/

Here is a sample recipe to help you cook up a tasty heart healthy meal

Vegetarian Spaghetti Sauce (Day 1)

2

Tbsp

olive oil

2

small

onions, chopped

3

cloves

garlic, chopped

1/4

cup

zucchini, sliced

1

Tbsp

oregano, dried

1

Tbsp

basil, dried

1

8 oz can

tomato sauce

1

6 oz can

tomato paste

2

medium

tomatoes, chopped

1

cup

water

1. In a medium skillet, heat oil. Saute onions, garlic, and zucchini in oil for 5 minutes on medium heat.

2. Add remaining ingredients and simmer covered for 45 minutes. Serve over spaghetti.

Makes 6 servings. Serving size: 3/4 cup

Per Serving:


Calories

102

Magnesium

37 mg

Total Fat

5 g

Potassium

623 mg

Saturated Fat

1 g

Calcium

42 mg

Cholesterol

0 mg

Sodium

459 mg