Northwest Health Magazine Spring 2013 IssueNorthwest Health Spring 2013

Taking Control of Your Blood Pressure

Do you know if you have hypertension? It's easy to diagnose, and you can take steps to manage this dangerous condition.

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Kathleen Butler was first diagnosed with hypertension, also known as high blood pressure, more than 10 years ago. This Group Health member thought she knew the symptoms. "I would start feeling strange. I'd have a headache, and I would just know something was out of balance," she says. More recently, however, Butler learned that hypertension isn't always something you can feel. When she had her blood pressure checked while visiting her doctor for a different health issue, it was alarmingly high.

The truth is, high blood pressure rarely has symptoms until it reaches an extreme level. "That's why high blood pressure is called the silent killer," says Andrea Chun, MD, a family physician at the Group Health Poulsbo clinic. "You can go years having high blood pressure and not know it."

And "going years" with this condition is cause for concern. While occasional high blood pressure — for a few hours or a few days — isn't a problem, long-term, untreated high blood pressure is a health risk. "We know from many studies that controlling high blood pressure is important for stroke prevention, heart attack and heart failure prevention, and for protecting the kidneys," says Dr. Chun.

What's High? Who's At Risk?

Blood pressure is a measure of the amount of pressure your circulating blood puts on the walls of your blood vessels. A reading of your blood pressure will provide two numbers. The top one is called systolic pressure, which shows how hard the blood presses when your heart is pumping. The bottom number is diastolic pressure, which shows how hard the blood is pushing between heartbeats. High blood pressure is 140/90 or higher, measured on three or more separate occasions, with readings usually one or more weeks apart.

Unfortunately, readings this high or higher are all too common in the United States. If you are age 55 or older, you have a 90 percent risk of developing the condition.

Sedentary lifestyles, unhealthy diets, smoking, and overconsumption of alcohol are all risk factors for hypertension. Butler says her blood pressure went up when she gained weight a few years ago after her husband fell ill, and she quit her job to help him. Older people are also at risk for high blood pressure because, like joints, arteries get stiffer with age and make it harder for blood to travel through your body, which causes pressure to rise. A family history of high blood pressure is also a risk factor.

Get a Blood Pressure Reading — Regularly

The best way to know if you have high blood pressure is to get regular readings, especially if you have risk factors, or have had high readings in the past. It's a good idea to have this done at your doctor's office, but you can also check your blood pressure at locations in your community (for example, some drug stores, grocery stores, and fire departments offer this service), or at home if you have access to a blood pressure cuff.

For members who get their care at Group Health Medical Centers, it's easier than ever to get a blood pressure check. When you visit the doctor for any reason, your blood pressure will be taken. But in addition to this, if you and your doctor are working to control your blood pressure, you can call for an appointment with a nurse to have your blood pressure checked, and have no copayment for the appointment. During regular clinic hours, you can also drop by the lobby of any of our clinics and use a blood pressure cuff.

How to Control Your Hypertension

If you do have high blood pressure, it's important to get treatment. "Controlling blood pressure is a cornerstone of good preventive care," says Marty Levine, MD, a family physician at our Northgate clinic. "It has a big impact on your overall health."

Once hypertension is identified, you and your health care provider may decide that a first step is to try to lower it through lifestyle changes. "The most important are to stop smoking, exercise more, and lose weight," says Dr. Chun. Changing your diet can also make a difference.

If a patient is very motivated, and their blood pressure is not extremely high, these changes may lower their blood pressure over time. However, it may be safer to go on medication and then make lifestyle changes, tapering off the medication after losing some weight and quitting tobacco.

If you have a hard time making a change, have other health conditions, or are age 75 or older, Dr. Levine says taking medication may be the right choice. "Many of these pills work very well at low doses. And there are many different kinds of blood pressure medication, so if someone has trouble with one kind they can take another." Some people may need more than one type of blood pressure medication, since the pills often work best in combination.

A blending of lifestyle changes and medication has worked well for Butler. "I'm moving around more and my doctor has adjusted my medications," she says. She has an active job, is exercising, and has also made changes to her diet, including lowering her salt intake.

"It's important for patients and their health care providers to be partners in controlling hypertension," says Dr. Levine. "The more they understand about it, and the more active they are in their treatment, the better the results."

Lower Blood Pressure With the DASH Diet

You might have heard that people with high blood pressure should consume a low-sodium diet. Cutting back on salt is only one of several dietary changes that can help lower blood pressure. The DASH (Dietary Approaches to Stop Hypertension) diet emphasizes foods that are high in calcium, potassium, and magnesium, all of which can lower blood pressure. Taking supplements of these nutrients does not have the same effect.

With the DASH Diet, the number of servings you consume is important. In addition to the categories below, the diet includes: fats and oils, 2-3 servings/day; low-fat and fat-free milk products, 2-3 servings/day; and added sugars, 5 servings/day.

Grains, 7-8 servings/day; fruits, 4-5 servings/day; vegetables, 4-5 servings/day; legumes, nuts, seeds, 4-5 servings/day; meat, poultry, fish, no more than 2 servings/day

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