Hypertension

What is Hypertension?

Hypertension means high blood pressure.  Blood pressure describes the force of the blood travelling around the body pushing against the walls of the transport tubes called blood vessels.  Science has identified a healthy range for this force.  When the force is above this range it is high = hypertension.  When the force is below the range it is low = hypotension.  Both hypertension as well as hypotension, in certain situations and if left untreated, can lead to severe illness and death.

The heart is the pump which pushes the blood along in the vessels.  The heart is made of openings called chambers and muscles which squeeze automatically in a coordinated fashion. The first squeeze from the heart produces a force called systolic blood pressure which is the ‘top’ number.  When the heart muscle rests, blood still flows but at a lower force which is called the diastolic blood pressure and is the ‘bottom’ number e.g. 120/80.

Know your numbers! 

  SYSTOLIC DIASTOLIC
NORMAL <120 <80
ELEVATED 120-129 <80
STAGE I 130-139 80-90
STAGE II >140 >90
HYPERTENSIVE CRISIS >180 >120

 Blood vessels form a network of connected tubes of different widths, spread across the entire body.  Blood vessels run close to the outer surface and all the way to the very middle of all organs including the heart, brain and liver.  Arteries are blood vessels which transfer blood, oxygen and nutrients from the heart & lungs to other organs.  Veins are blood vessels which transport blood & waste from other organs back to the heart & lungs.

Blood is made up of solids e.g. red & white blood cells and platelets suspended in liquid i.e. plasma which is a solution of water, gases, proteins and salts.  Together, the heart, veins, arteries and blood are called the Cardiovascular System (also known as the Circulatory System).

Hypertension is a silent killer!

RISK FACTORS FOR HYPERTENSION:

I CAN change these…. I CANNOT change these…
Any tobacco use Age
Harmful alcohol use Genes (from family history, DNA)
Physical inactivity Gender
Unhealthy eating habits Race
Chronic stress
Poor quality sleep
Unsafe medicines

 

TOBACCO USE & HYPERTENSION

Any and all tobacco use is dangerous.  This includes exposure to second-hand smoke and the habitual practice of chewing tobacco.

Nicotine is a chemical which is present in cigarettes and works to excite the muscles of the heart and the muscles located in the walls of the arteries.  This results in a faster heart beat and arteries which squeeze more strongly.  Both actions increase blood pressure.

ALCOHOL USE & HYPERTENSION

Evidence-based research, suggests the following maximum quantities of daily alcohol consumption:

  • No alcohol for children (< 18 years)
  • No alcohol for pregnant women
  • Adult women: 1 unit alcohol/day
  • Adult men < 65 years: 2 units alcohol/day
  • Adult men > 65 years: 1 unit alcohol/day
  • 1 unit alcohol = 12 ounces (355 ml) of beer = 5 ounces (148 ml) of wine = 1.5 ounces (44 ml) of 40% alcohol/80-proof distilled spirits.
  • 1 beer can = 1 “shot’’ of scotch 

All alcohol is a combination of calories, fats and sugar.  When alcohol is consumed, in any quantity, these materials enter the bloodstream adding volume to the blood causing a temporary increase in blood pressure.  A few hours after consuming alcohol, the blood pressure should normalize.

However, in the case of harmful alcohol use i.e. consuming more than the recommended daily amount or habitual excessive use of alcohol:

  1. The blood pressure does not return to normal
  2. The fat content of the alcohol gets stored in the body.
    1. Fay layers form on the outside of the intestines but under the skin at the level of the waist.  Over time, this build-up of fat may produce a ‘beer gut’ /‘beer belly’.
    2. Along the inner lining of arteries.  This build-up of fat clogs the arteries and blocks the free flow of blood into organs.  The limited delivery of oxygen and nutrients causes the organ to malfunction e.g. circulation pain in the calves.

Continuous high alcohol intake + persistently high blood pressure + clogging of the arteries with fat causes:

  1. Heart attack (i.e. poor blood supply to the heart muscle)
  2. Stroke (i.e. poor blood supply to the brain)
  3. “Circulation problems”/Claudication (i.e. poor blood delivery to the calves and feet)
  4. Impotence
  5. Early death (i.e. < 60 years)
  6. Sudden death

PHYSICAL ACTIVITY & HYPERTENSION

Exercise is the purposeful movement of the body sufficient to increase the rate at which the heart beats.

Sitting is almost harmful as smoking, so remember to exercise regularly and keep active. International public health agencies encourage all adults to participate in 150 minutes of moderate-intensity, aerobic exercise each week.  Examples include:

  • Brisk walking: You should just be able to carry-on a conversation
  • Cycling (16-20 km/hr)
  • Gardening e.g. with a “weed-whacker”
  • Mowing lawn with lawn-mower
  • Playing a steelpan (standing)
  • Sitting to play/beat a drum
  • Tennis
  • Racquetball or squash
  • Vigorous cleaning e.g. vacuuming, mopping, washing windows by hand
LIGHT INTENSITY EXERCISE VIGOROUS INTENSITY EXERCISE
Gardening (> 45 mins) i.e. pulling-up weeds (manually), re-potting plants Construction i.e. mixing cement, fitting tiles, laying bricks
Playing most musical instruments Cycling (> 20 km/h)
Standing: e.g. while cooking, washing dishes, teaching Dancing
Sitting at a desk Gardening
Walking slowly Jogging
Hiking
Swimming
Team sports e.g. volleyball, football
Tennis

PHYSICAL ACTIVITY & HYPERTENSION – MUSCLE-STRENGTHENING EXERCISE 

It is common to become less physically active in our retirement years.  This contributes to age-related wasting of the muscles because of lack of use of these muscles attached to our bones.  Use them or lose them!   The arms and legs may become lean.  Alternatively, you may observe loose flesh or jiggly cellulite where there once was muscle.  This occurs in both men and women.

Older adults should regularly practise muscle-strengthening exercises to improve balance and help maintain independence. Online resources provide a variety of videos even for persons with limited ability or joint disease who are chair bound.

Some useful tools for these types of workouts include:

  • Free weights (5-10 lbs size): For a home-made ‘free weight’, fill a plastic water bottle with wet sand.
  • Resistance bands: These are jumbo-sized rubber bands which can be purchased at a sporting goods store.  The alternative is using a bath towel, rolled lengthwise.
  • Climbing stairs (with and without using the railings for support).
  • Squats: In seniors, this maneuver can be achieved with sit-to-stand routines.  Begin with a dining table chair that has the arms on it.  Clasp your hands in-front of you or across your chest and stand up and sit down 10-15 times in a row.  Do not let your butt touch the chair during the workout.

DIET & Hypertension

Dietary Approaches to Stop Hypertension (DASH) is a scientifically proven nutrition plan to aid the lowering of blood pressure.  This flexible eating plan highlights the benefits of getting nutrition from vegetables, fruit and whole grains and requires no special foods.  {LINK: https://www.nhlbi.nih.gov/health-topics/dash-eating-plan}

SLEEP, STRESS MANAGEMENT & HYPERTENSION

Adults require 6-8 hours of uninterrupted sleep every 24 hours for the body AND the brain to repair, replenish and renew.  Good quality sleep reduces the body’s stress hormone levels and regulates hormones responsible for hunger and impulse control.

TYPE DEFINITION EXAMPLES
EUSTRESS Pleasurable, temporary experience Preparing for a bridal shower or child’s 1st holy communion
ACUTE STRESS Deadlines less than 6 weeks away where  the individual can influence the outcome Sitting an examination, awaiting test results, staff appraisal
CHRONIC STRESS Difficult situation with challenging solution where the individual cannot directly or easily influence the outcome that continues for more than 6 weeks Persons in leadership positions, toxic work environments, toxic inter-personal/romantic relationships

Acute stress temporarily raises cortisol and adrenaline production to allow you to protect yourself e.g. sprint out of the way of a speeding vehicle while crossing the road.

Chronic stress i.e. a difficult situation that

  1. Cannot be resolved easily;
  2. Continues to get worse;
  3. Negatively affects your mood, concentration, libido, appetite or energy levels, can be life-threatening and often requires the help of others to resolve.

Chronic stress drives the continual release of adrenaline and cortisol into the blood which:

  1. Increases the blood volume;
  2. Excites the muscles of the heart and in the walls of the arteries; and leads to
  3. Elevated blood pressure;
  4. Fast resting heart rate;
  5. High blood sugar levels; and

Which ultimately increases the individual’s risk of:

  1. Heart disease;
  2. Stroke;
  3. Diabetes;
  4. Premature death;
  5. Sudden death.

MEDICATION USE & HYPERTENSION 

ALWAYS INFORM YOUR PROVIDER OF ALL MEDICATIONS YOU REGULARLY TAKE! 

Alternative medicine i.e. home remedies, plant-based extracts and prescription medication can complement OR counteract each other.

DO NOT SHARE PRESCRIPTION MEDICINES!

Prescription medication is targeted treatment for one specific patient.

When attending a scheduled appointment or the emergency room, take with you all medicines or the names and doses of all medicines.  Make a list of the medication and place in your wallet or purse.  Take a photo of the prescription or pills and keep on your phone.

 

 

 

Published in NWRHA Service