By JUDD MATSUNAGA, ESQ.
For over 50 years, I never paid much attention to my blood pressure (or really understood it). Then, at 59 years of age, I suffered a heart attack.
Do you know that heart attacks occur in about 805,000 people each year with 605,000 being first-time events? (Source: Centers for Disease Control and Prevention) The average age of a first heart attack is 65.6 years for men and 72.0 years for women. Approximately 695,000 people die from heart disease in the U.S. each year, which represents about one in five deaths in the country.
High blood pressure, or hypertension, is referred to as “the Silent Killer.” That’s because, quite often, there aren’t any symptoms. And, if left untreated, high blood pressure can lead to disability, a poor quality of life, or even a deadly heart attack or stroke.
In my case, the main artery into my heart, aka “The Widow Maker,” was almost completely blocked. The cardiologist who performed the surgery put a stent into the main artery and I’ve been fine (on medications) for several years now.
If you’re a senior citizen, you might have high blood pressure too. High blood pressure affects an estimated 70% or more of older adults. Having high blood pressure can quietly damage your body for years before symptoms appear. Perhaps that’s why every time you go to the doctor or to urgent care, they take your blood pressure. So, I’d imagine that your blood pressure must be pretty important, right?
In case you’ve never really paid too much attention to your blood pressure (like me), or you’re on medication for high blood pressure, or you’re taking care of somebody who has high blood pressure, this **Rafu Shimpo** article is to review the basics of blood pressure so you can understand this condition better.
Now, I’m not a doctor, and I don’t know too much about how our bodies work. However, after reading several articles from various, reliable sources, the following is my simple version of understanding blood pressure:
Your heart is a pump. Your heart pumps blood filled with nutrients and oxygen to your vital organs and tissues throughout your body. To do this, your heart contracts, then relaxes (an action similar to clenching and unclenching your fist). When the heart beats, it pushes out blood through your arteries that generates a pressure against the walls of the arteries. Arteries are the blood vessels that carry the blood from the heart. Veins are the blood vessels that bring the blood back to the lungs and the heart.
As children, we never worried about our blood pressure. How many kids at grammar school do you remember checking their blood pressure? NONE. That’s because, as children, you have healthy arteries that are flexible, strong and elastic. Healthy arteries have a inner lining that is smooth, unclogged, loose and more pliable so that blood flows freely and your blood pressure is low.
However, as we get into our 60s, 70s, and 80s, the artery walls become less elastic. Our blood vessels tend to get stiffer, less supple and less resilient in general. Fats from food enter the bloodstream, collecting and clogging arteries. This limits blood flow and increases the pressure of blood flowing through the arteries. This makes blood pressure go up.
Furthermore, if people have experienced inflammation, high cholesterol, and/or high blood sugar, that tends to thicken and stiffen the artery walls as well.
When your doctor measures your blood pressure, you hear two numbers. The top number is your systolic blood pressure. It tells you how much pressure is in your blood vessels when your heart contracts (pumps).
The bottom number is your diastolic blood pressure. It gives you an idea of how much pressure is in your blood vessels between your heart’s contractions (when your heart is resting). Both of these numbers are important.
Blood pressure is measured in millimeters of mercury (mm Hg). Hopefully, your heart is pumping a certain amount of blood and your vessels are stretchy enough, your blood pressure should fall within a normal range. A normal blood pressure is a systolic pressure of less than 120 over a diastolic pressure of less than 80. This is commonly written as 120/80mm Hg.
But if your heart starts to work overtime, e.g., pumping blood through narrow or clogged arteries, or if your blood vessels become too stiff, your blood pressure will rise, i.e., hypertension.
In the U.S., the American Heart Association define hypertension is that they say that Stage 1 hypertension is a systolic blood pressure of 130 to 139 millimeters of mercury or a diastolic of 80 to 89. And then they say that Stage 2 hypertension is a systolic over 140 or a diastolic over 90.
For years, the guidelines identified hypertension as starting at a systolic of 140, not 130, but the guidelines were changed in 2017 (possibly because the pharmaceutical companies want to sell more drugs).
Speaking about medications, blood pressure medications, aka, “antihypertensive medications,” while effective at lowering blood pressure, can cause a all kinds of side effects. These include dizziness, fatigue, headache, cough, and sexual dysfunction. More serious side effects can include angioedema (swelling of the face and neck), heart block, and even death in rare cases.
Chances are, the more medications (or greater dose of the same medication), the greater the chance of adverse side effects. So, if you want to minimize the risk of taking more medications, I found the following 10 lifestyle changes that can lower blood pressure and keep it down online. (Source: www.mayoclinic.org, “10 Ways to Control High Blood Pressure Without Medication, July 23, 2024):
1. Lose extra weight and watch your waistline
Weight loss is one of the best ways to control blood pressure. If you’re overweight or have obesity, losing even a small amount of weight can help lower blood pressure.
Also, the size of the waistline is important. Carrying too much weight around the waist can raise the risk of high blood pressure.
In general, men are at risk if their waist measurement is greater than 40 inches and women are at risk if their waist measurement is greater than 35 inches. Ask your healthcare professional about a healthy waist size for you.
++2. Exercise regularly++
Regular aerobic exercise can lower high blood pressure. It’s important to keep exercising to keep blood pressure from rising again. As a general goal, aim for at least 30 minutes of moderate physical activity every day.
Exercise also can help keep elevated blood pressure that’s slightly higher than ideal from turning into high blood pressure, also called hypertension. For those who have hypertension, regular physical activity can bring blood pressure down to safer levels.
Some examples of aerobic exercise that can help lower blood pressure include walking, jogging, cycling, swimming and dancing.
++3. Eat a healthy diet++
Eating a diet rich in whole grains, fruits, vegetables and low-fat dairy products and low in saturated fat and cholesterol can lower high blood pressure. Food makers often add sodium to processed foods to make them taste salty.
Ask your healthcare professional about healthy eating plans.
4. Reduce salt and sodium in your diet
Don’t add table salt. Use herbs or spices to add flavor to food. Even a little less sodium in the diet can improve heart health and blood pressure. Sodium’s effect on blood pressure varies among groups of people.
Eat fewer processed foods. Only a small amount of sodium occurs naturally in foods. Most sodium is added during processing. Read food labels. Look for low-sodium versions of foods and drinks.
5. Limit alcohol
Limiting alcohol to less than one drink a day for women or two drinks a day for men can help lower blood pressure by about 4 mm Hg. One drink equals 12 fluid ounces of beer, 5 ounces of wine or 1.5 ounces of 80-proof liquor.
But drinking too much alcohol can raise blood pressure by many points. It also can make blood pressure medicines less effective.
6. Quit smoking
Smoking raises blood pressure. Stopping smoking helps lower blood pressure. It also can lower the risk of heart disease and improve overall health, possibly leading to a longer life.
7. Get a good night’s sleep
Adults should aim to get 7 to 9 hours of sleep every night. Getting fewer than seven hours of sleep every night for weeks can play a role in hypertension. Limit naps — for those who find napping during the day helpful, limit naps to 30 minutes and take them earlier in the day. You may sleep better at night.
Conditions that can disrupt sleep include sleep apnea, restless leg syndrome and general sleeplessness, also called insomnia.
Let your healthcare professional know if you often have trouble sleeping.
++8. Ease stress++
Long-term stress may play a part in high blood pressure. Figure out what causes stress, such as work, family, finances or illness. Once you know the causes of your stress, try to avoid them.
– Don’t try to do too much. Learn to say no. Focus on your most important tasks.
– Stay away from stress triggers. For example, rush-hour traffic. If possible, stay away from people who cause stress.
– Make time to relax. Take time each day to sit quietly and breathe deeply. Make time for enjoyable activities or hobbies, such as taking a walk, cooking or volunteering.
– Practice gratitude. Showing other people that you feel grateful to them can help lower stress.
9. Track your blood pressure at home and get regular checkups
You can measure your blood pressure at home to help make sure that your medicines and lifestyle changes are working. Home blood pressure monitors are available widely and without a prescription. Talk to a healthcare professional about home monitoring before you get started.
10. Control your cholesterol and blood sugar
High blood sugar and high levels of “bad” non-HDL cholesterol raise the risk of heart disease. To help manage cholesterol and blood sugar, try some of the same healthy habits that help lower blood pressure. Eat healthy, get exercise, lose extra weight and don’t smoke.
Follow your healthcare professional’s advice on how to manage cholesterol and blood sugar.
In conclusion, you might not be able to make all 10 of these lifestyle changes all at once. Don’t stress over it! Do what you can do. If you can just make one or two lifestyle changes, you’ll be much better off.
For me, I’ve made three of the 10 (and working on more) to help lower my blood pressure: (1) I stopped reaching for the salt shaker at the dinner table; (2) By avoiding situations (and people) who cause me stress, e.g., driving at rush hour; and (3) I have a home blood pressure monitor and I’m tracking my blood pressure regularly.
Judd Matsunaga, Esq., is the founding partner of the Law Offices of Matsunaga & Associates, special-izing in estate/Medi-Cal planning, probate, personal injury and real estate law. With offices in Torrance, Hollywood, Sherman Oaks, Pasa-dena and Fountain Valley, he can be reached at (800) 411-0546. Opinions expressed in this column are not nec-essarily those of The Rafu Shimpo.