Tuesday, July 06, 2010


Avoid the “silent killer” with a heart-healthy lifestyle

Hypertension, or high blood pressure, is often referred to as the “silent killer” because it causes damage without creating symptoms. Many people may have high blood pressure for years without knowing it, and during this time damage to the organs, such as the blood vessels, the heart, and kidneys can occur, which could ultimately lead to heart attack, heart failure, stroke, and kidney failure.

Screening for hypertension is quick, easy, and painless, and is performed right in your doctor’s office. The American Heart Association recommends adults maintain a blood pressure of less than 120/80 mm Hg (millimeters of mercury). This means systolic readings of less than 120 mm Hg AND diastolic readings of less than 80 mm Hg.

Although there is no cure for hypertension (in most cases), it is a disease that is usually manageable.

If your resting blood pressure falls in the pre-hypertension range (systolic between 120 and 139 mm Hg OR diastolic between 80 and 89 mm Hg, your doctor will often recommend lifestyle modifications, such as:

1) Eating a healthy diet. The National Heart Lung and Blood Institute recommends the following Heart Healthy Diet Guidelines. You should eat:
• 8-10% of the day's total calories from saturated fat.
• 30 percent or less of the day’s total calories from fat.
• Less than 300 milligrams of dietary cholesterol a day.
• Limit sodium intake to 2400 milligrams a day.
• Just enough calories to achieve or maintain a healthy weight and reduce your blood cholesterol level (Ask your doctor or registered dietitian what is a reasonable calorie level for you).

2) Increasing physical activity. In general you should gradually work up to an aerobic session lasting 20 to 30 minutes, at least three to four times a week. Exercising every day or every other day will help you keep a regular aerobic exercise schedule.

3) Maintain a healthy weight. Being overweight or obese increases your risk of developing high blood pressure. In fact, your blood pressure rises as your body weight increases. Losing even 10 pounds can lower your blood pressure—and losing weight has the biggest effect on those who are overweight and already have hypertension.
If your doctor recommends that you lose weight, there are a variety of healthcare professionals who can help get you on the right track. People who are slowly gaining weight can either gradually increase physical activity to 300 minutes a week of moderate-intensity aerobic activity, or reduce caloric intake, or both, until their weight is stable.

4) Managing stress. After you've identified the cause of stress in your life, the next step is to learn techniques to help you cope. There are many techniques you can use to manage stress. Some of which you can learn yourself, while other techniques may require the guidance of a trained therapist.

5) Limiting alcohol intake. Numerous studies suggest that moderate alcohol consumption helps protect against heart disease by raising HDL (good) cholesterol and reducing plaque accumulations in your arteries. Alcohol also has a mild anti-coagulating effect, keeping platelets from clumping together to form clots. Both actions can reduce risk of heart attack but exactly how alcohol influences either one still remains unclear.
On the other hand, drinking more than three drinks a day has a direct toxic effect on the heart. Heavy drinking, particularly over time, can damage the heart and lead to high blood pressure, alcoholic cardiomyopathy (weakened heart), congestive heart failure, and stroke.

6) Avoiding tobacco smoke. The negative effects of smoking are well documented, and it can lead to a wide range of health problems from cancer to heart disease to death. One of the most important things you can do to reduce your risk of heart disease is to avoid tobacco smoke.

If your resting blood pressure falls in the hypertensive range (systolic over 140 mm Hg and diastolic over 90 mm Hg), then your doctor will likely prescribe antihypertensive medications in addition to lifestyle modifications.

Managing hypertension requires a lifelong commitment to working with your doctor to achieve adequate blood pressure control. Remember that doing so will help reduce your risk of developing heart disease, stroke, and serious kidney diseases, as well as reducing your risk of premature death.

Dr. Michael J. Fucci is a cardiologist on the Backus Medical Staff with an office at the Plainfield Backus Health Center and member of Cardiology Associates of Norwich. This column should not replace advice or instruction from your personal physician. If you want to comment on this column or others, visit the Healthy Living blog at www.backushospital.org/backus-blogs or e-mail Dr. Fucci or any of the Healthy Living columnists at healthyliving@wwbh.org

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