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Prevention

  

Primary Prevention of High Blood Pressure

 

 

Blood Pressure Statistics

  • 50 million Americans have high blood pressure

  • 1 in four adults

  • 1/3 are unaware of their problem

  • Deaths from high blood pressure are up 21% in past 10 years

  • Another 23 million adults have "high normal" pressure increasing risk by 60% to 80%

  • 44% of all persons 50 or older have high blood pressure

  • At age 60+, one of every two persons has high blood pressure

  • The lifetime probability of having high blood pressure is 90%

Source: AHA Heart and Stroke
Statistical Update, 2002
 

The DASH Diet

  • Emphasize fruits and vegetables. Daily goal is 5 servings of fruit and 4 servings of vegetables daily

  • Choose non or low fat dairy products

  • Choose whole grain breads and cereals

  • Eat nuts

  • Reduce intake of red meats, sweets, and soda pop

Source: National High Blood Pressure Education Program
  In spite of continued emphasis on blood pressure control, high blood pressure continues to be a major health problem. Consider the American Heart Associations statistics to the left. Preventing high blood pressure can reduce the risk for:
  • Heart attack and heart failure
  • Stroke
  • Kidney disease
  • Blindness

In America, blood pressure increases with increasing age. In populations that are healthier (active, not overweight, healthy eating habits, etc.) blood pressure does not increase with age. The most effective way to control high blood pressure problems is to prevent it from developing.

October 16, 2002 the National High Blood Pressure Education Program (NHBEP) of NIH launched a new program for the nation on prevention of high blood pressure.

Here are the new standards for blood pressure1.

Healthy blood pressure 120/80 or below
High normal (increases risk of stroke or heart disease by 60% to 80%) 130/85 to 139/89
High blood pressure (increases risk of heart disease or stroke by 2-3 times) 140/90 or higher

The NHBEP is recommending six major lifestyle modifications for the nation. These six modifications                 are proven effective in reducing blood pressure1. These same principles can help prevent a blood pressure problem from ever occurring.

1. Maintain a healthy weight. Body mass index (BMI) less than 25 and waist girth less than 35 inches for men or less than 33 inches for women is ideal.

2. Reduce dietary sodium intake to no more than 2400 mg per day (100 mmoles). That means cutting salt intake and salty foods (pickles, chips, soy sauce etc.) Also learn to read food labels.

3. Engage in regular aerobic physical activity such as brisk walking. Aim for at least 30 minutes per day, daily when possible. The national Institute of Medicine recommends working up to 60 minutes per day for optimum benefit.

4. Limit alcohol intake if you drink alcohol at all. A high alcohol intake (more than 1 drink per day for women or 2 per day for men) increases the risk of high blood pressure.

5. Maintain an adequate intake of dietary potassium. 3500 mg/day is recommended (90 mmol/day). Potassium is protective against high blood pressure. Most fruits and vegetables are good sources of potassium.

6. Consume a diet that is rich in fruits and vegetables. Also choose non or low fat dairy products and limit other foods high in saturated fat such as meats and rich desserts. This eating plan is called the DASH diet.

These 6 simple steps can significantly reduce the risk for high blood pressure. The good news is that even a small drop in pressure can result in a rather large drop in risk. For example, only a 5% drop in systolic blood pressure (top number) will:

  • Reduce the risk of a stroke by 14%
  • Reduce the risk of coronary heart disease by 9%
  • Reduce the risk of mortality from any cause by 7%

Lifestyle Intervention Trial2. A large community based intervention trial looked at weight loss and sodium reduction in reducing blood pressure. Everyone in the study had high blood pressure and were taking blood pressure medication. The study continued for 18 months.

Of those people who reduced their weight by only 10 pounds 36% were able to control their blood pressure without medication. 31% of those who reduced their sodium intake were able to get off their medications. If they both lost weight and reduced sodium intake, 53% were able to control their blood pressure without medications. These are remarkable results with only 2 of the 6 lifestyle changes being implemented. Think of the financial impact alone if half of all people on blood pressure medications could get off their medicines and control their pressure with healthy lifestyle changes!

 

 

Reference

1. Whelton PK et al, Primary prevention of hypertension, JAMA Oct. 16, 2002|
2. Whelton PK et al, Sodium reduction and weight loss in the treatment of Hypertension in older persons, JAMA Mar 18, 1998; 279:839-46


Making Healthy Choices articles are written by Don Hall, DrPH, CHES president of LifeLong Health with contributions from associated health professionals. Content is general health information from evidence based research. It's purpose is not to treat disease or take the place of advice by your doctor but to promote healthy lifestyles. Persons with health problems should contact their physician for specific guidance.

Copyrighted 2002 by PrevMedix LLC. All rights reserved. Do not make unauthorized copies.

Updated: 12/17/02