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Health Information Five Things You Should Know About ... High Blood Pressure

Blood pressure affects your health at every level.

With Thanksgiving kicking off the holidays, it's important to remember that the ups and downs of the season can take a toll on your well-being. Overindulging in empty calories, missing workouts, dealing with holiday stress and skimping on sleep can all raise your blood pressure, putting you at risk for long-term health problems.

Blood pressure is the force of blood pushing against the walls of arteries as the heart pumps blood. High blood pressure, also referred to as hypertension, is when that force is too high and begins harming the body. It is measured in two numbers: The top systolic blood pressure measures the force pushing against artery walls when the heart is contracting. The bottom diastolic blood pressure measures pressure in the arteries when the heart is resting between beats. Normal blood pressure levels are 120 mmHg/80 mmHg or lower. At risk levels are 120-139 mmHg/80-89 mmHg. Readings of 140 mmHg/90 mmHg or higher are defined as high blood pressure.

There’s a good reason that every doctor's appointment starts with a blood pressure check. While one in three American adults has high blood pressure, about 20 percent of people are unaware that they have it because it is largely symptomless.

"Most people find out they have high blood pressure during a routine office visit," says Rolando Lara, MD, a primary care physician at Rush University Medical Center. "If left untreated, high blood pressure will damage the heart and blood vessels." Here are five other things you should know about high blood pressure.

Blood pressure is linked to other medical issues. High blood pressure can be the first indication of a serious underlying condition. "When a patient comes in with high blood pressure, we check their urine and kidney function; do an electrocardiogram to check the size of the heart; and look for lung changes," says Lara.

Stress on the blood vessels makes people with hypertension more prone to heart disease, heart attack, stroke, kidney disease and aneurysms. Correspondingly, chronic conditions such as diabetes, kidney disease, sleep apnea and high cholesterol increase the risk for developing high blood pressure.

In some women, pregnancy can contribute to high blood pressure, leading to preeclampsia. Postpartum blood pressure typically goes back to normal levels within six weeks. However, some women who have high blood pressure during more than one pregnancy may be more likely to develop high blood pressure and other cardiovascular diseases as they age.

You shouldn't ignore white coat hypertension. Some people experience white coat hypertension, when blood pressure is elevated in the doctor's office but not in other settings. Lara says that these patients need to monitor their blood pressure at home or wear an ambulatory blood pressure monitor that takes your blood pressure every 30 minutes for 24 hours.

While white coat hypertension was formerly considered simple nervousness, recent research suggests otherwise. A study published in the journal Hypertension found that people with white coat hypertension are at a significantly greater risk for developing sustained high blood pressure than people who have normal blood pressure. One possible explanation is that people with white coat hypertension have a harder time managing stress and anxiety.

Learning to cope with stress can help. Stress and hypertension have often been linked, but researchers are still looking into a direct relationship between the two. Still, Lara's first piece of advice to hypertensive patients: "Try to relax."

When you are stressed, your body sends stress hormones — adrenaline and cortisol — into the bloodstream. These hormones create a temporary spike in blood pressure, causing your heart to beat faster and blood vessels to narrow. When the stressful situation is over, blood pressure goes back to its normal level. Chronic stress, however, may cause your body to stay in this highly-charged state longer than natural.

While stress itself may or may not affect blood pressure, how you cope with stress does. For instance, overeating, smoking and drinking alcohol in response to stressful situations are direct causes of sustained high blood pressure. On the flip side, healthier coping mechanisms like exercising, practicing yoga and meditating can all help lower blood pressure.

Good sleep can prevent and manage high blood pressure. Most people experience a dip in blood pressure during the deepest stage of sleep (also known as slow wave sleep), which is the body’s normal and healthy reaction to sleep. Not having that nighttime dip is a risk factor for heart disease and may increase daytime blood pressure. Typically people spend 90 minutes to two hours in slow wave sleep per night. A recent study published in Hypertension found that men who got less slow wave sleep each night were a higher risk for hypertension than men who got more deep sleep.

While sleep disorders like sleep apnea and age can both affect the amount of deep sleep you get, there are steps you can take to ensure a good night's sleep. Getting seven to eight hours of sleep a night, maintaining a consistent sleep schedule and being more active during the day can help improve the quality of your sleep.

Excessive salt raises blood pressure. Too much sodium can cause water retention that puts increased pressure on your heart and blood vessels. People with high blood pressure and those at a high risk for developing hypertension, including adults over 50 and blacks, should have no more than 1,500 milligrams (mg) of sodium daily, less than 3/4 teaspoon of salt, while people with normal levels should have no more than 2,300 mg of sodium, about one teaspoon of salt.

Most dietary sodium comes from processed foods. Rules of thumb are to choose foods with five percent or less of the daily value of sodium per serving and opt for fresh poultry, fish and lean meats, rather than canned, smoked or processed. Similarly, fresh or frozen vegetables are better than canned.

A recent study published in the New England Journal of Medicine found that if people cut just 1/2 teaspoon of salt per day, it could help lower the number of new cases of heart disease per year by up to 120,000.

Further, potassium — found in foods like sweet potatoes, spinach, bananas, oranges, low-fat milk and halibut — can counterbalance the pressure-increasing effects of sodium by helping to rid the body of excess sodium.


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Please note: All physicians featured in Discover Rush Online are on the medical faculty of Rush University Medical Center. Some of the physicians featured are in private practice and, as independent practitioners, are not agents or employees of Rush University Medical Center.

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November 2012 
 

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