understanding hypertension - lifestylemedicalcenters.com · stage 1 hypertension 140-159 90-99...



Blood pressure does vary some throughout the

day; it is lowest as you sleep and rises when

you get up. It also can rise when you are active,

excited, or nervous. Still, for most of your

waking hours, your blood pressure stays pretty

much the same while you are standing still or

just sitting. It is possible, though uncommon, for

someone to have blood pressure that is so low

that it is unhealthy. However, the much more

common problem is blood pressure that is too

high, and this is called ‘hypertension’.

What do the blood pressure numbers mean?Blood pressure is always given as two numbers.

The first number is the pressure when the heart

contracts; this is called the systolic pressure

and is the higher number. The second number

is the pressure between heart beats; this is the

diastolic pressure and is the lower number.

Both are important. Usually they are written

one above or before the other, such as 120/80

mmHg. Verbally this blood pressure would be

expressed as “120 over 80.” The diagnosis of

hypertension is based on your blood pressure

numbers, as shown in the table below:

Blood Pressure Category Systolic Diastolic

Healthy less than 120 less than 80

Prehypertension 120-139 80-89

Stage 1 Hypertension 140-159 90-99

Stage 2 Hypertension 160 or higher 100 or higher

Notes: When the systolic and diastolic blood

pressures fall into different categories, the

higher category should be used to classify

blood pressure level. For example, 150/82

would be stage 1 hypertension. Also, if you are

taking medication to lower your blood pressure,

you are still diagnosed with ‘hypertension’

regardless of your current blood pressure

numbers.

Why should I care about my blood pressure?Higher blood pressure puts excessive

mechanical stresses on the arteries, which

damages them and increases the workload on

the heart. Over time the health consequences

of this can include:

• Damage to the heart muscle, including

thickening, weakening, and failure

• Stroke

• Kidney failure

• Loss of vision

• Erectile dysfunction

• Memory loss and dementia

• Fluid in the lungs

• Angina (chest pain) and heart attacks

• Peripheral vascular disease

It is important to

understand that these

are not the symptoms

of hypertension;

these are the

consequences of

hypertension. High

blood pressure

is sometimes

called ‘the silent

killer’ because it

contributes to these

serious and sometimes

Blood is carried from the heart out to all parts of your body in vessels called arteries. Blood pressure is the force generated against the walls of the arteries by the blood as it moves along. Each time the heart beats it generates pressure and pumps blood out into the arteries. Your blood pressure is at its highest when the heart beats, pumping the blood. When the heart is at rest, between beats, your blood pressure falls.



even fatal consequences without causing any

symptoms until the damage has already been

done. Find out if you have high blood pressure

BEFORE these devastating problems develop.

If diagnosed early, you can still take steps to

prevent and to some extent even reverse the

damage.

Who should have their blood pressure checked?The American Heart Association recommends

that all persons over the age of 20 years have

their blood pressure checked. This is good

advice even if you are young, slim, and fit since

genetic factors could be working against you

even if everything else is very favorable. As

long as your blood pressure is good (less than

120/80 mmHg), then checking it only at regular

healthcare visits, or at least every 2 years, is

reasonable. If your blood pressure

reading is higher than normal, your

health care provider may take

several readings over time

and/or have you monitor

your blood pressure at

home before diagnosing

you with high blood

pressure.

It is also important to know

that your risk of damage

from high blood pressure is

even greater if you have high

blood pressure along with:

• Obesity or being overweight

• Smoking

• High cholesterol

• Diabetes

• Physical inactivity

• Family history of high blood pressure, or

any other problems associated with high

blood pressure

If any of these apply to you, then it becomes

even more important for you to keep a close

eye on your blood pressure!

What should I do if my blood pressure is elevated?The first step is for you and your health care

provider to look at multiple factors, and not just

the numbers from a one-time measurement of

your blood pressure. If after that the decision

is made to take steps, then there are several

factors to consider.

Diet: Your diet, and whether it is contributing to

your elevated blood pressure, is one potentially

important issue to discuss with a health care

provider well trained in nutrition. Clinical studies

have shown that changes in your diet can lower

your blood pressure, even if you do not lose

weight1. A knowledgeable provider can evaluate

your current diet and then work with you on

implementing changes that will help to lower

your blood pressure.

Weight Loss: If you are

overweight and have an elevated

blood pressure, then losing

some of those extra pounds

can be a very effective way to

significantly lower it. However,

it is not necessary to get ‘slim’

in order to help your blood

pressure. Studies have shown

that even a modest weight loss,

such as 5 to 10 percent of your

total body weight, can produce

significant health benefits.2,3 This means

that someone who weighs 200 pounds can help

lower their blood pressure by losing just 10 to

20 pounds.

There are many diets and weight loss programs

to choose from, but there is no one diet or

weight loss program that is ‘best’ for everyone.

Be cautious about getting important health

care information from TV advertisements and

magazine articles in the grocery checkout lanes;

these sources of information know nothing

about you. The critical factor is to develop a



weight loss program that will enable you to lose

weight, lower your blood pressure, provide all

essential nutrients, and be a diet you can live

with. Developing a weight loss program with

the greatest chance of success must start with

a careful and thorough assessment of your

current status. But that is just the beginning.

Continuing support, education, monitoring, and

adjustments will be necessary as you work with

your program.

It is also important to know that not all weight

loss is the same when it comes to improving

your health. For example, weight loss

programs advertising large

amounts of weight loss in

a very short time fail to

mention that most of

the lost weight is water

rather than body

fat. Losing body fat

is the key. A good

weight loss program

should include more

than just measuring

your body weight; it

is important to monitor

your body composition to

track changes in fat, water, and

the other tissues as you lose weight.

Specialized centers like LifeStyle Medical Clinic

can easily measure your body composition using

equipment that looks much like a regular scale.

Exercise: Clinical studies have shown that exercise

can help to lower blood pressure4. But does

knowing this mean that you will start spending

an hour in the gym 5 times a week? Probably not.

Having a healthy lifestyle and lowering your blood

pressure generally includes getting some exercise,

but how much exercise? What kinds of exercise?

How often and for how long?

These are important questions for you to ask,

but no one can give you the answers without

first talking with you about your situation:

• Knee arthritis or a bad back?

• Medical conditions that impact your

exercise tolerance and safety?

• Never been to a health club or do not

have ready access to one?

• Too much work and not enough time?

• Exercise activities you enjoy, and ones you

do not?

As with a weight loss program, the critical

factor is developing a safe exercise program

that you can stick with, and that starts with

a careful evaluation of your current status

and includes the support, education, and

adjustments necessary to implement lasting

changes.

Medications: 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), the initial treatment

will usually be changes in your diet, weight loss,

and exercise as discussed above. However, if

your blood pressure is 140/90 or higher, then in

addition to lifestyle modifications, doctors will

usually recommend starting medication5.

It is important that you fully discuss blood

pressure medications with your health care

provider, and then carefully follow their

recommendations. The unfortunate truth is that

sometimes effective treatment of hypertension

may mean taking medication every day for the

rest of your life; the need for this will depend to a

great extent on your success with diet changes,

weight loss, and increased physical activity.

Where can I get help?The most important thing is that you check your

blood pressure. If it is elevated, get some help

understanding what the numbers really mean

for you. Most primary health care providers



can provide you with this service. Hypertension

has potentially catastrophic consequences. Do

not miss the opportunity to lower your blood

pressure before you develop hypertension.

Anyone committed to lowering

their blood pressure and

improving their health

will be best served by

working with a clinic

that specializes in

the evaluation and

management of

chronic conditions.

Hypertension is

a lifelong disease,

and by partnering with a healthcare team like

LifeStyle Medical Center we can combine medical

and lifestyle treatments into an individualized

treatment plan that will help you successfully

reach your treatment goals and enjoy the benefits

of better health. On-going evaluation, education,

support, monitoring, and adjustments are the keys

to your success.

For more information about our services,

insurance coverage, clinic location and hours,

please feel free to Call (919) 354-7077 or e-mail

us at [email protected].

References:1 Appel LJ, et al. Dietary Approaches to Prevent and Treat Hypertension: A Scientific Statement From the American Heart Association. Hypertension, volume 47,

pages 296-308, 2006.

2 NIH, NHLBI Obesity Education Initiative. Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults. Available online

from the Center for Disease Control: http://www.nhlbi.nih.gov/guidelines/obesity/ob_gdlns.pdf

3 Blackburn G. Effect of degree of weight loss on health benefits. Obesity Research, volume 3, pages 211S-216S, 1995.

4 Kokkinos PF, Papademetriou V. Exercise and Hypertension. Coronary Artery Disease, volume 11, pages 99-102, 2000.

5 Chobanian AV, et al. Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Hypertension,

volume 42, pages 1206-1252, 2003.

understanding hypertension - lifestylemedicalcenters.com · stage 1 hypertension 140-159 90-99...

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