What’s the No. 1 risk factor for cardiovascular disease?
Is it high cholesterol? Stress? Being male? If you guessed high blood pressure (hypertension), you’re ahead of many of us. High blood pressure is one of the strongest risk factors for cardiovascular disease.1 However, a large number of people are unaware they have high blood pressure because they have no symptoms. No wonder they call it the silent killer.
Some risk factors for cardiovascular disease are not controllable. Older age, male gender, being postmenopausal and having a family history of the disease are uncontrollable risk factors. Fortunately for many, hypertension is among the controllable risk factors, in addition to smoking, being overweight, having diabetes or metabolic syndrome and the presence of elevated triglycerides and cholesterol.
How many of us know our average blood pressure reading and have had it recently measured? And how many who have been told they have high blood pressure have taken steps to control it?
Listen to Life Extension’s Michael A. Smith, MD, and Crystal Gossard, DCN, CNS®, LDN, as they review the importance of blood pressure in heart disease on www.LiveForeverish.com
What is normal blood pressure?
Normal blood pressure is less than 120/80 mm Hg. When the top number (systolic) is between 120 and 129 mm Hg and the bottom number (diastolic) is less than 80 mm Hg, blood pressure is elevated. Stage 1 hypertension occurs when the systolic reading is between 130 and 139 mm Hg and the diastolic reading is 80 to 89 mm Hg. Stage 2 hypertension is categorized as blood pressure greater than 140/90 mm Hg.2
Some evidence suggests that a target blood pressure of 115/75 mm Hg may be optimal.
Blood pressure meaning
Blood pressure is a measure of the pressure inside the blood vessels when the heart beats and when the heart is at rest.
Systolic blood pressure (the top number) measures the pressure inside the blood arteries when the heart beats. Diastolic blood pressure (the bottom number) reflects the pressure within the arteries when the heart is at rest between beats.
When pressure against the walls of the arteries is chronically elevated, it slowly damages the blood vessel lining. This makes the arterial lining susceptible to the buildup of plaque, which narrows the arteries and further increases pressure. If plaque ruptures, a blood clot can form that blocks narrowed arteries and impedes blood flow. When blockage occurs in the arteries that provide blood to the heart muscle, it is called a heart attack (myocardial infarction). When it occurs in the vessels that nourish the brain (due to blood-clot formation within the vessel, or a blood clot or plaque that traveled through the bloodstream), it is known as a stroke (cerebrovascular accident). High blood pressure can also cause a blood vessel in the brain to burst, which is known as a hemorrhagic stroke.3
Blood pressure measurement
Blood pressure is measured with a device known as a sphygmomanometer. Many of these devices are now electronic and can rapidly deliver accurate blood pressure measurements when applied to the arm or wrist. Because blood pressure changes throughout the day and may be higher than usual when measured in a medical practitioner’s office due to “white coat syndrome” (patient anxiety), monitoring blood pressure at home is an ideal way to gauge the effectiveness of one’s blood pressure maintenance program.
How to lower blood pressure
You’ve heard it before, but not smoking; maintaining a healthy weight; consuming a healthy diet (such as the DASH or Mediterranean diet) that contains a low amount of salt; engaging in regular, physician-approved exercise; and periodic monitoring of blood pressure by a medical professional, along with taking any prescribed medicines as directed, are essential for blood pressure control.
Long-term stress management is also important. Learn how to handle life’s challenges in a positive manner. Meditation, walking or engaging in other relaxing activities can be helpful. Those who need more help may wish to ask their physicians about biofeedback therapy, which helps train the user to modify factors that affect blood pressure. In one study of biofeedback training among hypertensive patients, more than half lowered their blood pressure sufficiently enough to eliminate the need for medication.4 Similar reductions in blood pressure occurred among those who were not using blood pressure medications.
Foods to reduce blood pressure
As part of a comprehensive program to support healthy blood pressure, fruits and vegetables that are naturally low in sodium are good dietary choices. The Dietary Approaches to Stop Hypertension (DASH) diet recommends fruit and vegetables, whole grains and low-fat dairy products to lower blood pressure.5 Combining this eating pattern with sodium reduction has been associated with an even greater benefit.6
Nutritional supplements can be added to the diet to further improve blood pressure management. Research suggests that quercetin, stevioside (from stevia), fish oil, magnesium, pomegranate and potassium may be helpful.7-12
Although it often has no symptoms, high blood pressure is nothing to ignore. It’s critical to have blood pressure checked periodically, particularly as we get older. If you have high blood pressure, count yourself among the lucky individuals who have a health condition that is largely controllable. You’ll find that the recommended lifestyle changes that help control blood pressure will benefit many other aspects of health and well-being and lower the risk of other aging-associated conditions.
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1. Kjeldsen SE et al. Pharmacol Res. 2018 Mar;129:95-99.
2. Whelton PK et al. Circulation. 2018 Oct 23;138(17):e426-e483.
3. Available at: https://www.heart.org/en/health-topics/high-blood-pressure/health-threats-from-high-blood-pressure
4. Fahrion S et al. Biofeedback Self Regul. 1986 Dec;11(4):257-77.
5. Chiu S et al. Am J Clin Nutr. 2016 Feb;103(2):341-7.
6. Sacks FM et al. N Engl J Med. 2001 Jan 4;344(1):3-10.
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9. Geleijnse JM et al. J Hypertens. 2002 Aug;20(8):1493-9.
10. Rosanoff A et al. Magnes Res. 2013 Jul-Sep;26(3):93-9.
11. Asgary S et al. Phytother Res. 2014 Feb;28(2):193-9.
12. Filippini T et al. Int J Cardiol. 2017 Mar 1;230:127-135.