Unlocking Longevity: Your Heart is the Key - Part 3

This is a part 3 of our discussion about what we can do to lower the risk of heart disease. If you have not read the previous posts, you can find them here - Part 1 and Part 2. Today we will talk about abnormally high blood pressure.

High blood pressure, or hypertension, is a major risk factor for premature death and disability around the world. Imagine that your heart is a pump and your blood vessels are pipes. The higher the pressure in the system, the more force is acting on the blood vessel walls, resulting in more wear and tear damage. In the United States, nearly half of adults have high blood pressure, but only about 20% have it under control. Uncontrolled hypertension can lead to serious health problems, including heart attacks, strokes, kidney disease, heart failure, and dementia.

Taylor, Brent & Wilt, Timothy & Welch, H. (2011)

What is a normal blood pressure reading?

• According to the American College of Cardiology and the American Heart Association, hypertension is defined as blood pressure readings consistently at or above 130/80 mmHg.

• Blood pressure readings are classified as either systolic (the top number) or diastolic (the bottom number).

• For most adults, the goal is to keep blood pressure below 130/80 mmHg.

• There may be some variability for older individuals, where blood pressure goals may need to be slightly higher or lower depending on the patient's overall health, risk of falls or other side effects.

  

  Source: American Heart Association and American College of Cardiology

Is Your Blood Pressure Reading Accurate? Why It Matters for Your Health

Many factors can lead to inaccurate blood pressure readings. The quality of the medical office can be judged sometimes by how blood pressure measurements are taken. Here is the proper procedure:

• Rest for at least 5 minutes, preferably 10 minutes, in a seated position with your back straight and supported before blood pressure measurement.

• Sit with both feet flat on the floor, legs uncrossed, back straight, and arm supported at heart level on a table or other surface. Resting an arm in a lap can overestimate blood pressure readings by about 4 points. A dangling arm can produce even higher readings.

• Use a blood pressure cuff of the right size. A cuff that is too small can make the blood pressure reading higher, while a cuff that is too large can make it lower. Remove any clothing covering the area where the cuff will be placed.

• Avoid talking or using a phone during the measurement.

• Avoid caffeine, physical activity, stress, and smoking for at least 30 minutes before a reading.

• Empty your bladder before the reading.

  
  

Blood pressure should be measured multiple times, separated by at least one minute, and both arms should be checked at the first measurement date to determine which arm has the higher reading for future measurements.  Self-monitoring at home can help confirm a diagnosis and assess treatment effectiveness, but it is important to use validated devices and follow proper techniques. You can find a list of validated blood pressure measuring devices at https://www.validatebp.org. Approximately 84% of blood-pressure devices available for purchase online have not been verified for accuracy, as reported in a 2023 study. For my practice I chose the validated Omron Platinum blood pressure monitor.

Lifestyle changes and treatment

High blood pressure is a major risk factor for cardiovascular disease, but there are many ways to manage it.

• Diet: A healthy diet that emphasizes vegetables, fruits, legumes, nuts, whole grains, seeds, and fish can help to lower blood pressure. Reducing sodium intake to less than 2300 mg a day is also recommended.

• Limit alcohol consumption: Reduce alcohol intake to no more than one drink per day for women and two for men.

• Physical activity: Regular physical activity, even in short periods daily, can significantly reduce blood pressure and the risk of cardiovascular disease.

• Weight Management: Achieving and maintaining a healthy body weight can greatly improve blood pressure control in people with unhealthy weight.

• Manage stress: Practice stress-reduction techniques such as yoga or meditation

• Medications: For those who need it, medications play an important role and can be life-saving.

If you'd like to discuss your personal situation and receive individualized advice, schedule an appointment with the Institute for Diabetes, Endocrinology, Adiposity, and Longevity today.

Till next time,

Dr. Koren

DISCLAIMER: The content on this webpage is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your doctor or qualified healthcare provider. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.

References:

1. Taylor BC, Wilt TJ, Welch HG. Impact of diastolic and systolic blood pressure on mortality: implications for the definition of "normal". J Gen Intern Med. 2011 Jul;26(7):685-90.

2. Rahimi, Kazem et al. Age-stratified and blood-pressure-stratified effects of blood-pressure-lowering pharmacotherapy for the prevention of cardiovascular disease and death: an individual participant-level data meta-analysis. The Lancet, Volume 398, Issue 10305, 1053 - 1064

3. Your Blood Pressure Reading Is Probably Wrong by Betsy McKay. Wall Street Journal, Dec 16, 2024. https://www.wsj.com/health/wellness/blood-pressure-reading-wrong-902d9fbe

4. Picone DS, Chapman N, Schultz MG, Schutte AE, Stergiou GS, Whelton PK, Sharman JE. Availability, Cost, and Consumer Ratings of Popular Nonvalidated vs Validated Blood Pressure-Measuring Devices Sold Online in 10 Countries. JAMA. 2023 May 2;329(17):1514-1516.