May 26, 2000

"Silent Killer" Can be Controlled With Lifestyle Changes Smoking Cessation, Weight Loss and Aerobic Exercise Can be Helpful

High blood pressure, or hypertension, is one of the greatest threats to public health in the developed nations of the world. Left unchecked, as it often is, hypertension leads to a host of complications including heart attacks and strokes as well as damage to the retina of the eye and/or kidney damage. It is known as "the silent killer" because the symptoms are not usually evident until it has caused a significant amount of damaged to the body.

In fact, many people live with high blood pressure for years without experiencing any symptoms or attribute the symptoms to some other minor condition. According to Alfredo Rat-niewski, M.D., an internal medicine physician with Centro Medico Latino, which is affiliated with Sharp Community Medical Group, the most common symptoms are headaches (usually in the back of the head, especially on rising in the morning), and dizziness or light-headedness. When high blood pressure become severe, headache, double vision, nosebleed, rapid heartbeat, ringing in the ears and twitching muscles are common. Nausea, vomiting and mental confusion can also occur.

Dr. Ratniewski explained that blood pressure is the force produced by the heart as it pushes blood through the arteries and capillaries in the body. It normally goes up and down throughout the day in response to stress and exertion. Hypertension occurs when the walls of the small arteries squeeze tight, reducing the size of the opening the blood flows through. To maintain the flow of blood through the body, the heart must pump harder.

Because blood pressure fluctuates with each heartbeat, the reading is given in two parts: systolic pressure, when the heart contracts; and diastolic, when the heart relaxes between contractions. Blood pressure is read with a sphygmomanometer, or blood pressure cuff which measures in millimeters of mercury (mm Hg). Hypertension is usually defined as a consistent systolic pressure of at least 140 mm Hg and a consistent diastolic pressure of at least 90 mm Hg. The key is consistent. A diagnosis of high blood pressure is made only after the blood pressure is found to be elevated on three occasions several days apart. Hypertension with readings of 180/110, on the other hand, or higher may require emergency medical treatment.

About one million Americans die each year as a result of high blood pressure. However, many of these deaths could be prevented if the condition were detected and treated early. Once diagnosed, high blood pressure can almost always be successfully treated.

While medication can be used to lower blood pressure, healthy lifestyle changes can help achieve a significant drop in blood pressure. Dr. Rat-niewski recommends the following lifestyle changes:

o If you smoke, stop.

o If you are overweight, losing 10 to 20 pounds can help lower blood pressure. An aerobic exercise program practiced regularly for at least 20 minutes three times a week will also bring blood pressure down. However, heavy weight training and isometric exercises can increase blood pressure.

o It is also important to limit the amount of salt in your diet and reduce, or eliminate entirely, alcohol consumption. Try to incorporate more fresh fruits and vegetables, low-fat dairy products, lean meats, poultry, fish and whole grain breads and cereals into your diet.

o In addition, if stress is contributing to your hypertension, learn a relaxation technique and practice it regularly to keep your blood pressure within bounds.

o Medication may plan an important role in your control plan. It is important that you take the medication as directed by your physician and on the label of the prescription bottle.

"As mentioned earlier, high blood pressure rarely shows symptoms early on," said Dr. Ratniewski. "The best way to know if your blood pressure is under control is to have it tested regularly, especially of you have a family history of high blood pressure or heart disease.

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