High Blood Pressure (Hypertension)
High blood pressure, known in the clinical setting as hypertension,
is often called the "silent disease" since it has no
primary symptoms. However, it does have very serious health consequences.
Blood pressure is measured in two readings: one for systolic and
one for diastolic pressure.
The systolic pressure is measured first and is the highest number.
It measures the maximum pressure generated by the contraction
of the heart muscle. Diastolic pressure, the lower value, is measured
second and represents the pressure as the heart muscle relaxes.
Normal, average blood pressure is about 120 systolic and 80 diastolic,
or 120/80. (See the chart below for normal and abnormal values.)
The incidence of hypertension increases with age and is more
common for blacks than for whites. Men are more likely to have
hypertension in young adulthood and middle age than are women;
thereafter, the reverse is true. You're also more likely to develop
hypertension if you're overweight. Following are some special
circumstances affecting women:
- Birth control pills: hypertension has been reported
to be 2 to 3 times more common in women taking oral contraceptive
pills for 5 years or longer, and the risk appears to increase
- Pregnancy: hypertension during pregnancy can be dangerous,
so be sure you are under a doctor's care.
- Hormone replacement therapy (HRT): while HRT treatment
may have a beneficial effect on blood pressure and cardiovascular
risk, a few women may develop hypertension as a result of taking
Since uncontrolled hypertension requires the heart to work harder
and puts added stress on arteries, it has a negative effect on
a woman's health. In fact, the higher your abnormal blood pressure,
the more likely you are to develop cardiovascular disease (which
causes heart attacks and strokes), kidney disease and certain
eye problems. Hypertension currently has no cure, but it can be
controlled through medication and the lifestyle changes described
CLASSIFICATION OF BLOOD PRESSURE FOR ADULTS
OVER 18 YEARS
less than 130
less than 85
|Stage 1 (Mild)
|Stage 2 (Moderate)
|Stage 3 (Severe)
|Stage 4 (Very Severe)
more than 209
more than 119
Your Physician or Nurse Practitioner
Your physician or nurse practitioner will carefully evaluate
you if your blood pressure reads high on at least two separate
office visits. They will take a health history to evaluate your
lifestyle habits, stress profile, family history, past personal
history with hypertension, heart disease, stroke, diabetes or
kidney problems, as well as any medications you may currently
be taking. Certain medications can actually increase blood pressure.
You will also receive a thorough physical exam, including weight
check, further blood pressure checks, heart exam and sometimes
an EKG, eye and neck exam, exam of the abdomen and the extremities
to check for swelling or abnormal pulse.
If you are diagnosed with high normal hypertension, your physician
or nurse practitioner will make some lifestyle recommendations
and follow up with you at your next annual exam. If you have Stage
1 hypertension, you may be able to try some lifestyle modifications
for three to six months to see if your blood pressure will come
down without medication. Lifestyle modifications include:
- Lose weight if overweight.
- Eliminate or limit alcohol intake.
- Get regular, aerobic physical activity.
- Reduce sodium intake to less than 2 to 3,000 milligrams per
- Get adequate dietary potassium, calcium and magnesium.
- Stop smoking.
- Reduce dietary saturated fat.
If you have Stage 2 through 4 hypertension, your physician or
nurse practitioner will likely prescribe medication in addition
to lifestyle changes. They will monitor you closely to be sure
the medication is effective with the minimum of side effects.
Although many women don't like the idea of having to take medicine,
anti-hypertension drugs have contributed to the 50-percent reduction
in heart attack and stroke rates over the past 2 decades in the
U.S. It can be dangerous to alter or discontinue your medication
without your physician or nurse practitioner's supervision.
Traditional Chinese Medicine (TCM)
Your TCM practitioner can provide you with the most effective
therapy for High Normal and Stage 1 hypertension. Therapy would
include herbal or tea formulas as well as twice-weekly acupuncture
treatments. The TCM practitioner will also recommend dietary changes
such as those already mentioned. They will also recommend special
meditation techniques such as Tai Gi or Qi Gong, which are potent
A diet rich in vegetables, fruits, whole grains with moderate
amounts of lean protein and unsaturated fat and very limited quantities
of saturated fat, salt, sweets and alcohol will not only help
you control your hypertension, but also your weight. Special considerations:
- Get adequate potassium, calcium and magnesium. Good sources
for: potassium: winter squash, potato, pinto & kidney beans,
spinach, melon, banana and broccoli magnesium: spinach, tofu,
black-eyed peas, shrimp, broccoli, beans, wheat germ, beets,
figs, baked potato calcium: nonfat dairy products, greens, spinach,
fish canned with bones, soybeans, tofu, fortified orange juice.
- To reduce your sodium intake: do not use salt at the table
and only lightly in cooking; avoid salt-preserved foods such
as salted or smoked meat or fish; avoid highly salted snack
pretzels and chips; read soup, rice and pasta mix, sauce and
other processed food labels carefully for sodium content; limit
use of salty condiments including bouillon cubes, soy and Worcestershire
sauce, seasoning 'salts'; limit cheese and peanut butter.
- To limit saturated fat intake: use only lean cuts of meat,
skinless poultry and fish; use unsaturated oils such as olive,
safflower or canola instead of butter or margarine (or use fat-free
butter substitutes); avoid baked goods such as doughnuts, cookies
and cakes, as well as chocolate and caramel candies. Instead,
try eating more potassium-containing fruit!
- Don't forget to limit your alcohol intake. If you're watching
your weight, limit alcohol to special occasions. If weight is
not a problem, one or two cocktails or glasses of wine or beer
on any given day is within your limit. Remember, though, that
even this modest level can cause other health problems.
- Garlic can help reduce blood pressure. To avoid strong breath,
try taking a garlic capsule once per day.
Regular, aerobic exercise will not only directly work to lower
your blood pressure over time, but it will help you control your
weight. However, it is important that your blood pressure be controlled
(at least not above 160/109) before it is safe to begin or continue
your exercise program. This is because blood pressure rises with
your heart rate while you're exercising, and you don't want blood
pressure to get dangerously high. Once you have received your
health care practitioner's clearance, resolve to make exercise
a regular part of your life.
The best prescription is regular, moderate aerobic exercise most
days of the week. A walking, cycling or swimming program for 30
to 60 minutes 4 to 5 days per week will actively work to reduce
your hypertension. You may want to invest in a piece of stationary
equipment (cycle or treadmill) when you can't get outdoors during
short days or inclement weather. Supplement your regular program
with active housework, gardening, tennis, dancing or other fun
There are no large-scale research study results indicating that
stress reduction techniques have a significant effect on hypertension.
However, smaller studies are beginning to show benefits of some
forms of stress-relieving activities such as meditation, yoga
and tai chi. Since the overall health benefits of stress-reduction
techniques are many, why not make these a part of your life? Following
are a few of the many techniques you may wish to learn more about:
Deep abdominal breathing--induces a state of peace and relaxation
and counteracts the shallow breathing that can often be induced
by stress. Progressive relaxation--helps you discover and relax
tense, tight muscles. Affirmations and visualizations--create
the mind-body connection to enhance relaxation and natural healing.
Meditation--calms the mind and relaxes the body. Massage--loosens
tense muscles and enhances a feeling of relaxed wellbeing.
Contributors: Carolyn Coker Ross, MD, MPH; Barbara Whiteside,
RN, CNP; Julie Martin, MS; Jacqueline Zhang, LAc, OMD
Find a licensed acupuncturist here: "Resources
for Finding Acupuncturists and Herbalists"
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