High blood pressure, or hypertension, is inevitable if you live long enough. Recognizing hypertension and taking appropriate steps to combat it, however, are what really count.
"We can't prevent high blood pressure, but we can delay it with diet and exercise," said Dr. Ron Victor, chief of hypertension and professor of internal medicine at
UT Southwestern. "Once you have hypertension, it requires medication, as well as diet and exercise, to get blood pressure back down to where it needs to be."
Offering practical medical advice at a Friends of the Center for Human Nutrition luncheon, Dr. Victor cited case histories of three U.S. presidents; Franklin D. Roosevelt, Dwight D. Eisenhower and Bill Clinton, who suffered from hypertension.
"Franklin Roosevelt had terrible hypertension, which frustrated his personal physician because effective medication wasn't available back then to treat the president," Dr. Victor said. "His doctor knew he was at risk of having a stroke, which he did in 1946 during his fourth term."
Since then, one of the biggest medical success stories has been the development of more than 70 different drugs for hypertension, Dr. Victor said. In addition, doctors have studied and learned much more about the importance of proper diet and physical activity in helping control hypertension.
Dr. Victor provided the following suggestions for lowering blood pressure:
Monitor salt intake; not only what you get from the shaker, but from processed foods typically high in sodium.
Eat lots of fruits and vegetables. A new diet plan called Dietary Approaches to Stop Hypertension (DASH) offers a meal plan low in total fat, saturated fat and cholesterol, and rich in fruits, vegetables and low-fat dairy products.
Consume alcohol in moderation if at all.
Pay close attention to cholesterol levels, as many people with hypertension also have higher-than-normal cholesterol levels.
Dr. Victor also discussed various classes of blood pressure medications.
Diuretics: The oldest type of blood pressure drug, diuretics help rid the body of excess fluids and salt. They have few side effects if taken in low doses, yet take about a month before producing results.
ACE inhibitors: Developed in the mid-1980s, ACE inhibitors block the effects of angiotensin-converting enzymes in blood. They are quite effective and may provide additional protection for the heart and kidneys, yet cause a dry cough in about 3 percent to 10 percent of patients.
ARBs: A new type of drug, antiotensin II receptor blockers (ARBs) act similar to ACE inhibitors, but do not cause a cough. They have fewer side effects than any other class of hypertension medication and also protect the heart and kidneys, particularly in patients with high blood pressure and diabetes.
Calcium channel blockers: Effective medications that received unwarranted negative publicity in the past, linking it to heart attacks. Swelling ankles is often a side effect from these drugs.
Beta-blockers: Another older medication, beta-blockers are prescribed for patients who already have heart disease, as they protect against further injury to the heart. However, side effects are often numerous.
"Sometimes, doctors combine medications to get fewer side effects," Dr. Victor said. "Most side effects come with higher dosages. If you have to take two or three drugs, it doesn't mean you have a really bad case; it's just that your doctor is trying to lower the possibility of side effects."
Does our blood pressure change with age?
"If a woman is 65 and has had normal blood pressure up until then, there's about a 90 percent chance she will develop hypertension during the next 20 years," Dr. Victor said. "The percentage is about the same for men. That doesn't mean our blood pressure rises as we get older."
When treating patients ages 55 and older, doctors place more emphasis on the systolic (higher) number than the diastolic (lower) blood pressure reading, he said. It's more important to get the higher number in check. A normal, or good, level would be less than 135 for systolic and less than 85 for diastolic.G
