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Pressure’s on: How to combat your hypertension

Of all the dread diseases and difficult medical conditions being bandied about online and in health care publications these days, high blood pressure – or hypertension – sounds relatively benign.

It’s not.

High blood pressure can kill you.

Worse, according to the Centers for Disease Control, fully one-third of all American adults – or about 67 million people – are afflicted with high blood pressure.

The Mayo Clinic says high blood pressure is determined “by the amount of blood your heart pumps and the amount of resistance to blood flow in your arteries. The more blood your heart pumps and the narrower your arteries, the higher your blood pressure. High blood pressure increases your risk of serious health problems including heart attack and stroke.”

The CDC adds that “high blood pressure costs the nation $47.5 billion each year. This total includes the cost of health care services, medications to treat high blood pressure and missed days of work.”

There are basically two types of high blood pressure: primary or essential hypertension, and secondary hypertension.

Essential hypertension tends to develop over many years as arteries begin to “clog up” either from age or from diet. Secondary hypertension, meanwhile, can come on quite suddenly and is usually the result of an underlying condition such as kidney problems, adrenal gland tumors, thyroid problems, congenital defects in blood vessels, alcohol abuse or obstructive sleep apnea.

While secondary hypertension is sometimes cited as being more dangerous, Dr. Cassi Jones, a newly arrived internal medicine specialist with the Sebastian River Medical Group, disagrees.

“I think they’re both equally dangerous; hypertension is hypertension,” declares Jones. “Both roads can lead to stroke, heart disease and kidney disease, and that’s ultimately why we want to control hypertension. It’s not just having low blood pressure: it’s because we don’t want damage done to our organs.” Jones agrees that essential hypertension is “probably more common.”

The good news about this dangerous and epidemic-level disease is that the condition often can easily be reduced, or even eliminated, by several simple, inexpensive means.

For instance, for those with blood pressure at or above the hypertension threshold of 140/90, weight loss can deliver startling improvements in blood pressure, according to Jones.

“Weight loss,” Jones explains “can lower your systolic blood pressure (the top number) by five to 20 points. For every 22 pounds someone loses, says Jones, “you’re looking at possibly a 20 millimeter drop of your systolic blood pressure. That’s huge. That’s going from 140 to 120, for 22 pounds.”

Similarly, limiting salt intake can almost instantly help drive down high blood pressure but avoiding salt isn’t always as easy as leaving the salt shaker alone. A single glass of tomato juice, for instance, can add 520 mg of sodium to your daily total and a cup of cottage cheese can contain 900 mg more.

Jones says “your body only needs 1/4 teaspoon of sodium a day” to survive, and like most doctors she says people should set a target of no more than 1200 milligrams or 1/2 teaspoon of salt per day as their maximum intake.

Just that tomato juice and cottage cheese mentioned above exceed that total by 220 mg.

And even if someone is carefully reading all their food labels, Jones points out, there other sources of salt few people consider.

For example, she points to people with water softeners in their homes.

“I have well water where I live,” Jones says, “So we have a water softener . . . where you run the salt pellets through it. That will increase your sodium. You shouldn’t cook with [softened water] or drink it.”

Even cold remedies such as Alka-Seltzer, Jones points out, are packed with sodium.

“If we could decrease sodium [intake] to 1,200 milligrams a day,” Jones states, “we can save 68,000 lives each year. That’s from the National Institute of Health. That’s a lot and that’s just by reducing [sodium intake] to 1,200 milligrams a day.”

There also are a wide variety of highly effective medications that can help lower blood pressure, including diuretics; beta-blockers; angiotensin converting enzyme (ACE) inhibitors; angiotensin II receptor blockers (ARBs); calcium channel blockers (CCBs); alpha-blockers; alpha-2 receptor agonists; alpha-beta-blockers; central agonists; peripheral adrenergic inhibitors; vasodilators and renin inhibitors.

That gives patients and their doctors many treatment choices, and choosing carefully is important because there definitely is not any “one-size-fits-all” answer as to which medication is right for each individual patient.

Jones says a number of factors – including diagnosis, family history, age and pre-existing conditions – all play a role in determining the best course of treatment.

It is, she says, absolutely essential for patients to have an open and frank discussion with their primary care doctor about hypertension and for that doctor to consult with any specialists the patient may also be seeing in order to make the best medication selection possible.

Dr. Cassi Jones, a Doctor of Osteopathy, is at 7765 144th Street, Suite 6 in Sebastian. The phone number is 772-581-0334.

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