What can I do about my high blood pressure?

Resistant hypertension is a complex diagnostic and management problem.

Untreated, it can lead to many problems including target organ damage and life-threatening complications.

There is also increased likelihood of secondary hypertension as a cause of the resistant hypertension.

Secondary hypertension causes such as obstructive sleep apnoea, primary hyperaldosteronism, renovascular hypertension, etc. These often require further workup and do have specific management rather than just “antihypertensive tablets”

Therefore one must be advised in strongest terms to seek further medical advice from a GP in the first instance.

Regards,
Dr Kevin Lee
BSc(Med), MBBS, MHS(Clin Epi), FRACP
Consultant Physician Endocrinologist

High blood pressure (hypertension) is a very common problem, and there is a strong link to your diet.

To improve your blood pressure, it is best to follow the DASH diet - this is "Dietary Approaches to Stop Hypertension."

In summary, this diet focuses on plant-based foods. It encourages a high intake of vegetables (5+ daily) and fruit (2-3 daily), low-fat dairy, lean meats, wholegrains, and healthy fats such as those found in nuts and oily fish (recommended consumption 2-3x/week).

It is also important to limit the amount of salt added to your foods and cooking, and when choosing tinned foods, to look out for "No Added Salt" or 'reduced salt' products. 

Hypertension is a condition commonly associated with a number of other medical issues, and as an Accredited Practising Dietitian, I will be more than happy to discuss your condition and advise you further. 

Health Victory Nutrition Experts - http://www.healthvictorynutrition.com.au/contact-us/  or email katherine@healthvictorynutrition.com.au

Ideally you should try and control your blood pressure without medication. If this is not possible you will have to see your doctor about putting you on the correct medication.

By making these 10 lifestyle changes, you can lower your blood pressure and reduce your risk of heart disease.

If you've been diagnosed with high blood pressure (a systolic pressure — the top number — of 140 or above or a diastolic pressure — the bottom number — of 90 or above), you might be worried about taking medication to bring your numbers down.

Lifestyle plays an important role in treating your high blood pressure. If you successfully control your blood pressure with a healthy lifestyle, you may avoid, delay or reduce the need for medication.

Here are 10 lifestyle changes you can make to lower your blood pressure and keep it down.

1.Lose extra kilos and watch your waistline

Blood pressure often increases as weight increases. Losing just 5 kg can help reduce your blood pressure. In general, the more weight you lose, the lower your blood pressure. Losing weight also makes any blood pressure medications you're taking more effective. You and your doctor or dietitian can determine your target weight and the best way to achieve it.

Besides shedding kilos, you should also keep an eye on your waistline. Carrying too much weight around your waist can put you at greater risk of high blood pressure. In general:

Men are at risk if their waist measurement is greater than 102 cm.

Women are at risk if their waist measurement is greater than 89 cm.

Asian men are at risk if their waist measurement is greater 91 cm.

Asian women are at risk if their waist measurement is greater than 81 cm.

2. Exercise regularly

Regular physical activity — at least 30 to 60 minutes most days of the week — can lower your blood pressure by 4 to 9 millimeters of mercury (mm Hg). And it doesn't take long to see a difference. If you haven't been active, increasing your exercise level can lower your blood pressure within just a few weeks.

If you have prehypertension — systolic pressure between 120 and 139 or diastolic pressure between 80 and 89 — exercise can help you avoid developing full-blown hypertension. If you already have hypertension, regular physical activity can bring your blood pressure down to safer levels.

Talk to your doctor about developing an exercise program. Your doctor can help determine whether you need any exercise restrictions. Even moderate activity for 10 minutes at a time, such as walking and light strength training, can help.

But avoid being a "weekend warrior." Trying to squeeze all your exercise in on the weekends to make up for weekday inactivity isn't a good strategy. Those sudden bursts of activity could actually be risky.

3. Eat a healthy diet

Eating a diet that is rich in whole grains, fruits, vegetables and low-fat dairy products and skimps on saturated fat and cholesterol can lower your blood pressure by up to 14 mm Hg. This eating plan is known as the Dietary Approaches to Stop Hypertension (DASH) diet.

It isn't easy to change your eating habits, but with these tips, you can adopt a healthy diet:

• Keep a food diary. Writing down what you eat, even for just a week, can shed surprising light on your true eating habits. Monitor what you eat, how much, when and why.

• Consider boosting potassium. Potassium can lessen the effects of sodium on blood pressure. The best source of potassium is food, such as fruits and vegetables, rather than supplements. Talk to your doctor about the potassium level that's best for you.

• Be a smart shopper. Make a shopping list before heading to the supermarket to avoid picking up junk food. Read food labels when you shop and stick to your healthy-eating plan when you're dining out.

• Cut yourself some slack. Although the DASH diet is a lifelong eating guide, it doesn't mean you have to cut out all of the foods you love. It's OK to treat yourself occasionally to foods you wouldn't find on a DASH diet menu, such as a chocolate or mashed potatoes with gravy.

  4. Reduce sodium in your diet

  Even a small reduction in the sodium in your diet can reduce blood pressure by 2 to 8 mm Hg. The recommendations for reducing sodium are:

• Limit sodium to 2,300 milligrams (mg) a day or less.

• A lower sodium level — 1,500 mg a day or less — is appropriate for people 51 years of age or older, and individuals of any age who are African-American or who have high blood pressure, diabetes or chronic kidney disease.

  To decrease sodium in your diet, consider these tips:

• Track how much salt is in your diet. Keep a food diary to estimate how much sodium is in what you eat and drink each day.

• Read food labels. If possible, choose low-sodium alternatives of the foods and beverages you normally buy.

• Eat fewer processed foods. Potato chips, frozen dinners, bacon and processed lunch meats are high in sodium.

• Don't add salt. Just 1 level teaspoon of salt has 2,300 mg of sodium. Use herbs or spices, rather than salt, to add more flavor to your foods.

• Ease into it. If you don't feel like you can drastically reduce the sodium in your diet suddenly, cut back gradually. Your palate will adjust over time.

  5. Limit the amount of alcohol you drink

  Alcohol can be both good and bad for your health. In small amounts, it can potentially lower your blood pressure by 2 to 4 mm Hg. But that protective effect is lost if you drink too much alcohol — generally more than one drink a day for women and men older than age 65, or more than two a day for men age 65 and younger. Also, if you don't normally drink alcohol, you shouldn't start drinking as a way to lower your blood pressure. There's more potential harm than benefit to drinking alcohol.

  If you drink more than moderate amounts of it, alcohol can actually raise blood pressure by several points. It can also reduce the effectiveness of high blood pressure medications.

• Track your drinking patterns. Along with your food diary, keep an alcohol diary to track your true drinking patterns. One drink equals 355 millilitersof beer, wine 150 mL or 80-proof liquor 45 mL. If you're drinking more than the suggested amounts, cut back.

• Consider tapering off. If you're a heavy drinker, suddenly eliminating all alcohol can actually trigger severe high blood pressure for several days. So when you stop drinking, do it with the supervision of your doctor or taper off slowly, over one to two weeks.

• Don't binge. Binge drinking — having four or more drinks in a row — can cause large and sudden increases in blood pressure, in addition to other health problems.

  6. Avoid tobacco products and secondhand smoke

  On top of all the other dangers of smoking, the nicotine in tobacco products can raise your blood pressure by 10 mm Hg or more for up to an hour after you smoke. Smoking throughout the day means your blood pressure may remain constantly high.

  You should also avoid secondhand smoke. Inhaling smoke from others also puts you at risk of health problems, including high blood pressure and heart disease.

  7. Cut back on caffeine

  The role caffeine plays in blood pressure is still debatable. Drinking caffeinated beverages can temporarily cause a spike in your blood pressure, but it's unclear whether the effect is temporary or long lasting.

  To see if caffeine raises your blood pressure, check your pressure within 30 minutes of drinking a cup of coffee or another caffeinated beverage you regularly drink. If your blood pressure increases by five to 10 points, you may be sensitive to the blood pressure raising effects of caffeine.

  8. Reduce your stress

  Stress or anxiety can temporarily increase blood pressure. Take some time to think about what causes you to feel stressed, such as work, family, finances or illness. Once you know what's causing your stress, consider how you can eliminate or reduce stress.

  If you can't eliminate all of your stressors, you can at least cope with them in a healthier way. Take breaks for deep-breathing exercises. Get a massage or take up yoga or meditation. If self-help doesn't work, seek out a professional for counseling.

  9. Monitor your blood pressure at home and make regular doctor's appointments

  If you have high blood pressure, you may need to monitor your blood pressure at home. Learning to self-monitor your blood pressure with an upper arm monitor can help motivate you. Talk to your doctor about home monitoring before getting started.

  Regular visits to your doctor are also likely to become a part of your normal routine. These visits will help keep tabs on your blood pressure.

  10. Get support from family and friends

  Supportive family and friends can help improve your health. They may encourage you to take care of yourself, drive you to the doctor's office or embark on an exercise program with you to keep your blood pressure low. Talk to your family and friends about the dangers of high blood pressure.

  If you find you need support beyond your family and friends, consider joining a support group. This may put you in touch with people who can give you an emotional or morale boost and who can offer practical tips to cope with your condition.

   

Hypertension is a serious condition, can lead to heart failure and stroke, losing weight can definitely help. But there are many safe and well proven medications that will lower your BP and save your life. See your GP or NP.