Most people older than 65 have high blood pressure, but this group also has the least success in controlling the condition, Dr. Jennifer Dumbolton told members of the Payson Regional Medical Center’s Senior Circle at a Lunch & Learn program April 24.
Some 50 million people have high blood pressure, which increases the risk of strokes and heart attacks.
Lowering blood pressure can reduce the risk of:
• Stroke by 35 to 40 percent;
• Heart attack by 20 to 25 percent; and
• Heart failure by 50 percent
Although experts continue to refine the guidelines, current recommendations say that a blood pressure of 120 over 80 is normal; 120 to 139 over 80 to 89 is pre-hypertensive; 140 to 159 over 90 to 99 is Stage 1 hypertension; 160 and above over 100 and above is Stage 2 hypertension.
People with diabetes and kidney disease should keep blood pressure below 130/80 to avoid cardiovascular disease, Dumbolton said.
Risk factors for developing high blood pressure include smoking, diabetes, sedentary lifestyle, high cholesterol, age and family history.
Family risk factors include: a parent or grandparent was hypertensive; and if a parent or grandparent developed heart disease under the age of 65 or had a cardio event under the age of 65 — especially if the relative was female.
Additional elements that may increase risk of hypertension: sleep apnea, prescription or other drugs, chronic kidney disease, renal vascular disease, chronic steroid therapy, Cushing’s syndrome, and thyroid and parathyroid disease.
Dumbolton said the following tests can detect hypertension: an EKG, urinalysis and a variety of blood tests.
Patients should start by changing their lifestyle — by losing weight and getting exercise. Then, they can consider single prescription therapy, additional prescription therapy and referral to specialist.
Dumbolton noted that losing 20 pounds can reduce blood pressure between 6 and 10 percent. She recommends the DASH (Dietary Approaches to Stop Hypertension) or Mediterranean diets as well as sharply limiting salt in the diet.
The Centers for Disease Control guidelines limit salt to no more than 2,300 mg of sodium per day. At the same time, consume potassium-rich foods, such as fruits and vegetables. Higher risk groups should limit sodium to 1,500 mg daily, with 4,700 mg/day of potassium.
High risk groups include:
• Older than 51
• African American
• Existing high blood pressure;
• Chronic kidney disease
The 1,500 mg/day recommendation applies to about half of the U.S. population overall. Nearly everyone benefits from reduced sodium consumption, the CDC report concludes.
Dumbolton noted that moderate use of alcohol can also reduce blood pressure, especially less than two daily glasses of red wine for women and three for men.
She gave the following recommendations to address high blood pressure:
• Modify your behavior — “It’s never too late to start getting healthy,” Dumbolton said.
• Monitor your blood pressure closely and follow-up with your doctor.
• Follow your doctor’s advice after discussing other concerns and conditions like diabetes and kidney disease.
• Identify the reason(s) for not complying with advice and remedy.
• Collaborate with your doctor on your care.