THE DOCTOR IS IN
OP / ED BY DR. ADIL MANZOOR
I know we doctors never fail to mention the risk of hypertension (high blood pressure) to adults, but I still don’t think that does enough justice to the condition. Hypertension affects close to 120 million adults in the United States. The total adult population in the country is around 260 million, which means hypertension affects around half the adults in the country. That is bonkers. Like, unheard of in the history of health conditions.
With a condition this prevalent, you would expect that a lot of adults would have detailed information about its management and control. You will be wrong. For many, the treatment of hypertension is medications and just medications. I cannot deny the benefits of medications in managing hypertension, but I must state clearly that they are only a part of managing hypertension, you still need lifestyle modifications for comprehensive control of hypertension.
Of course, some know that you should be physically active and not eat salty and junk foods, but those are only a few of the many lifestyle modifications for hypertension control. Considering the devastating effects hypertension can have – from heart failure to stroke to kidney disease – and the sheer number of people who have it, it is essential to consider the lifestyle modifications necessary for the full management of hypertension.
Number one – Get active. Yes, I know again that this is advice that we doctors never fail to mention, but trust me, it is perhaps the most important lifestyle health advice anyone can give. The benefits of physical activity extend far beyond hypertension, as it positively influences virtually every system in the body, but I will focus on just hypertension.
Physical activity makes the heart stronger. A stronger heart is more efficient in pumping blood, which reduces the force and pressure on the blood vessels. Eventually, the blood pressure falls. And, according to scientific studies, reducing systolic blood pressure by 5 mmHg can reduce stroke-related deaths by 14% and death from coronary artery disease by 9%. Those are mighty numbers for a single lifestyle modification.
According to the CDC, regular physical activity is 150 minutes of moderate-intensity exercise or 75 minutes of vigorous-intensity exercise a week. If you are unsure of what constitutes moderate and vigorous exercise, use this rule of thumb. Any activity that causes your heart rate to increase but you can still talk just fine is moderate-intensity. On the other hand, vigorous-intensity exercise increases the heart rate and you can’t say more than a few words before having to take a break.
The second lifestyle modification I’d touch on is to quit smoking and limit drinking. Both of these activities can increase blood pressure and also interfere with the normal functioning of blood pressure medications. Smoking in particular can damage the blood vessel and raise the risk of virtually all of the common heart conditions. Don’t smoke at all.
With drinking, there is a greater leeway, or should I say there used to be. In the past, doctors could forgive one standard drink a day for women and two for men, with the limit in a week being 14. However, newer evidence totally discourages drinking entirely, especially in women, because of the risk of cancer.
I’d say this, though, if you can avoid drinking, please do. If not, ensure you are responsible for it. With smoking, however, you need to totally avoid it – no compromise here.
Moving on to the third. Before I proceed, please note that the modifications on this list are not entirely in the order of importance. The exact impact these modifications have on heart disease is difficult to estimate, so for all I know, the number 3 modification can be more important to you than the number 2. So, what’s number 3? It is your weight.
Your weight is related to your blood pressure. In men, weight variation over 2 pounds a year is associated with a 5.5 mmHg increase in systolic BP. Systolic blood pressure is denoted by the first figure in the blood pressure reading. In women, the figure stands at a 3.3 mmHg increase in systolic BP. If you haven’t already, I want you to do a quick mental math of how much your BP can actually increase over a year. You see now how important weight management is?
This opens the door to the fourth point – diet. Your diet plays an important role in your weight. You will want to cut off fatty foods, sugary foods, and junk foods generally from your diet in favor of more plant-based and fiber-rich foods. Don’t be stingy with your fruits, too. Diet can also modify various health parameters that can improve overall heart health. A healthier heart is correlated with lower blood pressure. Of course, reduce your sodium intake, as well.
Other useful lifestyle modifications are stress management, quality sleep, and avoiding cocaine and other sympathomimetic agents. All of these lifestyle modifications alone can greatly increase the chances of preventing hypertension altogether, but they can also help control hypertension among people who already have it. Remember to carry your doctor along if you have to make any drastic changes to your diet or lifestyle. Stay safe.
This article was written by Dr. Adil Manzoor, DO, a Board-Certified Internist; Board certified Pediatrician who works as a Hospitalist and Emergency Room Physician. He is also the current President of Garden State Street Medicine, a non-profit organization whose sole purpose is to provide free preventive and acute urgent care services for the homeless. He is also the co-founder of his own unique medical practice, Mobile Medicine NJ; House Call Doctors. He is also currently pursuing an Executive MBA and a Master’s of Science in Healthcare Leadership at Samuel Curtis Johnson Graduate School of Management and the Weill Cornell Graduate School of Medical Sciences.
References
- https://www.cdc.gov/high-blood-pressure/living-with/index.html
- https://pmc.ncbi.nlm.nih.gov/articles/PMC2991739/
- https://pmc.ncbi.nlm.nih.gov/articles/PMC8109382/
- https://www.emro.who.int/media/world-health-day/physical-activity-factsheet-2013.html
