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A Different High

"An In-Depth Look at Hypertension"
By: Risa Caldoza-De Leon MD, FPAPSHPIA Different High

Hypertension is a condition where a person’s blood pressure is continually higher than the recommended level of 120/80 millimeters of Mercury (mmHg). It is a biomarker for risk to develop cardiovascular (CVD) events such as stroke, heart attacks, or heart/kidney failure. Simply put, the more blood your heart pumps and the narrower your arteries, the higher your blood pressure.

The bad news is it rarely has noticeable symptoms.You can have high blood pressure for years without feeling something amiss, even with dangerously high levels. However, a few may complain of dull headaches, dizzy spells, nausea,nosebleeds, problems with vision, chest pains, breathing problems, irregular heartbeat, and blood in the urine. The good news? Hypertension is preventable.

The Number Game

Worldwide, one in three adults have hypertension. In the home front, there are almost 14 million Filipino adults aged 20 and above that are hypertensive, according to a study of Food and Nutrition Research Institute of the Department of Science and Technology (FNRI- DOST).

The latest data from the World Health Organization (WHO) published in 2011 showed that hypertension accounted for 8% of total deaths in the Philippines, ranking it as the fourth leading cause of death in the country and fifteenth in the world. In 2009, almost 167,000 Filipinos died from heart disease and stroke. Half of these deaths are likely related to hypertension.

The Philippine Institute for Development Studies (PIDS) avers that three of 10 cardiovascular deaths are happening prematurely or at age below 60 years, tragically ending the lives of our countrymen during their supposedly most productive years.

You are what you eat

One’s chances of getting hypertension are higher if one is overweight or obese, over the age of 45 (male) or over the age of 55 (female), has a family history of high blood pressure, has pre-hypertension, with a reading of 120-139/80-89 mmHg, has a stressful sedentary lifestyle including anxiety, excessive alcohol and smoking, and inadequate intake of fruits and vegetables.

Excess dietary sodium intake can make high blood pressure soar by causing the body to retain fluid. Filipinos eat too much salt, on average about 10grams/capita/day inreference to the WHO recommendation (1,500 mg/day) of only half of that.

The Nutritionist-Dietician’s Association of the Philippines advises keeping a healthy body weight. An overweight person can lower his blood pressure by losing even just five pounds. Easier said than done but a combination of healthyfood choices, regular exercise, and behavioral modification is key to preventing a lot of diseases.

A healthy diet means eating only the amount of food your body needs. Studies show that to reduce blood pressure, one has to eat lots of fiber, such as blond psyllium and wheat bran, and food low in sugar but rich in omega-3 fatty acids such as fatty fish, fish oil supplements or flaxseed.

The DASH Study (Dietary Approaches to Stop Hypertension) found that a diet rich in fruits, vegetables, fat-free or low-fat milk and milk products, whole grain foods, fish, poultry without skin, beans, seeds and nuts reduced blood pressure compared to the average diet Americans eat.

The DASH diet suggests getting daily 7-8 servings of grains, 4-5 servings of vegetables, 4-5 servings of fruits, 2-3 servings of low-fat or fat-free dairy products, 2 or less servings of meat, poultry, and fish, and 2-3 servings of fats and oils. In a week, nuts, seeds and dry beans should only be served 4-5 times, while sweets should be limited to 5 servings.

Pump up those muscles by exercising at least 30 minutes every day. Not only will it help control weight, it’s a great stress reliever too! When stress builds up, chemicals in our body respond to it by making the heart pump harder and faster, ergo, high blood pressure.

Partying all the time can take its toll. NDAP recommends one drink daily for women and two for men, but only one drink when one is over 65 years. One drink means either 12 ounces of regular beer, five ounces of wine, or 1.5 ounces 80-proof distilled spirits.

Smoking and inhaling second hand smoke immediately raise blood pressure for a while. The chemicals in cigarettes or tobacco can wreak havoc to the lining of arterial walls, causing them to narrow and harden, and increasing blood pressure.

Popping pills

In addition to lifestyle changes, there are medications to lower blood pressure. Diuretics or water pills act on the kidneys to help the body flush out sodium and water. Beta-blockers, whose names normally end in LOL such as metoprolol and atenolol, cause the heart to beat slower and with less force.

Doctors may prescribe one drug or a two-drug combination to stave off blood pressure. Sometimes a third medication, or more, may be needed to achieve your blood pressure goal.

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