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The Bad High

By: Darleth Romana-Bantiles, MDThe Bad High

Hypertension, or the elevation of blood pressure (BP), is a phenomenon that is common during the holiday season. The combination of additional activities and missed doctor appointments or medications may wreak havoc on blood vessels and cause BP shoot ups. While this may take away a little bit of the fun, people experiencing hypertension can still enjoy and make the most out of the holiday season.  But, they need to be extra diligent in managing their condition.

Avoiding the bad high

How elevated is a high BP? The latest update of the American College of Cardiology and the American Heart Association has more vigilant criteria for hypertension that needs to be treated with medication and lifestyle modifications. They modified the categories endorsed by the 8th Joint National Committee (JNC), and define hypertension as:

  • a BP beyond 130/80 mmHg, as Stage 1 hypertension;
  • a BP above 140/90 mmHg, as Stage 2 hypertension;
  • and a systolic BP >180 and diastolic BP >120, being a hypertensive crisis that requires hospitalization or prompt adjustment of medications (as appropriate). 

Stress indirectly leads to high BP as it increases specific hormones (cortisol and adrenaline) in the body that may constrict blood vessels. Also, chronic stress may keep a person in an excited state (which is not necessarily due to bad situations) that encourage unhealthy habits such as insomnia, excessive alcoholic beverage drinking, and smoking. Some signs of a hypertensive attack include dizzy spells, nausea, excessive sleepiness, lethargy, difficulty of breathing, and a dull headache or nape pain.

During the holiday season, one should always remember to keep a schedule in order to avoid stress caused by too many commitments. Furthermore, it is important to include regular periods of exercise, aside from rest. Having healthy workouts will help maintain one’s ideal body weight, as well as prevent hypertension. The concept of taking out a similar amount of what you have put into your body is a good rule to follow during these times.

Cutting back is gaining

Moderation is the key. Limiting some things may advance a hypertensive person to better health. Salt or sodium is the primary culprit in food sources that induce hypertension. Some fares that are discreetly laden with salt are ham, canned sauces and soups, and other processed meats. A hypertensive person is allowed only 1500mg of salt per day. Some other food sources that need to be restricted are:

  • Sugar – Another ingredient that is often found in holiday treats. Filipino buffets will not be complete without cakes, sticky kakanin or pudding, ice cream, and creamy salads. Take a bite or two for dessert, but do not go overboard. If you had a very heavy meal, try drinking tea instead of soda or coffee to wash it down.
  • Alcohol – Binge drinking may result to irregular heart contractions that affect the BP negatively. So, if social drinking is unavoidable, make sure it is just a sip or, at most, a glassful.
  • Emotional extremes – Situations that cause your senses to feel very high or very low should be avoided. Choose to have a good perspective of anything and anyone. Have a grateful heart and never pass up on an opportunity to do acts of kindness. At the end of the day, this will effectively spread the true spirit of celebrations aside from controlling the BP.

More so, whether you or a loved one is diagnosed with hypertension, it is essential to keep tabs of necessary lifestyle changes and medications or supplements. A consensus from evidence-based data recommends that the initial antihypertensive treatment include either a thiazide, calcium channel blocker (CCB), angiotensin-converting enzyme inhibitor (ACEI), or angiotensin receptor blocker (ARB). The latter two (ACEI or ARB) are especially mentioned to improve kidney outcomes.

Other than writing it down on a list of to-do’s, an alarm on your mobile may be set or a person may be tasked to give you a needed reminder of due times. Additional activities are not valid reasons to skip doses or miss an appointment with your health provider. Doctor appointments aid in monitoring a hypertensive person’s clinical response, as drug regimens should be individualized and dosages titrated. Never make the mistake of taking a medication, just because it worked for your neighbor or another relative (when they had an episode of high BP).

Putting off or tweaking medication regimens or clinic visits may lead to life-changing consequences, like a stroke or heart attack. If modification is unavoidable, an appointment with your healthcare provider is even more necessary to discuss possible options that will not risk your life or someone else’s. At the end of the day, prevention will go a longer way than non-compliance when it comes to allowing you to have a more memorable time with family and friends.

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