Nutritionist-Dietitians' Association of the Philippines

Healthier You Facts:  HYPERTENSION                                                                                                                    

Hypertension is another name for high blood pressure .  It is not only a disease but a biomarker for risk to develop cardiovascular ( CVD) events such as stroke, heart attacks, or heart/renal failure. Blood pressure is the force exerted by circulating blood on the walls of blood vessels.  The top, or first, number is the systolic, the  highest pressure when heart beats and is pumping blood out into blood vessels. The bottom, or second number, is the diastolic, the drop in pressure when heart is at rest between the beats. For persons over the age of 50, systolic pressure is more important than diastolic as CVD risk factor.

Changes in blood pressure classification

Causal factors have been identified :  excess body weight, excess dietary sodium intake, inadequate intake of fruits/ vegetables , sedentary lifestyle,  and excess alcohol. 

Myths About Hypertension

Cholesterol matters more than blood pressure.
The reverse more often is true. If one has high cholesterol but the ratio of HDL ("good) to LDL ("bad") is healthy, or if  cholesterol particles tend to be large, one’s  risk of heart attack is not great. High blood pressure, however, is always putting stress on the blood vessels, including those supplying the  heart with blood. This stress makes it easier for the bad LDL cholesterol particles to penetrate the inner lining of the blood vessel walls, where they accumulate and form plaque that eventually obstructs blood flow leading to heart attack and stroke.

If one is hypertensive and feeling poorly, it's probably because the blood pressure is elevated.
This is almost never the case. Whatever is causing the symptoms is responsible for the raised blood pressure, not the other way round. When one does not feel well or have pain, whether from a virus or a minor sprain, the body releases adrenaline, which causes  blood pressure to rise.

High Blood Pressure Can't Be Prevented.
      Perhaps one has relatives with high blood pressure. Maybe one is a member of a   group of people who are at greater risk. For these or other reasons, one is  tempted to think that there's nothing one can do about high blood pressure.
       Here is some good news about high blood pressure: Even if one has many risk, factors, there are steps that can be taken to prevent high blood pressure:

• Keep body weight at a healthy level - by a combination of balanced food choices regular exercise, and behavioral modification.
• Eat a healthy diet - This includes eating only the amount of food your body needs and including at least 2 servings of fish/week. Diet should be high in fiber, low in sugar and fat but rich in omega-3, found in studies to reduce high diastolic blood pressure
• Limit salt intake - Most of the sodium one eats is in the form of added salt at the table or salt added during processing and/or cooking of foods .
• Limit alcohol.  See illustration below.
• Avoid tobacco, and minimize exposure to secondhand smoke.
• Get regular exercise- at least 30 minutes of activity each day. Exercise relieves stress and helps  control body weight.
• Avoid stress build up. The chemicals the  body makes in response to stress make the  heart beat harder and faster and cause blood vessels to tighten. All these make blood pressure go higher. 

Frequently Asked Questions

Are there foods that can lower high blood pressure?
Research has shown that potassium may help lower blood pressure. But potassium should be considered as only part of the total dietary pattern that includes: lower salt intake ( 2300 mg Na), lower fat ( 27% of calories)  modified type of dietary fat ( 6% saturated fat),  cholesterol ( 150 mg) , protein ( 18% of calories) and fiber ( 30 g), as well as minerals focused on  potassium ( 4700 mg), calcium( 1250 mg) and magnesium ( 500 mg) per day, and limited alcohol.
For example, 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 systolic and diastolic blood pressure by 5.5/3.0 mm Hg compared to the control diet (what the average American eats). The DASH Study diet also contained less sweets, added sugars , sugar-containing beverages, fats,  red meats,  and salt  than the typical American diet. 

What is isolated systolic hypertension?
About two out of every three people over the age of 60 who have high blood pressure have isolated systolic hypertension. This means that only the top number, the systolic pressure, is high ≥ 140 mmHg. Isolated systolic hypertension can be as harmful as when both numbers are high. One may have isolated systolic hypertension and feel fine. As with other types of high blood pressure, it often causes no symptoms.

Who is most likely to get high blood pressure ?
One’s chances of getting hypertension are higher if one:

• is overweight or obese
• is 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 ( active or passive).

What actions have been taken to prevent hypertension ?
The recent Philippine National Nutrition Survey showed that high blood pressure prevalence has significantly increased from 22.5 to 25.3 between 2003 and 2008.
It increases with age starting from ages 40-49 .  The Philippine government has come out with Proclamation No. 1761 declaring month of May each year as
“  Hypertension Awareness Month .”  World Hypertension Day has been established every 17^th of May  to highlight the preventable  stroke, heart, and  kidney disease. 

References/Links

The Seventh Report of the Joint National Committee on Prevention, Evaluation, and Treatment of High Blood Pressure. JAMA 2003; 289: 2560-71.
http://www.nhlbi.nih.gov/health/public/heart/hbp/dash/new_dash.pdf
www.webmd.com
www.cdc.gov
www.aha.org
Philippine Society of Hypertension www.psh.org.ph
www.bloodpressurereading.net
Bisognano, JD.  The hypertension connection.Preventive Cardiovascular Nurses Association. 2007.