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BLOOD PRESSURE CONTROL WITH DIET AND EXERCISE KIMBERLY HARM, PHD, APRN-NP KIM HARM, PHD, APRN-NP • Columbus Community Hospital’s Humphrey Medical Clinic • Primary care • Harmony Health and Wellness • Functional medicine • Personalized, lifestyle medicine OBJECTIVES • To understand the underlying causes of high blood pressure • To become familiar with lifestyle changes to prevent or reverse high blood pressure • To develop confidence in your ability to make changes to optimize your control of high blood pressure HIGH BLOOD PRESSURE • 29% of Americans (around 70 million) have high blood pressure • 1 in 3 adults • Another 1 in 3 have prehypertension • High blood pressure costs the US $46 billion each year • High blood pressure as a primary or contributing cause of death • 1000 deaths per day • Key risk factor for heart disease and stroke • Heart disease is the leading cause of death for both men and women • 610,000 people die of heart disease in the US yearly; 1 in 4 deaths Cardiovascular disease (CVD) deaths versus cancer deaths by age (United States: 2011). Dariush Mozaffarian et al. Circulation. 2015;131:e29-e322 Copyright © American Heart Association, Inc. All rights reserved. Prevalence of high blood pressure in adults ≥20 years of age by age and sex (National Health and Nutrition Examination Survey: 2007–2012). Dariush Mozaffarian et al. Circulation. 2015;131:e29-e322 Copyright © American Heart Association, Inc. All rights reserved. BLOOD PRESSURE • The force of blood against the walls of the arteries. • Normal • Systolic: <120 mmHg • Diastolic: < 80 mmHg • At Risk (Prehypertension) • Systolic: 120-139 mmHg • Diastolic: 80-89 mmHg • High • Systolic: > 140 mmHg • Diastolic: > 90 mmHg CONSEQUENCES • Damage to the heart and coronary arteries—heart attack, heart disease, congestive heart failure, aortic dissection, atherosclerosis • Stroke • Kidney disease • Loss of eye sight • Erectile dysfunction • Memory loss • Angina • Peripheral artery disease • http://www.heart.org/HEARTORG/Conditions/HighBloodPressure/WhyBloodPressureMatters/Why-Blood-Pressure-Matters_UCM_002051_Article.jsp RISK FACTORS • Age • Heredity, but your genes are not your destiny • Overweight or obesity • Smoking and second hand smoke • High cholesterol • Diabetes, metabolic syndrome • Physical inactivity • Poor diet, too much salt, not enough potassium • Drinking too much alcohol • Stress • Sleep and sleep apnea • http://www.heart.org/HEARTORG/Conditions/HighBloodPressure/WhyBloodPressureMatters/Why-Blood-PressureMatters_UCM_002051_Article.jsp CAUSES OF HIGH BLOOD PRESSURE • Unhealthy relationship between your genes and your environment • Includes your lifestyle • How you move • How you rest and sleep • How you stress • How you eat CAUSES OF HIGH BLOOD PRESSURE • High fat • High sugar • High alcohol • High stress • No exercise • Depression • Hostility • Weight gain, especially in the middle LIFESTYLE CHANGES TO LOWER BLOOD PRESSURE • Get moving • Focus on nutrition • Cut the salt • Take your medications • Check your blood pressure • Lose weight • Cut back on alcohol • Don’t smoke • De-stress • Sleep well GET MOVING! • Keep it simple if you are not doing anything already • Walk each day • Stand instead of sitting • Park further away • Optimally: • 5 days per week, moderate intensity for 30 or more minutes FOCUS ON NUTRITION • • • • You gotta eat your veggies!!!! Mind your portion sizes Keep proportion of vegetables half or more of your meals Whole grains, not processed! • Can you eat anything else besides cereal and toast for breakfast? • Does it always have to be a sandwich for lunch? • Homemade is best • Avoid processed foods and packaged, semi-made items CUT THE SALT • At the table • See what food tastes like without it • Biggest source is from processed foods and dining out • Homemade is better MEDICATIONS • If on medication for blood pressure • Take your medications as instructed • Keep a card of the medications you take with you • Keep the card up-to-date • Keep your regular follow-up appointments and blood draws with your primary care provider • If not on medications, let’s keep it that way! Prevention is best CHECK YOUR BLOOD PRESSURE • Make sure you do not have high blood pressure • It does not have symptoms, “The Silent Killer” • Remember, the incidence increases with age • Getting away with poor choices earlier in life does not mean that will last! • Seek the care if the numbers are creeping up LOSE WEIGHT • See numbers 1, 2, 7, and 8 • Get moving • Nutrition • Eat your veggies • Whole fruits and vegetables • No processed foods • Cut back on alcohol • Get a handle on stress • Get good sleep • Ask for local resources if you need help ALCOHOL • Drinking too much alcohol can cause heart failure, lead to stroke, cause irregular heart beats, contribute to high triglycerides, cancer, obesity, alcoholism, suicide and accidents • 2 per day for men • 1 per day for women • Caution, there are those who cannot handle this much • May need to reduce to 3-4 per week • Optimally, alcohol only on holidays or special occasions SMOKING • There is no amount of smoking consistent with optimal health goals • Please stop smoking tobacco • Seek special counseling • Nebraska Tobacco quit line • 1 (800) QUIT NOW • Nebraska Department of Health and Human Services has online resources • Stop smoking all substances DE-STRESS • “Stress is not a product of the world, it is the lens through which you view the world.” • Shilpa Saxena, MD DE-STRESS • Find a sense of purpose • Participate in your community • Find a community • Deep breathing exercises twice daily • Real versus perceived threats • Yoga • Walking or moving • Smile SLEEP WELL • Devote 8 hours per day to sleep • Prepare for sleep with a bedtime ritual • Have regular bed and wake times • No work in the bedroom • Do not check email or search on the web • No TV • Make the bedroom comfortable • Do not stay in bed if you toss and turn • No clock in the bedroom SLEEP APNEA • People who snore or stop breathing at night • This needs to be evaluated • Your primary care provide can get you set up for a sleep apnea test THANK YOU! QUESTIONS?
