What is a Healthy Blood Pressure?
Did you know the 2017 Diagnostic and Treatment Guidelines for Hypertension published by the American College of Cardiology, American Heart Association, and Centers for Disease Control LOWERED the systolic and diastolic blood pressure thresholds? According to these guidelines, your blood pressure is considered elevated if the top number (systolic) is between 120-129 mm Hg and the bottom number (diastolic) is 80 mm Hg. The recommendation is that people < 60 years of age aim for a blood pressure < 120/80 mm Hg. The thresholds are slightly higher as you age and have more comorbidities or medical conditions; however, it is very important that you confirm your blood pressure goals with your physician. Stage 1 hypertension (high blood pressure) is diagnosed when blood pressure reaches 130-139/80-89 mm Hg and Stage 2 Hypertension is >140/90 mm Hg. The recommendations for treatment and follow-up vary based on each category. It is also important that blood pressure is measured after resting in a seated position for several minutes and multiple measurements are taken before a diagnosis of elevated blood pressure or hypertension is confirmed.
Why is having elevated blood pressure or hypertension bad for your health? Research has shown that elevated blood pressure taxes many of our organs and can lead to many health consequences. The second leading cause of kidney failure in the United States is high blood pressure. Kidney failure over time can lead to dependence on dialysis, which acts as an artificial kidney to remove toxins from the blood, and can be a very difficult adjustment and is life-altering. The leading cause of strokes is high blood pressure, which can result in problems with speech, swallowing, and mobility. High blood pressure puts stress on our heart and vessels and damages tissue, so blood cannot pump efficiently to our organs and extremities.
The good news is that there are many behavioral changes you can make to lower your blood pressure. Smoking is a significant risk factor for the development of hypertension, so it is important to find an effective smoking cessation program if you smoke. Did you know that exercising for 30 minutes a day can lower systolic pressure by 5-10 points? All physical activity has a positive impact on health, even short amounts of 10 minutes or less!
Decreasing sodium in your diet also decreases blood pressure and can make some blood pressure medications work better. The recommendation for total sodium intake according to the Dietary Guidelines for Americans is 2300 mg per day. The average American diet is estimated to provide more than 3400 mg a day and as much as 7000-8000 mg a day, given our dependence on processed food and eating out! Ways to decrease sodium include using alternatives to salt like black pepper, red pepper, Kelp flakes, vinegar, olive oil, and herbs to flavor food. Use these ingredients in cooking as well as at the table. Avoid purchasing cured meats that have sodium nitrate or sodium phosphate. Choose fresh or frozen vegetables over canned. Look at the sodium content of the foods you are purchasing and aim for < 300 mg per serving for entrees (like frozen foods) and < 140 mg per serving for other foods. Even if you make these lower sodium food choices some of the time, you are benefitting your health. Finally, eat out less often and when you do eat out, ask for your food to be prepared without salt or less salt. You will be amazed at how you can actually taste the food better when you cut back on sodium!
Finally, there are minerals you can increase in your diet to help you with blood pressure control. Foods high in magnesium, calcium, and potassium aid in blood pressure control. Choose unsalted nuts and seeds, legumes, and green leafy vegetables for more magnesium in your diet. Choose low-fat dairy products like Greek yogurt, feta cheese, and dark green leafy vegetables for more calcium in your diet. Choose oranges, bananas, potatoes, melon, dried fruits, and tomatoes for more potassium in your diet.
Knowing your blood pressure and monitoring it at home when your doctor recommends it is important to prevent chronic diseases. Your physician will work with you on whether lifestyle changes alone can lower your blood pressure or lifestyle changes and medications. Fortunately, modern medicine has given us many choices regarding effective medications to lower blood pressure. A registered dietitian can help you make changes to your diet and exercise regimens and introduce you to the DASH eating plan (Dietary Advances to Stop Hypertension) to achieve a healthy blood pressure and enjoy better health!
-Meg Martin, MS, RDN
Sources:
-- J Am Coll Cardiol. Sep 2017 (acc.org)
-- American Heart Association (heart.org)
-- National Heart, Lung, and Blood Institute. What is the DASH eating plan? ----http://www.nhlbi.nih.gov/health/health-topics/topics/dash/
-- 2018 Physical Activity Guidelines Advisory Committee Scientific Report. U.S. Department of Health and Human Services
