Blood pressure is the force of blood against artery walls. It is
measured in millimeters of mercury (mm Hg) and recorded as two
numbers--systolic pressure (as the heart beats) over diastolic pressure
(between heartbeats). Both numbers are important.
BLOOD PRESSURE CATEGORIES FOR ADULTS*
Systolic** | Diastolic** | ||
| Optimal | <120 mm Hg | and | <80 mm Hg |
| Normal | <130 mm Hg | and | <85 mm Hg |
| High-Normal High | 130-139 mm Hg | or | 85-89 mm Hg |
| Stage 1 | 140-159 mm Hg | or | 90-99 mm Hg |
| Stage 2 | 160-179 mm Hg | or | 100-109 mm Hg |
| Stage 3 | >=180 mm Hg | or | >=110 mm Hg |
* Categories are for those age 18 and older and come from the
National High Blood Pressure Education Program. The categories are for
those not on a high blood pressure drug and who have no short-term
serious illness. If your systolic and diastolic pressures fall into
different categories, your overall status is the higher category. <
means less than, and >= means greater than or equal to.
In the United States, hypertension is a public health problem of
enormous proportions, more than 60 million individuals have been found
to have elevated blood pressure or have reported taking
anti-hypertensive drugs prescribed by a physician.
When blood pressure is too high, the heart is working harder than it should. Once
developed, high blood pressure lasts a lifetime. It is a dangerous condition, which often
has no warning signs or symptoms. If uncontrolled, it can lead to heart and kidney disease,
and stroke.
Currently, three non-drug methods are recommended as part of the treatment for high
blood pressure (hypertension) - weight control, alcohol restriction, and sodium
restriction.
Certain nutrients are implicated in hypertension regulation as well as the mechanisms
by which dietary factors are known to influence hypertension. The association between
hypertension and weight reduction has been investigated in many epidemiologic studies. A
significant reduction of elevated blood pressure occurs with weight loss.
Complicating the relationship of obesity to blood pressure is the role of sodium. The
relationship between the intake of salt and the development of hypertension was
emphasized as early as 1904 by Ambard and Beaujard. Long term studies have shown that
hypertensive patients can control blood pressure by reducing sodium intake. Even small
reductions in sodium intake over a long period may reduce blood pressure.
Population studies have shown both a positive relationship between sodium intake and
blood pressure and an inverse relationship between potassium and blood pressure -
potassium salt produces a regular decline in blood pressure.
The nutritional requirement for sodium for growth and unavoidable
loses from the skin and feces is in the range of 100 - 200 mg of sodium
per day (about 500 mg of salt). The average sodium chloride intake is
about 10 g per day, about 20 times the nutritional requirement. There
is no reason to believe that reduction of sodium chloride intake to
levels of 3 g per day would be harmful for healthy persons, and it may
be a preventative factor of hypertension in susceptible individuals.
Achieving an intake of 3 g of salt per day would require an elimination
of salt in cooking and at the table, since nondiscretionary salt intake
in foods amounts to at least 3 g per day.
The consumption of 150 mg of caffeine (about 2 cups of brewed
coffee) may promote an increase in blood pressure within 15 minutes
that is maintained for as long as 2 hours. However prolonged use of
caffeine has not been associated with increased rates of hypertension
in some individuals. Thus, there appears to be adaption or tolerance to
the hemodynamic effects of caffeine.
Epidemiologic studies have shown that individuals who regularly
consume large amounts of alcohol have higher blood pressure than people
who abstain from alcohol.
Prolonged excessive intake of vitamin D can cause anorexia, nausea,
weakness, weight loss, hypertension, anemia, hypercalcemia,
irreversible renal failure, and death.
In emergency situations the agents used to treat elevated blood
pressure should be easily titratable with a quick onset of action but
with a limited risk of excessive and sudden lowering of blood pressure.
Preferred agents include low doses of intravenous labetalol or low
doses of enalapril. Some investigators have also used small patches of
nitropaste. More aggressive, but also easily titratable, treatment of
blood pressure includes continuous intravenous infusions of
nitroglycerin, nitroprusside, or esmolol. Sublingual nifedipine is one
of the most commonly used agents to lower blood pressure in the
emergency department. However, it should be viewed as second-line
therapy since its effect may be delayed, it is more difficult to
titrate as compared to the intravenous medications, and its use can be
associated with precipitous drops in blood pressure. If blood pressure
is lowered in this setting, serial neurological examinations should
look for signs of deterioration such as increasing weakness or a
reduced level of consciousness. The presence of these findings should
prompt consideration of more conservative control of blood pressure.
Research has shown that diet affects the development of high blood
pressure. Recently, a study found that a particular eating plan can
lower elevated blood pressure (NIH Publication No. 98-4082 September
1998).
The eating plan is meant for those with elevated blood pressure. It
also is a heart-healthy plan that you can share with your family.
Even slight elevations of blood pressure above the optimal level of
less than 120/80 mm Hg are unhealthy. The higher the blood pressure
above normal, the greater the health risk.
In the past, researchers had tested various single nutrients, such
as calcium and magnesium, to find clues about what affects blood
pressure. These studies were done mostly with dietary supplements and
their findings were not conclusive.
Then, scientists supported by the National Heart, Lung, and Blood
Institute (NHLBI) tested nutrients as they occur together in food. The
results were dramatic. The clinical study, called "DASH" for Dietary
Approaches to Stop Hypertension, found that elevated blood pressures
can be reduced with an eating plan low in saturated fat, total fat, and
cholesterol, and rich in fruits, vegetables, and lowfat dairy foods.
The plan is rich in magnesium, potassium, and calcium, as well as
protein and fiber.
The DASH eating plan
is rich in various nutrients believed to benefit blood pressure and in
other factors involved in good health. The amounts of the nutrients
vary by how much you eat. If you eat about 2,000 calories a day on the
plan, the nutrients you get will include:
- 4,700 milligrams of potassium
- 500 milligrams of magnesium
- 1,240 milligrams of calcium
Those totals are about two to three times the amounts most Americans get.
The DASH eating plan can be found at this site - http://www.nhlbi.nih.gov/health/public/heart/
Here is a sample recipe to help you cook up a tasty heart healthy meal
Vegetarian Spaghetti Sauce (Day 1)
| 2 | Tbsp | olive oil |
| 2 | small | onions, chopped |
| 3 | cloves | garlic, chopped |
| 1/4 | cup | zucchini, sliced |
| 1 | Tbsp | oregano, dried |
| 1 | Tbsp | basil, dried |
| 1 | 8 oz can | tomato sauce |
| 1 | 6 oz can | tomato paste |
| 2 | medium | tomatoes, chopped |
| 1 | cup | water |
1. In a medium skillet, heat oil. Saute onions, garlic, and zucchini in oil for 5 minutes on medium heat.
2. Add remaining ingredients and simmer covered for 45 minutes. Serve over spaghetti.
Makes 6 servings. Serving size: 3/4 cup
Per Serving: | |||
| Calories | 102 | Magnesium | 37 mg |
| Total Fat | 5 g | Potassium | 623 mg |
| Saturated Fat | 1 g | Calcium | 42 mg |
| Cholesterol | 0 mg | Sodium | 459 mg |
