Is High Blood Pressure Inevitable? Here’s How to Keep It in Check

Almost every adult will face this health problem as they get older. But knowing how blood pressure might change over a lifetime can give people a better appreciation of why it’s important to keep it in check at any age.

When left uncontrolled or if undetected, high blood pressure can lead to heart disease, heart failure, stroke, kidney disease or other major health problems.

“Preventing damage is possible by keeping blood pressure well controlled,” said Dr. Sandra Taler, a professor of medicine and consultant in the division of nephrology and hypertension at the Mayo Clinic in Rochester, Minnesota. “If you ignore it, that’s when there’s a much higher risk of complications.”

Nearly half of U.S. adults – an estimated 116 million – have high blood pressure, or hypertension, according to American Heart Association statistics. High blood pressure is defined as a reading of 130 or higher as the top number (systolic) or 80 or higher as the bottom number (diastolic).

The percentage of people in the United States with high blood pressure creeps up with each decade of life. Among women ages 20 to 34, 13% have hypertension; nearly 86% have the condition by their mid-70s. Men see a similar trajectory over that same time, increasing from about 26% to 80%.

“Blood pressure increases with age in Western societies – or really most every society now – is related to the intake of salt,” said Taler, who was a member of the writing group for the current hypertension guidelines from the American College of Cardiology, AHA and other organizations. Reducing the amount of sodium in the diet can help.

Too much salt in the bloodstream pulls water into blood vessels, which in turn increases the volume of blood inside them. An increase in blood pressure can strain vessel walls, speed the buildup of blockages and tire the heart by forcing it to work harder to pump blood.

Other risk factors include older age, having a higher body mass index and race. The prevalence of high blood pressure for black adults in the U.S. is among the highest in the world. Almost 59% of black men and 56% of black women have hypertension, compared to 48% and 41% for white men and women, respectively.

When looking at differences in gender, regardless of race or ethnicity, Taler said blood pressure tends to be higher in men until they reach their 50s, when women start to have slightly higher rates of hypertension.

Research published in January in JAMA Cardiology took a closer look at blood pressure patterns for men and women over the course of a lifetime. The study found that while men tend to have higher blood pressure than women at younger ages, the rate of increase is faster for women than men starting as early as their 20s.

The findings suggest women might be underdiagnosed for high blood pressure, said Dr. Hongwei Ji, the study’s lead author and a clinical investigator at Brigham and Women’s Hospital in Boston.

Similar differences were found by race and ethnicity, Ji added.

“When it comes to investigating or treating blood pressure and cardiovascular health, women and men should be compared by different standards,” Ji said. “More importantly, we should definitely pay more attention to controlling early-life blood pressure, especially for women.”

Taler said more research is needed to pinpoint how factors exclusive to women, such as early menopause and oral contraceptives, might contribute to differences.

But no matter someone’s age, race or gender, she offered some familiar recommendations to keep blood pressure in check: limit salty or processed foods, maintain an ideal body weight, exercise regularly and avoid smoking. Some people also may need blood pressure-lowering medications.

Said Taler: “It’s really important for people to understand that high blood pressure is treatable.”

Source: American Heart Association


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Pilates May Be Good Medicine for High Blood Pressure

Pilates exercises can do more than help strengthen your abs — the moves may also lower high blood pressure and reduce artery stiffness, new research suggests.

Pilates is a workout program that focuses on core strength, flexibility, body posture and controlled breathing.

The new study included 28 obese women, aged 19 to 27, with high blood pressure (“hypertension”). The participants were non-smokers, had no chronic diseases, and did less than 90 minutes of regular exercise a week.

For the study, half of the women completed 12 weeks of mat Pilates sessions supervised by a certified instructor. The other 14 women made up a non-exercising control group.

The women in the Pilates group did three one-hour sessions a week, which included 10 minutes of warm up and stretch, 40 minutes of general mat Pilates exercises, and 10 minutes of cool down. The training intensity increased over the 12 weeks.

By the end of the training period, the Pilates group had significantly reduced arterial stiffness and blood pressure, including central (aortic) pressure, the investigators found. But the study did not prove that Pilates actually causes blood pressure to drop.

The study, published April 1 in the American Journal of Hypertension, is the first of its kind, according to study author Alexei Wong and his colleagues. Wong is assistant professor in the department of health and human performance at Marymount University, in Arlington, Va.

“We hypothesized that mat Pilates might decrease the risk of hypertension in young obese women. Our findings provide evidence that mat Pilates benefit cardiovascular health by decreasing blood pressure, arterial stiffness, and body fatness in young obese women with elevated blood pressure,” the researchers wrote.

“Because adherence to traditional exercise (both aerobic and resistance) is low in obese individuals, mat Pilates training might prove an effective exercise alternative for the prevention of hypertension and cardiovascular events in young obese adults,” the authors concluded.

High obesity rates among young adults are a major public health issue. Exercise is an important factor in preventing and managing heart health risks, but obese women tend not to stick with traditional workout routines, Wong’s team noted in a journal news release.

Source: HealthDay


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Long Work Hours at the Office Linked to Both Regular and Hidden High Blood Pressure

Office workers who spend long hours on the job are more likely to have high blood pressure, including a type that can go undetected during a routine medical appointment, according to a new study published today in the American Heart Association’s journal Hypertension.

High blood pressure affects nearly half of Americans ages 18 and older and is a primary factor in more than 82,000 deaths per year. Approximately 15-30% of U.S. adults have a type of the condition called masked hypertension, meaning their high blood pressure readings are normal during health care visits but elevated when measured elsewhere.

The new study, conducted by a Canadian research team, enlisted more than 3,500 white-collar employees at three public institutions in Quebec. These institutions generally provide insurance services to the general population. Compared with colleagues who worked fewer than 35 hours a week:

  • Working 49 or more hours each week was linked to a 70% greater likelihood of having masked hypertension and 66% greater likelihood of having sustained hypertension– elevated blood pressure readings in and out of a clinical setting.
  • Working between 41 and 48 hours each week was linked to a 54% greater likelihood of having masked hypertension and 42% greater likelihood of having sustained hypertension.

The findings accounted for variables such as job strain, age, sex, education level, occupation, smoking status, body mass index and other health factors.

“Both masked and sustained high blood pressure are linked to higher cardiovascular disease risk,” said lead study lead author Xavier Trudel, Ph.D., assistant professor in the social and preventive medicine department at Laval University in Quebec, Canada.

“The observed associations accounted for job strain, a work stressor defined as a combination of high work demands and low decision-making authority. However, other related stressors might have an impact,” Trudel said. “Future research could examine whether family responsibilities – such as a worker’s number of children, household duties and childcare role – might interact with work circumstances to explain high blood pressure.”

The five-year study involved three waves of testing – in years one, three and five. To simulate in-clinic blood pressure readings, a trained assistant provided participants with a wearable monitor to check each participant’s resting blood pressure three times in one morning. For the rest of the workday, the participant wore the blood pressure monitoring device, which took readings every 15 minutes – collecting a minimum of 20 additional measures for one day. Average resting readings at or above 140/90 mmHg, and average working readings at or above 135/85, were considered high.

In all, almost 19% of the workers had sustained hypertension, which included employees who were already taking high blood pressure medications. More than 13% of the workers had masked hypertension and not receiving treatment for high blood pressure. “The link between long working hours and high blood pressure in the study was about the same for men as for women,” Trudel said.

The study “did not include blue-collar workers (employees who are paid by the hour and perform manual labor work in positions such agriculture, manufacturing, construction, mining, maintenance or hospitality service), therefore, these findings may not reflect the impact on blood pressure of shift-work or positions with higher physical demands,” the authors said. Other limitations include the study’s measurement of blood pressure only during daytime hours, and the omission of hours worked outside participants’ primary job.

The authors noted several strengths of the study, including its many volunteers, accounting for multiple factors that can impact blood pressure, repeated testing over several years, the use of wearable monitors instead of relying on workers’ reports of their blood pressure readings; and the use of the same monitors for all blood pressure measurements.

“People should be aware that long work hours might affect their heart health, and if they’re working long hours, they should ask their doctors about checking their blood pressure over time with a wearable monitor,” Trudel said. “Masked hypertension can affect someone for a long period of time and is associated, in the long term, with an increased risk of developing cardiovascular disease. We have previously shown that over five years, about 1 out of 5 people with masked hypertension never showed high blood pressure in a clinical setting, potentially delaying diagnosis and treatment.”

Source: American Heart Association


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High Fiber Diet Associated with Reduced Cardiovascular Risk in Hypertension, Type 2 Diabetes Patients

Patients with hypertension and Type 2 diabetes who consume a high fiber diet had improvement in their blood pressure, cholesterol and fasting glucose, according to a study presented at the American College of Cardiology (ACC) Middle East Conference 2019 together with the 10th Emirates Cardiac Society Congress. The conference is Oct. 3-5 in Dubai, United Arab Emirates.

Hypertension and diabetes are major risk factors for future cardiovascular disease. Diet also plays a role in the severity of cardiovascular disease. Researchers from Care Well Heart and Super Specialty Hospital in Amritsar, India, investigated the relation between a high fiber diet and its impact on cardiovascular disease risk factors.

According to guidelines from the National Institute of Nutrition and the Indian Council of Medical Research, the recommended dietary allowance (RDA) for dietary fiber is 40gm/2000kcal. Patients in this study had Type 2 diabetes and a calorie intake of 1,200-1,500kcal, causing their RDA for fiber to be 24-30gm. The fiber intake of these patients was increased up to 20 to 25 percent from the recommended allowances for them to be consuming a high fiber diet.

The study tracked 200 participants’ fiber intake for six months and included check-ups at the start of the study, three months and six months. Participants were provided diet prescriptions, which included detailed lists of different food groups with portion sizes in regional languages. Qualified dietitians provided the information through regular counseling sessions and used audio-visual aids to ensure understanding among study participants.

The researchers tracked participants’ fiber intake several ways, including having patients send photos of their meals on WhatsApp–which not only helped in knowing their fiber intake but also helped approximate portion sizes–and telephone calls three times a week during which detailed dietary recall was taken.

“Comprehensive evaluation of etiological effects of dietary factors on cardiometabolic outcomes, their quantitative effects and corresponding optimal intakes are well-established,” said Rohit Kapoor, MD, medical director of Care Well Heart and Super Specialty Hospital and lead author of the study. “This study helps us determine three important things for this patient population. Firstly, a high fiber diet is important in cases of diabetes and hypertension to prevent future cardiovascular disease. Secondly, medical nutrition therapy and regular counseling sessions also hold great importance in treating and prevention of diabetes and hypertension. Thirdly, this type of diet in combination with medical treatment can improve dyslipidemia, pulse wave velocity, waist-to-hip ratio and hypertension.”

Participants on a high fiber diet experienced significant improvement in several cardiovascular risk factors, including a 9 percent reduction in serum cholesterol, 23 percent reduction in triglycerides, 15 percent reduction of systolic blood pressure and a 28 percent reduction of fasting glucose. The researchers found a high fiber diet is inversely related with cardiovascular risk factors and plays a protective role against cardiovascular disease.

Source: EurekAlert!

Gum Disease Linked with Higher Risk of Hypertension

Sophia Antipolis wrote . . . . . . . . .

People with gum disease (periodontitis) have a greater likelihood of high blood pressure (hypertension), according to a study published today in Cardiovascular Research, a journal of the European Society of Cardiology (ESC).1

Senior author Professor Francesco D’Aiuto of UCL Eastman Dental Institute, UK, said: “We observed a linear association – the more severe periodontitis is, the higher the probability of hypertension. The findings suggest that patients with gum disease should be informed of their risk and given advice on lifestyle changes to prevent high blood pressure such as exercise and a healthy diet.”

High blood pressure affects 30–45% of adults and is the leading global cause of premature death,2 while periodontitis affects more than 50% of the world’s population. Hypertension is the main preventable cause of cardiovascular disease, and periodontitis has been linked with increased risk of heart attack and stroke.

“Hypertension could be the driver of heart attack and stroke in patients with periodontitis,” said Professor D’Aiuto. “Previous research suggests a connection between periodontitis and hypertension and that dental treatment might improve blood pressure, but to date the findings are inconclusive.”

This study compiled the best available evidence to examine the odds of high blood pressure in patients with moderate and severe gum disease. A total of 81 studies from 26 countries were included in the meta-analysis.

Moderate-to-severe periodontitis was associated with a 22% raised risk for hypertension, while severe periodontitis was linked with 49% higher odds of hypertension. Lead author Dr Eva Munoz Aguilera of UCL Eastman Dental Institute said: “We observed a positive linear relationship, with the hazard of high blood pressure rising as gum disease became more severe.”

Average arterial blood pressure was higher in patients with periodontitis compared to those without. This amounted to 4.5 mmHg higher systolic and 2 mmHg higher diastolic blood pressures. “The differences are not negligible,” said Dr Munoz Aguilera. “An average 5 mmHg blood pressure rise would be linked to a 25% increased risk of death from heart attack or stroke.”

Just 5 out of 12 interventional studies included in the review showed a reduction in blood pressure following gum treatment. The changes occurred even in people with healthy blood pressure levels.

Professor D’Aiuto said: “There seems to be a continuum between oral health and blood pressure which exists in healthy and diseased states. The evidence suggesting periodontal therapy could reduce blood pressure remains inconclusive. In nearly all intervention studies, blood pressure was not the primary outcome. Randomised trials are needed to determine the impact of periodontal therapy on blood pressure.”

Regarding potential reasons for the connection between the conditions, gum disease and the associated oral bacteria lead to inflammation throughout the body, which affects blood vessel function. Common genetic susceptibility could also play a role, along with shared risk factors such as smoking and obesity.

Professor D’Aiuto said: “In many countries throughout the world, oral health is not checked regularly, and gum disease remains untreated for many years. The hypothesis is that this situation of oral and systemic inflammation and response to bacteria accumulates on top of existing risk factors.”

He noted that the study investigated gum disease as a potential risk factor for hypertension, but the reverse could also be true. “Further research is needed to examine whether patients with high blood pressure have a raised likelihood of gum disease. It seems prudent to provide oral health advice to those with hypertension,” he said.

Source: European Society of Cardiology


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