By John Voelz, Exercise Specialist
If you suffer from high blood pressure (hypertension), you’re not alone. Approximately 68 million Americans also have high blood pressure. That translates into roughly 1 in 3 adults. Hypertension and type 2 diabetes are the two most common and most treatable chronic health conditions in the country today. If you’d like to read more about type 2 diabetes, go to my article from last December
If you’ve read the last two articles on “The Heart” and “Atrial Fibrillation,” you’ll recall that the heart and circulatory system work together in a very well controlled way to deliver oxygen and nutrient filled blood to your muscles, brain, skin, and other organs. Every square inch of tissue in your body requires exposure to blood, so if we had to choose one system that is vitally important for health; it would be your heart and circulation (the Cardio-Vascular System).
The heart works very much like any other pump. A mechanical water pump, for example, will push water through metal pipes at an efficient rate and pressure. If the metal pipes suddenly became much narrower, the amount of water pressure would increase, and over time this would wear out the pump and probably damage the pipes. But if the pipes were made of a nice flexible rubbery material, the pressure might be absorbed enough that the pump would be able to continue working at its normal rate without too much stress. The nice flexible pipes we have in our bodies are called “arteries” — they leave the heart, becoming smaller as they reach the body tissues in need of a blood supply.
|Blood Pressure Levels|
|Normal||systolic: less than 120 mmHg|
diastolic: less than 80mmHg
|At risk (prehypertension)||systolic: 120–139 mmHg|
diastolic: 80–89 mmHg
|High||systolic: 140 mmHg or higher|
diastolic: 90 mmHg or higher
Here is a short video that explains the top number (systolic) and bottom number (diastolic)
Within the walls of our arteries is a thin layer of muscle that can contract or relax, making the diameter of the artery smaller or larger. Dilated arteries allow blood to flow more smoothly. If arteries constrict, blood has a more difficult time flowing, and the resulting back pressure begins putting stress on the heart.
As we age, the larger arteries become slightly stiffer due to normal tissue changes. Age related hormonal changes cause constriction of smaller arteries. As a result, our blood pressure tends to rise as we get older, and often medication helps. What makes matters worse is when we add lifestyles that include stress, obesity, smoking, and poor diets that increase blood sugar, sodium and cholesterol. Separately and together, these risk factors cause increased stiffness, constriction, plaque accumulation, and narrowing of the important arteries causing blood pressure to rise dramatically. Elevated pressure against the artery walls causes further damage, inflammation, and narrowing. This vicious cycle of events continues to increase pressure and damage to artery walls.
A serious result of prolonged and uncontrolled hypertension is the accumulation of cholesterol and plaque in the walls of the arteries. This can become very serious if plaque build-up occurs in the:
Coronary Arteries Surrounding and Feeding the Heart:
And also if it occurs in the:
Carotid Arteries Leading to the Brain:
A lifetime of uncontrolled hypertension forces the heart muscle to work harder in order to pump blood against increased pressure (recall the mechanical pump example above). The muscular walls of the heart thicken, and the pumping action becomes less and less efficient.
This thickening of the ventricles is termed ventricular hypertrophy.
Now that I’ve scared everyone, the good news is the fact that high blood pressure is treatable and controllable. If you’re reading this article and have high blood pressure, chances are good that it’s being controlled through lifestyle changes, and possibly you are taking medication.
Discussing high blood pressure medications in this article would become pretty extensive (and is something you can talk to Dr. Amsler about!). But it is useful to know that the many medications for hypertension are very good at targeting the variety of causes; there are medications that decrease fluid and sodium volume (which contribute to pressure increase), others help constricted arteries to dilate and lower pressure, and others are designed to prevent your heart from working too hard.
Hopefully you are also controlling the lifestyle factors by not smoking, watching your weight, controlling stress, and getting some exercise.
A sedentary lifestyle is also a risk factor for heart disease, and regular exercise can help keep your blood pressure under control. Besides keeping your body weight in a good range, regular moderate exercise helps your heart stay strong so it doesn’t have to work as hard during activity. Rhythmic cardiovascular exercise causes “vasodilation,” which is the opening of small arteries, so the heart doesn’t have to pump against extra resistance. Regular exercise has also been shown to decrease the age related stiffening of arteries, preventing heart and vessel pressure damage. Activity also decreases stress and promotes better sleep, both of which can affect blood pressure.
Here is a really good 4 part series (takes about 12 minutes) that talks about blood pressure: