SUNBURY — Recognizing your risk factors for high blood pressure may save your life.

May is National Hypertension Month. Valley medical professionals share some tips on how to manage what could be “a silent killer.”

“We call hypertension the silent killer because many people with high blood pressure don’t know they have it. People may ‘feel fine’ though damage can be occurring throughout the body,” said Sonia Reich, a nurse practitioner at Family Medicine of Evangelical-Milton.

Long-term dangers include heart attack and stroke as well as damage to the kidneys, vision loss and heart failure, Reich said.

“When the blood pressure is too high for too long, cholesterol can begin to deposit in the walls of arteries and decrease the efficiency of the circulatory system. Most adults should be screened at least twice a year. Know your numbers,” Reich said.

Darcie Desiderio, a nurse practitioner at UPMC Heart and Vascular Institute broke down those numbers.

A normal blood pressure in adults should be 120/80. The top number, or systolic, measures the heart’s force against the arteries when it beats. The bottom number, or diastolic pressure, measures that pressure between beats.

Stage One High Blood Pressure is in the range of 130-139 systolic and 80-89 diastolic. Stage Two High Blood Pressure is any systolic number over 140 with a diastolic number 90 or above.

Desiderio said a patient in the stage one category needs to consider diet modification, including limiting high sodium foods. The patient may need to introduce more physical activity and weight loss. She said this patient would be referred to cardiology and tested for such concerns as heart failure, endocrine disorders and sleep apnea.

A person with stage two hypertension would likely be encouraged to monitor blood pressure at home with daily readings with a follow-up report of those readings after a week. Medication will likely be introduced.

Desiderio said self-checking blood pressure has become more common in recent year and patients can purchase their own blood pressure cuff at a pharmacy and it may be covered by some insurances.

“When checking blood pressures at home,” said Reich. “I recommend patients use a device that measures blood pressure in the upper arm and perform measurements in a quiet room after resting for five minutes. They should avoid smoking and caffeine for 30 mins before checking their blood pressure because these could cause elevated readings. Check blood pressure in a sitting position with legs on the floor and arms supported. I recommend checking blood pressure first thing in the morning, before stress and caffeine is into the body.

Both Desiderio and Reich said much is examined before implementing medications.

“Lifestyle changes are the first step in lowering blood pressure and may be enough to control blood pressure in some patients,” Reich said. “If the blood pressure is not extremely high, I discuss these options with patients and we decide what is doable for them and try those changes for a few weeks before considering medications.”

Getting started

Weight loss is a great place to start, both medical professionals said, and this includes implementing more exercise.

“Start where you are, working up to a goal of 30 minutes a day most days of the week or 150 minutes per week. You’ve got to pick an activity you enjoy, or it won’t get done. Exercise doesn’t have to occur in a gym. Walking is ideal,” said Reich.

Desiderio agreed, saying the pandemic has kept many people from going to the gym in the last year. “People are more sedintary. Many are tied to their computres,” she said, and lack much physcial movement in a typical day.

It’s not too late to make up for that lack of activity now.

“The weather is so nice this time of the year. Take long walks in your neighborhood for at least 30 minutes a day,” she said

Reich said limiting your diet only adds to the benefits.

“Eat a well-balanced diet that is low in salt,” Reich said. “You can lower salt in your diet by tasting foods before adding salt, checking labels for sodium content, and buying lower sodium foods, and cooking at home more. The DASH diet plan (Dietary Approaches to Stop Hypertension) was designed to help treat or prevent hypertension. It focuses on increasing vegetables and fruits, whole grains, low fat diary, poultry, fish, and nuts while limiting sodium.”

Other tips include stop smoking and limiting alcoholic beverages. Men should consume less than three drinks per day, and women should limit alcohol consumption to two drinks.

Risk factors

Stress is a major factor with hypertension.

“Anxiety and psychological factors can play a significant role,” Desiderio said. ”You need to be aware of that.” Many people have felt an increase in these areas due to the pandemic, she said.

Reich said she has seen an increase over the past year of patients with this issue.

When these changes do not make a significant change in the numbers, Reich said, it’s time to start medications.

“Other risk factors are examined before we start medications,” Desiderio said. In some cases, once medication is prescribed, “we can slowly wean patients and reduce the medications.”

Sometimes individuals may be at higher risk for hypertension due to things beyond their control such as genetic make up and race, Reich said.

“African Americans are at higher risk for elevated blood pressure and it tends to occur earlier in life and be more severe. Blood pressure increases with age. Genetics play a large role; you are twice as likely to have hypertension if you have one or two parents who have it,” Reich said.

Sometimes simply getting older can be a risk.

“Once you’ve reached about that sixth decade of life,” Desiderio said, primary care provider pay extra close attention to blood pressure.

“It’s not to say you can’t be hypertensive at 25 years old,” she added.

The comparisons among men and women with hypertension during the past year is still being examined. Reich said, “a study in Circulation in February indicating that women may need a lower blood pressure target to prevent cardiovascular events, but more research is needed before this becomes a recommendation. Stay tuned.”

Desiderio noted young women using oral contraceptives need to keep an eye on their blood pressure.

Symptoms of hypertension include headaches, dizziness, and vision changes. Desiderio said someone experiencing these symptoms should call his or her primary care provider. Since the pandemic has begun, Desiderio said more patients seem comfortable seeing their primary care provider than going to an emergency room.

“Evangelical’s Community Hospital’s Health and Wellness program offers blood pressure, blood sugar, and comprehensive blood screens regularly to help people know where they stand,” said Reich. These screenings can be found by visiting www.evanhospital.com/calendar.

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