Health & Fitness

Nearly half the U.S. population has high blood pressure. Here’s what to do about it.

Javier Riva finishes the Ironman 70.3 in Miami in 2016. The race consists of a 1.2-mile swim, a 56-mile bike ride and a 13.1-mile half marathon.
Javier Riva finishes the Ironman 70.3 in Miami in 2016. The race consists of a 1.2-mile swim, a 56-mile bike ride and a 13.1-mile half marathon.

Nearly four years ago, financial adviser Javier Martin was in his Miami office when he began feeling pain in his chest and arm.

After being rushed to the hospital, Martin learned his blood pressure was elevated and he was about to have a heart attack.

Martin, 50, admits that his job is stressful but that he has always regularly exercised and maintained a healthy diet.

In 2016, he competed in the IronMan 70.3 Miami, a half Ironman that consists of a 1.2-mile swim, a 56-mile bike ride and a 13.1-mile half marathon. He has also done triathlons in Spain and England.

“I consider myself in good shape,” said Martin, who doesn’t have any other medical conditions. “I am a triathlon freak.”

High blood pressure (HBP or hypertension) is known as the “silent killer” because there are often no symptoms. Yet high blood pressure causes the second largest number of preventable heart disease and stroke deaths after smoking.

Last November, the American Heart Association and the American College of Cardiology published the first new blood pressure guidelines since 2003. The guidelines lower the numbers for what is considered hypertension to 130/80 from the previous 140/90. A normal blood pressure is now less than 120/80.

The new guidelines mean that half of the U.S. adult population — 46 percent — have high blood pressure or hypertension, an increase from the 32 percent who suffered from the condition under the previous guidelines.

For a person who reaches age 45 without having hypertension, the risk for developing hypertension within the next 40 years is 93 percent for African Americans, 92 percent for Hispanics, 86 percent for whites, and 84 percent for Asian Americans, according to the guidelines.

Blood pressure is the measure of the pressure of the blood as it circulates through the body. It is the pressure that maintains blood flow.

The first number of a blood pressure reading, the higher of the two, is the systolic pressure. That measures the force in the arteries when the heart beats. The second number is the diastolic pressure, or the pressure in the arteries when the heart rests between beats.

“When the blood pressure is high, there is a higher risk of strokes and heart attacks,” said Dr. Gervasio Lamas, chief of cardiology at Mount Sinai Medical Center in Miami Beach. “It is like a garden hose: It only takes so much pressure before it pops and something bad will happen.”

Changing one’s diet and exercise is often the first step in treating patients with hypertension, Lamas said. In South Florida, Latin food is often high in salt and calories. Two of the highest obese populations are Hispanics and African Americans because of diet, portion size and genetics.

“People find it hard to get away from types of food and portion sizes,” Lamas said.

Lamas encourages people to exercise by walking, bicycling, swimming or going to the gym. Yoga also reduces blood pressure and heart rhythm complications.

People should exercise at least 30 minutes daily, three-to-five times weekly, said Dr. Ian Del Conde, cardiologist and head of vascular medicine at the Miami Cardiac & Vascular Institute at Baptist Health South Florida. Exercise should be moderate to vigorous so that the heart rate increases and people break a sweat.

Studies show that the DASH (Dietary Approaches to Stop Hypertension) diet, which encourages a low-salt, high-potassium diet with fruits and vegetables along with an active lifestyle, can help to control elevated blood pressure, Del Conde said.

Reducing alcohol consumption also plays a role. Alcohol intake affects blood pressure, said Dr. Carl Orringer, cardiologist at the University of Miami Hospital and associate professor of medicine at the University of Miami Miller School of Medicine. Men should limit alcoholic drinks to two a day, women once a day.

If lifestyle modifications don’t work or the patient’s risk is high, then the patient should be treated with medication. Hypertensive patients with a high risk are advised on lifestyle modification but are started on medication to reduce chances of complications, Orringer said. Patients who are diabetic, smoke or have high cholesterol are more prone to be treated with medication.

Patients can be proactive and check their blood pressure, Del Conde said. Patients can use blood pressure machines at their local pharmacy, but Del Conde also noted that it is fairly inexpensive to buy a blood pressure machine.

“Keep a log with the date and time of blood pressure reading,” Del Conde said. “Patients will then have a very good feel for their blood pressure and be able to tell doctors their blood pressure history.”

People should not neglect having their blood pressure checked by their doctor, Orringer said. To have a proper blood pressure measurement, the patient needs to rest for at least five minutes prior. Also, have the appropriate size blood pressure cuff for their body type. If a patient has a heavy arm and a small cuff is used, that can result in an inaccurate reading. Also, no coffee or alcohol 30 minutes before measuring blood pressure.

“Prevention is the name of the game,” Orringer said. “It is the responsibility of the patient to be aware of their blood pressure. Be vigilant and schedule regular doctor visits. Demand as a patient that your blood pressure is checked properly.”

Martin monitors his blood pressure by taking a reading every two to three days. He also takes two medications daily to control his blood pressure. He plans to compete in the South Beach Triathlon in April.

“High blood pressure is a silent killer,” Martin said. “People need to take it seriously. It is not a joke.”

Tips to Lower Blood Pressure

Follow a low salt diet. Sodium can increase blood pressure.

Exercise at least 30 minutes a day, three to five times a week.

Reduce alcohol consumption. The guidelines recommend a maximum of one drink a day for women and two drinks a day for men.

Get blood pressure checked correctly by a healthcare professional.