How to live successfully with hypertension

Eating plenty of fruits keeps the body
healthyMillions of people worldwide die each year from hypertension, which predisposes them to many other serious health problems. But shedding weight in combination with good diet and medications may help avoid several complications, such as heart disease, associated with hypertension, reports Sade Oguntola.

Approximately seven million people worldwide die each year from high blood pressure (hypertension), which predisposes people to heart disease and other serious health problems. While losing weight can lower blood pressure in some cases, a combination of good diet with certain medications may help reduce the risk of complications associated with hypertension.

Blood pressure is the pressure of the blood against the walls of the arteries. Blood pressure results from two forces. The heart creates one force as it pumps blood into the arteries and through the circulatory system. The other is the force of the arteries as they resist the blood flow. The higher, systolic number represents the pressure while the heart contracts to pump blood to the body. The lower, diastolic number represents the pressure when the heart relaxes between beats. While lowering blood pressure in patients with hypertension can reduce cardiovascular risks and reduce illness and death, weight loss can be a key factor in achieving that goal. A meta-analysis of 48 studies, published before March 2007, which was conducted by researchers at Medical University of Graz, Australia, and led by Dr. Karl Horvath found losing weight by pairing a healthy diet with weight-loss medication could help lower blood pressure. Of those studies, 38 assessed diet and 10 focused on medications for weight loss.

The researchers found that dieting and medication helped lower blood pressure in high BP patients. They stated: “Reduction of blood pressure was higher in patients treated with weight loss diets or drugs.” According to the authors, “a reduction in body weight of approximately 4 kilogrammes was necessary to achieve a reduction of approximately 6 milligrams of mercury in systolic blood pressure with dietary treatment and of approximately 2.5 milligrammes of mercury with drug.” The study was reported in the March 24 issue of Archives of Internal Medicine, one of the JAMA/Archives journals.

It is clear that diet affects blood pressure. Vegetarians, for example, tend to have lower blood pressures than non-vegetarians. Researchers at the Johns Hopkins Medical School reported that a diet rich in fruits, vegetables and low-fat dairy products is highly effective in lowering blood pressure. Their study involved 459 adults with systolic blood pressures below 160 mm Hg and diastolic pressures between 80 and 95 mm Hg. The fruits and vegetables diet (modified control diet) produced a drop in systolic and diastolic blood pressure of 2.8 mm Hg and 1.1 mm Hg respectively.

Experts have found that a diet that emphasises fruits, vegetables, and low-fat dairy products might act as a natural diuretic that could help many people reduce blood pressure. Results from their studies indicated that such a diet that promotes salt excretion, similar to diuretic drugs, which are widely used to treat high blood pressure by increasing urine production, is very helpful to black people and elderly people, including Nigerians. These are people found to have sodium-sensitive hypertension and whose blood pressures were very sensitive to changes in the amount of sodium intake.

As early as the 1920’s, researchers noted a relationship between caloric restriction, weight loss and a decreased incidence of hypertension. In 1988, a meta-analysis of aggregate data from 12 prospective studies, including five randomised controlled trials (RCTs), found that on average each 1 kilogramme decrease in body weight in obese hypertensive patients was associated with a 2.4 mm Hg systolic and 1.5 mm Hg diastolic decrease in blood pressure.

Experts have suspected that high blood pressure may be due to excess weight in half of overweight adults. Researchers in Italy found that about 50 per cent of overweight, hypertensive adults, ranging in age from 29 to 65 years, achieved normal body weight and blood pressure after six months of treatment with a reduced-calorie diet.

In a comment by Dr. Roberto Fogari, M.D., the lead investigator of the study and professor of medicine at the University of Pavia, Italy: “This is important because it means that in these patients with elevated blood pressure who were overweight, the blood pressure was not a form of essential hypertension but was hypertension secondary to body weight.” Fogari emphasised the importance of initiating dietary advice and treatment in overweight patients with high blood pressure before beginning drug treatment. “The first step is to help the overweight patient lose weight,” he said. “Only after six months of trying to reduce the patient’s weight can a decision be made about drug treatment.”

According to Dr. Babatunde Salako, a consultant physician at the University College Hospital (UCH), Ibadan, “diet and exercises are adjunct to hypertension treatment and diet regulation alone cannot ensure proper control of blood pressure, especially if the case is the moderate to severe type.” Dr Salako said much as diet and lifestyle changes may lower blood pressure in a case where the blood pressure is mild, such an individual will equally need to be regularly monitored to see that the blood pressure remains at a safe limit. Meanwhile, dieting to lose weight may lower blood pressure in overweight people with hypertension, but effects are modest and so dieting may not be effective alone. Though a number of medications are used to try to decrease high blood pressure, people may also wish to try non-drug treatments, especially if their hypertension is mild. One alternative is losing weight, as lowering body weight may lower blood pressure. Losing weight may also lower the medication doses needed by people taking drugs to try to treat hypertension. However, weight loss alone does not signifi-cantly reduce blood pressure.

In the meantime, here are some suggestions that can lessen your chances of developing high blood pressure and help keep you healthy in many other ways as well:
• Maintain a normal weight for your height.

•Exercise regularly. This can help in preventing you becoming overweight or help you in losing pounds if you need to. Exercise also helps keep your heart and blood vessels strong and healthy.

• Eat a healthy diet that includes lots of fruits and vegetables.

• Don’t smoke. Smoking and high blood pressure are major risk factors for having a heart attack or stroke later in life.

• Keep your stress levels in check. It may help to practice relaxation techniques such as deep breathing exercises.

• Decrease your sodium (salt) intake. Consuming less sodium has been proved to help lower blood pressure in some people and may prevent some from developing high blood pressure in the first place.

• Avoid drinking too much alcohol, which is associated with high blood pressure.

• Know your blood pressure. Have it checked regularly because, although high blood pressure is more common in adults, hypertension can occur at any age.