By DR. JANEL GORDON
WISH-TV Medical Expert
wishtv.com
High blood pressure affects almost half of all U.S. adults and is the leading cause of death globally.
New blood pressure guidelines call for early treatment, including lifestyle changes, to decrease the risk of dementia as well as improved management before, during and after pregnancy.
What is a normal blood pressure?
High blood pressure is the No. 1 preventable risk factor for dementia, cardiovascular disease (heart attack, stroke, heart failure), and kidney disease.
High blood pressure can damage the small blood vessels of our brain, leading to memory problems, cognitive decline and dementia. Therefore, early treatment is recommended.
- Stage 1 High Blood Pressure: 130 to 139 mmHg over 80 to 89 mm Hg
- Stage 2 High Blood Pressure: greater than 140 mmHg (systolic, the “top number”) or greater than 90 mm Hg (diastolic, the “bottom number”)
There’s a new risk calculator that allows us to assess the risk of an individual having a cardiovascular event in 10 to 30 years, taking into account an individual’s age, sex, blood pressure, cholesterol, smoking history, kidney function, race and ZIP code (the latter is an addition from our previous risk calculator from 2013). Results can help guide personalized treatment plans.
It is now recommended that people with high blood pressure have an annual urine protein test (urine albumin and creatinine ratio), assessing for kidney disease. Previously, this was optional. Though, many of my colleagues and I were already doing this.
What should people with high blood pressure who are considering pregnancy be aware of?
These individuals should speak with their healthcare team about the benefits of taking daily low-dose aspirin (81 mg), starting between 12 to 28 weeks (optimally, before 16 weeks) and continuing until delivery to prevent pre-eclampsia.
This is especially important for those who are 35 or older, have a history of diabetes, have a BMI of 30 or higher, have an autoimmune disease, have kidney disease, are pregnant with multiples, are pregnant for the first time, or have a personal or family history of pre-eclampsia.
It is critically important that pregnant people with high blood pressure, especially those with the previously mentioned risk factors, have continued blood pressure monitoring even after pregnancy and seek emergency evaluation for warning signs of pre-eclampsia:
- Blood pressure of 140/90 mmHg or higher
- Face, hands, legs or feet swelling
- Persistent headache
- Vision changes
- Difficulty breathing
- Nausea and vomiting
- Abdominal pain
- Decreased urination
- Rapid weight gain
Healthcare professionals should evaluate any pregnant or postpartum person presenting with these symptoms for pre-eclampsia.
What can we do to lower our blood pressure naturally?
- Limit sodium intake to 1,500 mg daily (watch pre-packaged and restaurant foods, in addition to added table salt and seasoning mixes).
- Limit/quit alcohol and quit smoking.
- Reduce body weight by 5 percent in individuals with excess weight (consider GLP-1 agonist medication in addition to lifestyle changes).
- Incorporate stress-reduction techniques such as meditation and yoga.
- Aim for seven to eight hours of sleep.
- Center nutrition on fruits, vegetables, whole grains, legumes, nuts, seeds, lean protein, and low fat.
- Aim for 75 minutes of vigorous cardio or 150 minutes of moderate cardio and two days of strength training.
- Monitor blood pressure at home if you have elevated office readings without a formal diagnosis.
This story was originally published by WISH-TV at wishtv.com/news/health-spotlight/high-blood-pressure-guidelines.