Diastolic blood pressure: How low is too low? – News

Low diastolic blood pressure is a risk factor for new-onset heart failure in older adults. UAB cardiologist Jason Guichard explains why that might be, the causes of low diastolic pressure and how to deal with it.

Written by: Matt Windsor
Media contact: Adam Pope

Blood pressure consists of two numbers. Systolic pressure, the force exerted on blood vessels when the heart beats, is the upper number. Diastolic pressure, the force exerted when the heart is at rest, is on the bottom — in more ways than one. Systolic pressure attracts the lion’s share of attention from physicians and patients, says UAB cardiologist Jason Guichard, M.D., Ph.D.

“Physicians are busy people, and like it or not they often focus on a single number,” Guichard said. “Systolic blood pressure is the focus, and diastolic pressure is almost completely ignored.” That is a mistake, he argues. “The majority of your arteries feed your organs during systole. But your coronary arteries are different; they are surrounding the aortic valve, so they get blood only when the aortic valve closes — and that happens in diastole.”

Diastolic pressure has been getting more attention lately, however, thanks in part to an influential paper in Hypertension, written in 2011 by Guichard and Ali Ahmed, M.D., then a professor of medicine in UAB’s Division of Gerontology, Geriatrics and Palliative Care and now the associate chief of staff for Health and Aging at the Veterans Affairs Medical Center in Washington, D.C. (Ahmed remains an adjunct faculty member at UAB.)

INFOGRAPHIC: See our quick guide to causes, and treatments, for low diastolic blood pressure.

That paper coined a new term, “isolated diastolic hypotension,” which refers to a low diastolic blood pressure (less than 60 mm Hg) and a normal systolic pressure (above 100 mm Hg). Older adults who fit those conditions are at increased risk for developing new-onset heart failure, the researchers found.

“High blood pressure is a problem, but low blood pressure is also a problem,” Guichard said. That realization helped drive a 2014 decision by the panel members appointed to the Eighth Joint National Committee (JNC 8) to relax target blood pressure guidelines for those over 60 years old. [Read Guichard’s take on “ideal blood pressure” and the new guidelines in this blog post.]

“Years ago and until recently, doctors were treating blood pressure so aggressively that many patients couldn’t even stand up without getting dizzy,” Guichard said. “We want to empower patients to know that you don’t have to drop those numbers all the way down to nothing, to the point where you can’t play with your grandkids or play golf or take a simple walk around the block because your blood pressure is so low. I think it’s important to raise awareness in this area, especially for older people.”

Jason GuichardAhmed and Guichard are continuing to explore the mechanisms behind low diastolic pressure in more detail. Several new papers are pending, Guichard says. In the meantime, he sat down with The Mix to explain the dangers associated with low blood pressure.

Most people are trying to lower their blood pressure. What would you define as “too low,” and why is that a problem?

A diastolic blood pressure of somewhere between 90 and 60 is good in older folks. Once you start getting below 60, that makes people feel uncomfortable. A lot of older folks with low diastolic pressures get tired or dizzy and have frequent falls. Obviously, none of that is good news for people who are older, who potentially have brittle bones and other issues.

Your coronary arteries are fed during the diastolic phase. If you have a low diastolic pressure, it means you have a low coronary artery pressure, and that means your heart is going to lack blood and oxygen. That is what we call ischemia, and that kind of chronic, low-level ischemia may weaken the heart over time and potentially lead to heart failure.

What could cause a person to have low diastolic blood pressure?

Medications are a big one. There are some medicines that are culprits for lowering your diastolic blood pressure more than your systolic — specifically, a class of medications called alpha blockers, or central acting anti-hypertensive agents.

Another reason is age. As you get older, your vessels become a little more stiff, and that tends to raise your systolic pressure and lower your diastolic pressure.

It’s hard to reverse the aging process; but one potential therapy is to find ways to allow your vessels to retain their elasticity — or, if they’ve lost it, maybe ways to gain that back.

The best current treatment is to lower dietary salt intake, which has been shown to be very closely linked with the elasticity of your vessels. The more salt you eat, the less elastic your vessels will be. Most peoples’ salt intake is too high. Salt intake is a highly debated topic in medicine, but most believe that dietary salt intake of greater than 4 grams per day is too high, and less than 1.5 grams per day is too low. This depends on a person’s age and underlying medical problems, but this range is a good rule of thumb. There is some data that the ideal salt intake for healthy people is around 3.6 grams per day, but again this is highly debated. 

UAB’s hypertension group, led by Dr. Suzanne Oparil and Dr. David Calhoun, has detailed much of the basic science showing the effect of salt at a molecular level in the blood vessels. On the inside, your blood vessels are lined with a thin monolayer of endothelial cells. In an experimental setting, adding salt to these cells causes changes almost immediately. They become less reactive — that means they stiffen up — and lose their elasticity, which is what you actually see clinically.

Additionally, the stiffening of the vessels happens very soon after you take on a salt load during eating, which is very interesting.

Beyond changes in medications, what can people do to raise their diastolic pressure if it’s too low?

Lifestyle changes like diet and exercise can have immediate effects. Your inside changes much quicker than the mirror shows you. On the inside, you’re getting much more healthy by eating better, getting exercise, controlling your weight and not smoking.

Everyone thinks, “I’m going to have to do this for six months or a year before I see any changes.” That’s not true. The body is very dynamic. Within a few weeks, you can see the benefits of lifestyle change. In fact, with dietary changes in salt intake, you can see a difference in a day or two.

If someone does have low diastolic pressure, what should they — and their doctors — look for?

If they aren’t on medications that we could adjust, the important thing is close monitoring; maybe seeing a patient more frequently in clinic and monitoring them closely for cardiovascular disease or heart failure symptoms.

Your original study in Hypertension got a lot of attention. What are you working on now?

We’re finalizing some papers that address two big criticisms of that study. The first criticism was that we were looking strictly, as the name suggests, at isolated diastolic hypotension. We didn’t really care at the time what the systolic pressure was doing; but a high systolic pressure is a risk for heart failure, among other things. When we looked at the patients in our study, their systolic blood pressures were all relatively normal, and we adjusted for patients with a history of hypertension.

So we actually went back and redid the analysis, completely excluding people with hypertension. And the results still remained true. In fact, the association was even stronger.

The other criticism involved something called pulse pressure. That’s the difference between your systolic and diastolic blood pressure. And multiple studies have shown that a widened pulse pressure is also a risk factor for cardiovascular disease. Some fellow researchers said, “Really, all you’re looking at is just a wider pulse pressure. This isn’t necessarily novel — that’s been shown before. ”

So we’ve actually looked at pulse pressure differences in all these patients and broken them down by differences in pulse pressure. And even when we adjusted for pulse pressure, the conclusion about the low diastolic pressure still rang true.

We actually looked at three different groups of pulse pressure — normal, wide and really wide. And it was true throughout. Low diastolic blood pressure increased one’s risk for heart failure.

You also have an interest in diastolic heart failure. What is that?

There are two different types of heart failure: one where the pumping function of the heart is abnormal — that is known as systolic heart failure — and one where the relaxation function is abnormal — that is known as diastolic heart failure. We have lots of medicines for, and experience treating, systolic heart failure, which is also called “heart failure with reduced ejection fraction” — everything from beta blockers, ACE inhibitors and ARBs to mineralocorticoid receptor antagonists and statins.

Diastolic heart failure, or “heart failure with preserved ejection fraction,” has no approved pharmacologic therapies to date. It was widely overlooked, to be honest, until about 10-15 years ago, when physicians realized that these poor patients were having terrible heart-failure symptoms but none of the classic objective measures of heart failure. In most cases, you can’t even tell the difference between a person with systolic and diastolic heart failure based on their symptoms. On the inside, however, their heart is pumping just fine; the problem is their heart is stiff — it doesn’t relax as well as it should. That stiffness leads fluid to back up into the lungs and extremities and causes a lot of the symptoms that you have with systolic heart failure, but the pumping function of the heart is normal.

Now that there is an awareness of diastolic heart failure, we’re realizing that it is a very common problem. It looks like there are as many people with diastolic heart failure as with systolic heart failure. As a matter of fact, there may even be more people with diastolic heart failure.

It has become a heavily studied form of heart failure right now. Everyone is clamoring to get a medicine to help these patients, because it turns out to be very prevalent, and a lot of times they have the same morbidity and mortality as people with systolic heart failure.

Make an appointment with a UAB doctor

Hypotension (Low Blood Pressure) | Cardiology

Causes of hypotension

There are several causes of hypotension including:

• Prolonged bed rest
• Pregnancy
• Low or high body temperature
• Excessive blood loss
• Severe dehydration
• Blood infections such as sepsis
• Anaphylaxis allergic reaction
• Reactions to medication or alcohol

Risk factors for hypotension

• Age — your risk of low pressure increases as you age. Approximately 10-20% of people older than 65 have postural hypotension.
• Medications — medications, such as alpha blockers, can lower blood pressure.
• Other serious conditions — if you have diabetes or Parkinson’s disease, you have a higher risk for developing hypotension.

Symptoms of hypotension

Most doctors don’t consider hypotension serious unless it produces noticeable symptoms such as:

• Nausea
• Fainting
• Dehydration
• Blurred vision
• Cold, clammy, pale skin
• Fatigue
• Depression

If you have cold, clammy or pale skin, rapid or shallow breathing, weak or rapid pulse or confusion, you could be suffering from extreme hypotension, which could lead to death. Call 911 immediately if you suspect you are suffering from extreme hypotension.

Diagnosis of hypotension

One abnormally low blood pressure reading without any other symptoms will usually not cause concern. In most cases, your doctor will monitor you over a series of visits to evaluate if the low blood pressure is a consistent pattern. The physician may also order other diagnostic tests to determine the underlying cause of the condition.

Tests that your doctor may order include:

• Blood tests — can help you determine if you have hypoglycemia (low blood sugar), hyperglycemia/diabetes (high blood sugar) or anemia (low red blood count).
• Electrocardiogram (ECG) — can detect the heart’s electrical signals to detect heart rhythm or structural abnormalities, as well as problems with the supply of oxygen-rich blood to the heart.
• Echocardiogram — can show detailed images of the heart to determine structure and function.
• Stress test — during a stress test, you will do some form of exercise to get your heart pumping faster and then you will be monitored with an echocardiogram or electrocardiogram.
• Tilt table test — will determine how your body reacts to changes in position; you will lie on a table that is then tilted to simulate moving from a lying to standing position.

Treatments of hypotension

Low blood pressure that doesn’t show any symptoms does not typically require treatment. For those who do have symptoms, you will be treated based on what the underlying cause of the low blood pressure is.

Home treatments include:

• Increasing water consumption and limiting alcohol consumption — water helps increase blood volume and prevent dehydration.
• Wearing compression socks — wearing compression socks promotes blood flow in the legs.
• Consuming more salt — sodium makes it harder for your body to rid itself of excess fluid and adds strain to the blood vessels resulting in raised blood pressure.
• Exercising regularly — regular exercise promotes blood flow.

If conservative treatments are not successful in increasing your blood pressure, your doctor may need to prescribe medication.

Drugs that treat hypotension include:

• Fludrocortisone — a drug which helps the body retain sodium in the kidney, which helps raise blood pressure.
• Midodrine — a drug that can increase blood pressure by activating receptors on the small arteries and veins.

With blood pressure, how low is too low? – LIFE0102 – recordonline.com

Dear Nurse Patti,

I have heard that high blood pressure spikes are dangerous, but what if your pressure tends to drop suddenly? I often suddenly feel the need to sit down. When I take my pressure, it’s very low. Last time it was 70/40. It gets lower every time I take it, so my question is, how low is too low?

R. from Middletown

Dear R.,

Within limits, the lower your blood pressure reading is, the better. In most people, blood pressure isn’t too low until it causes symptoms such as lightheadedness or fainting. However, 70/40 is a rather low reading, and could definitely cause the need to sit down or feel a little lightheaded.

Unusually low readings should be evaluated to rule out medical causes such as orthostatic hypotension, endocrine disorders, fainting, dehydration, severe infection and shock.

Depending on the reason for your low blood pressure, you may be able to take certain steps to help reduce or even prevent symptoms:

Drink more water to combat dehydration and increase blood volume.

Follow a healthy diet. Eat small, low-carb meals to prevent your blood pressure from dropping sharply after meals. Your doctor may also suggest adding more salt to your diet to increase your blood pressure.

Go slowly. Instead of jumping out of bed in the morning, breathe deeply for a few minutes and then slowly sit up before standing.

Dear Nurse Patti,

I’m concerned about my son’s frequent use of his iPod. I’m aware that there are studies indicating that hearing loss can occur from the loud decibels. I don’t want to seem like a mean, old-fashioned mom, but I am worried. My question, is it safe to use an iPod?

Concerned Mom from Pine Bush

Dear Concerned Mom,

Frequent use of an iPod with the volume on high can definitely cause hearing loss. It’s predicted that teens who listen to frequent loud music now will notice the signs of deafness by the age of 30.

It’s not the frequency of use of an iPod that’s the problem; it’s the volume. Volume controls on iPods can be turned up to 100 decibels, enough to be able to drown out the sound of a pneumatic drill from a five-meter distance.

If you’re standing next to your son and you can hear his music, it’s safe to assume that the noise is too loud, and potentially damaging. And if your son hears a ringing noise in his ears after using his iPod, it was too loud.

As with most things, moderation is the key. But as you well know, that’s a tough concept to sell to a teenager.

Dear Nurse Patti,

Is it true that timing your breast cancer surgery to coincide with your period will provide you with a better outcome?

Alecia from Port Jervis

Dear Alecia,

There is no clear evidence at this time that the optimal timing to have breast cancer surgery for premenopausal women is during one’s period.

Several studies have evaluated whether breast cancer surgery done during a particular phase of the menstrual cycle had an impact on long-term survival. One study published in 1998 suggested a link. However, many subsequent studies have failed to confirm such a relationship between the timing of surgery and menstrual cycle. The issue is still being studied.

Dear Nurse Patti,

I am seriously considering cosmetic surgery. Are there any special tips that you can provide as I search for the right doctor?

Sharyn from Pine Island

Dear Sharyn,

The first thing that you should do is to ask yourself the two following questions: Do I really want this surgery? If so, whom should I have perform it?

If you decide to go ahead with plastic surgery, keep the following in mind:

Make sure the surgeon is board-certified by the American Board of Plastic Surgery. You can do this by asking the physician directly, looking at the diplomas on the wall, or by going to the state’s Web site (www.op.nysed.gov) to check out doctor qualifications and to see if any complaints have been filed against him or her.

Ask where he or she has admitting privileges.

Ask to see samples of your surgeon’s average results for the procedure or surgery that you’re having. The surgeon may show you only the “best result.” You want to see a sample of technique, not just the best.

Nurse Patti of the Hudson Valley has been an RN for 32 years. Send questions to her c/o the Record, 40 Mulberry St., Middletown 10940, or to [email protected].

High blood pressure guidelines and treatments for older adults, elderl…

In some cases, doctors recommend ambulatory blood pressure testing, using a device that automatically takes readings of blood pressure over a 24-hour period. Ambulatory testing can identify people whose pressure doesn’t fall during the night, as it should. This phenomenon, called “non-dipping,” becomes more common as people age and has been shown to increase cardiovascular and stroke risk.

What should my numbers be?

High blood pressure in older people is very different from the condition in middle age.

“When people develop high blood pressure in middle age, the problem is typically elevated diastolic pressure, which is indicated by the lower number,” says Izzo. Ideally, the goal is to bring the numbers down close to a normal reading of 120/80.

Once you hit age 60, though, it’s the upper number — the systolic pressure — that can really climb, causing concern. Systolic hypertension occurs when the arteries close to the heart begin to stiffen, making them less responsive to blood flow.

“In a sense, you have almost two forms of hypertension,” Logan says. “Up until about 10 years ago, doctors only paid attention to diastolic hypertension. Now we know it’s really systolic hypertension that matters in older people.”

Further, many older people develop a condition called wide pulse pressure, in which diastolic pressure drops even as systolic pressure climbs. The widening gap between the upper and lower numbers has been shown to be an independent risk factor for heart disease and stroke.

It also poses a tricky challenge for doctors. Drugs that lower systolic blood pressure typically bring down diastolic blood pressure, too. If that number is already low, medications can prove risky.

Next: Do you really need medication? »

Orthostatic hypotension following spinal cord injury: understanding clinical pathophysiology

Low blood pressure during pregnancy

Published: February 2020

Many women experience low blood pressure, defined as below 90/60, while they’re expecting a baby. This is not usually a problem, doesn’t normally require medication, and will start returning to its previous level during the third trimester. Your doctor will monitor your blood pressure throughout the pregnancy.

Low blood pressure during pregnancy happens because your body secretes hormones, and progesterone in particular, which help to relax the walls of your blood vessels and increase the flow of blood to you and your baby.

Occasionally, low blood pressure may be indicative of some other problem. It may be the result of an ectopic pregnancy, in which a fertilised egg becomes implanted outside your uterus. And if it’s very low, it may cause falls, or shock, in which your brain and other vital organs don’t get enough blood to work properly.

Low blood pressure has a variety of symptoms. If you experience any of these, you should mention them to your doctor.

• Dizziness
• Nausea
• Weakness
• Fatigue and sleepiness
• Fainting
• Rapid heartbeat
• Confusion and inability to concentrate
• Blurry vision
• Pale, clammy skin

Can low blood pressure harm your baby?

We know a lot less about the effects of low blood pressure on babies than the effects of high pressure. Some research suggests that it may lead to stillbirth and low birth weight, but this correlation is difficult to establish because there are so many other variables and risk factors involved during pregnancy. In the vast majority of cases, low blood pressure at this time is nothing to worry about.

Is there anything you can do to deal with low blood pressure when you’re pregnant?

Although medication is not normally needed when this happens, there are some simple changes you can make that may reduce the likelihood of its happening.

Take it easy. Try to slow down, avoid making sudden movements, and don’t stand up too quickly. If you do feel faint or dizzy, lie down on your left side, which may help to increase the blood flow to your heart.

Drink lots of water. As well as preventing dehydration, this increases your blood volume, and thus your blood pressure.

Eat a healthy diet. Your doctor may also recommend that you increase your salt intake, though it’s important not to overdo this.

References:

www.bounty.com/pregnancy-and-birth/pregnancy/pregnancy-other-conditions/low-blood-pressure-in-pregnancy

www.healthline.com/health/pregnancy/low-blood-pressure-during-pregnancy#risks

www.medicalnewstoday.com/articles/320303.php

High Blood Pressure – HealthyWomen

Overview

What Is It?

Blood pressure is the amount of force your blood exerts against the walls of your arteries. High blood pressure, or hypertension, occurs when your blood pressure is elevated over time. Left untreated, it can damage your small blood vessels and organs and lead to heart attacks, stroke, kidney failure and circulatory problems.

Blood pressure is the amount of force your blood exerts against the walls of your arteries. Normal blood pressure effectively and harmlessly pushes the blood from your heart to your body’s organs and muscles so they can receive the oxygen and nutrients they need.

Blood pressure is variable—it rises and falls during the day. When blood pressure stays elevated over time, however, it is called high blood pressure or hypertension.

According to the American Heart Association, about 85.7 million Americans have high blood pressure. High blood pressure was a primary or contributing cause of death for 410,000 Americans in 2014, according to the U.S. Centers for Disease Control and Prevention.

Hypertension can occur in both children and adults, but it is more common in adults, particularly African Americans and the elderly. People with other conditions such as diabetes and kidney disease are likely to become hypertensive. In addition, being overweight, drinking alcohol excessively (defined as more than two drinks a day for men and one drink a day for women) and taking oral contraceptives may increase blood pressure.

About half of Americans with high blood pressure are women. More men than women have hypertension, until women reach menopause, when their risk becomes greater than men’s. About 30 percent of women have high blood pressure. ‘

Blood pressure is typically expressed as two numbers, one over the other, and is measured in millimeters of mercury (noted as mm Hg). The first number is the systolic blood pressure, the pressure used when the heart beats. The second number, diastolic blood pressure, is the pressure that exists in the arteries between heartbeats.

Depending on your activities, your blood pressure may increase or decrease throughout the day. If you are not acutely ill, are over 18 years of age and are not taking antihypertensive drugs, a blood pressure reading of less than 120 mm Hg systolic and less than 80 mm Hg diastolic (<120/80) is considered normal.

If your systolic blood pressure is 120 to 129 mm Hg systolic and your diastolic pressure is less than 80 mm Hg, you have elevated blood pressure.

A blood pressure level of 130 to 139 mm Hg systolic or 80 to 89 mm Hg diastolic is considered stage 1 hypertension (high blood pressure). Levels of 140 mm Hg or greater systolic or 90 mm Hg or greater diastolic are classified as stage 2 hypertension. If you have systolic and diastolic readings that fall in two categories, you will be designated with the higher blood pressure category.

These new classifications, released by the American College of Cardiology and the American Heart Association in 2017, reflect growing evidence that the risk of cardiovascular disease progressively increases from normal blood pressure to elevated to stage 1 and 2 hypertension. The new guidelines also include specific instructions for getting accurate blood pressure readings, which involves using proper measuring devices, taking several readings in the health care provider’s office and confirming the readings with out-of-office measurements.

If you have cardiovascular disease, including coronary heart disease, congestive heart failure or stroke, your health care provider may recommend treating your blood pressure with medication and lifestyle modifications even if you are not diagnosed with hypertension.

The cause of approximately 90 percent to 95 percent of all hypertension isn’t known. This type of hypertension is called primary or essential high blood pressure. Secondary hypertension is somewhat different because it represents all of the specific diseases that cause elevated blood pressure. It is important to diagnose this type of hypertension because the treatment differs from primary hypertension. While there is no cure for primary hypertension, it is easily detected and is usually controllable.

Still, many people who suffer from high blood pressure don’t know they have it, and people can have high blood pressure for years without knowing they have it. That’s why high blood pressure has been called “the silent killer.”

Of those with hypertension, only about half have the problem under control, defined as a level below 130/80 mm Hg. Left untreated, hypertension can result in permanent damage to the small blood vessels of the body, which can damage organs such as the heart, brain and kidneys, leading to heart attacks, stroke and kidney failure. It can also cause acute or chronic circulatory problems.

Elevated blood pressure levels significantly increase your risk for coronary heart disease, including heart attack and stroke. Consistent high blood pressure also increases your risk for congestive heart failure and can lead to other problems such as:

• Atherosclerosis: Plaque collects on the walls of hypertension-damaged blood vessels, which can eventually lead to blockages that may result in a stroke or heart attack. Although this plaque builds up for many reasons as you age, high blood pressure hastens the process.
• Eye damage: High pressure in blood vessels can cause tiny hemorrhages in the retina, the light-sensitive membrane in the back of your eye on which images are formed. If this happens, you may lose some of your vision.
• Heart enlargement or failure: There are two types of heart failure. In the first, the walls of the heart are weak and thin as a result of being stretched by increasing amounts of pooling blood in the heart. In the second, commonly seen in people with hypertension, the heart muscle enlarges in response to the higher pressure and increased workload. It becomes so big it begins to close off the ventricular chamber, decreasing the amount of blood that can fill the heart. This is called diastolic dysfunction, because the heart muscle can’t relax normally and allow blood to fill the chamber.
• Kidney damage and failure: Hypertension causes arteries going to your kidneys to become constricted, making them less efficient at filtering waste from your body. According to the National Kidney Foundation, high blood pressure caused more than 33,000 new cases of kidney failure in the United States in 2013. African Americans are particularly at risk. Early treatment of hypertension can help prevent kidney damage.

You should have your blood pressure checked whenever you see a health care professional. Because blood pressure can be variable, it should be checked on several days before a high blood pressure diagnosis is made. One elevated blood pressure reading doesn’t necessarily mean you have high blood pressure, but it does warrant repeated measurements and means you have to watch your blood pressure carefully.

Dietary and lifestyle changes may help you control high blood pressure. If you have mild hypertension, you may be able to lower your blood pressure by reducing the amount of sodium (salt) in your diet, reducing fat intake, eating a diet high in fruits, vegetables and low-fat dairy (such as the DASH diet) and reducing alcohol consumption. If you are overweight, losing weight may reduce your blood pressure. Increasing your physical activity, even if you don’t lose weight, can also reduce blood pressure.

For some people, lifestyle changes aren’t enough to lower blood pressure. Luckily, high blood pressure can be successfully treated with long-term medication.

Commonly prescribed drugs include diuretics, beta blockers, angiotensin-converting enzyme inhibitors (ACE inhibitors), angiotensin II receptor blockers (ARBs), direct renin inhibitors (DRIs), calcium channel blockers (CCBs), vasodilators, alpha-beta blockers, central-acting agents and alpha blockers. Because there is no cure for most hypertension cases, treatment generally must be carried out for life to prevent blood pressure from rising again.

Many of these drugs are also available to treat ISH to reduce your risk of coronary heart disease and stroke.

Causes of Hypertension

The 90 percent to 95 percent of hypertension cases in which the cause can’t be determined are called essential or primary hypertension cases. Hypertension may also be a symptom of an identified problem (see below) that generally corrects itself when the cause is corrected. This type of high blood pressure is called secondary hypertension.

Possible causes of secondary hypertension include:

• Renal artery stenosis (narrowing of the arteries leading to your kidneys)
• Adrenal gland disease (Cushing’s disease) or adrenal tumors
• Kidney disease
• Preeclampsia (hypertension and increased urine protein levels sometimes caused by pregnancy)
• Thyroid disease

Other factors affecting blood pressure include:

• Use of birth control pills
• Psychologic stress
• Severe pain
• Drug or alcohol withdrawal
• Use of amphetamines, cocaine or other stimulants
• Use of steroids
• Overuse of nicotine nasal sprays, gum, patches and lozenges designed to help smokers kick the habit
• Sleep apnea

Your health care professional should monitor your blood pressure if you are taking oral contraceptives. Your blood pressure should also be carefully monitored if you’re pregnant, because some women develop preeclampsia-related hypertension during pregnancy. One of the leading causes of maternal death, preeclampsia is hypertension combined with protein in the urine and/or swollen hands and feet. It typically occurs after the 20th week of pregnancy. It can lead to premature and low-birth–weight babies.

Diagnosis

Your health care professional should check your blood pressure at least once every two years, and more often if it’s high. A high blood pressure diagnosis is usually based on at least the average of two or more readings per visit, taken at two different visits after an initial screening.

The only way to properly check your blood pressure is to measure it with a device called a sphygmomanometer, commonly called a blood pressure cuff. This is a quick and painless test in which a rubber cuff is wrapped around your upper arm and inflated. As the cuff inflates, it compresses a large artery, stopping the blood’s flow through that artery. When your health care professional releases the air in the cuff, he or she can listen with a stethoscope for the blood to start flowing through your artery again. Your health care professional can watch the sphygmomanometer gauge to determine systolic pressure—the pressure when the first sound of pulsing blood is heard—and the diastolic pressure, the pressure when the last sound of pulsing blood is heard.

In November 2017, the American College of Cardiology and the American Heart Association issued new guidelines for classification of high blood pressure—or hypertension. A normal reading, for people not at high risk, is less than 120 mm Hg systolic and less than 80 mm Hg diastolic (<120/80).

If your systolic blood pressure is 120 to 129 mm Hg systolic and your diastolic pressure is less than 80 mm Hg, you have elevated blood pressure.

A blood pressure level of 130 to 139 mm Hg systolic or 80 to 89 mm Hg diastolic is considered stage 1 hypertension, and readings of 140 mm Hg or greater systolic or 90 mm Hg or greater diastolic are stage 2 hypertension. When systolic and diastolic pressures fall into different categories, your health care professional should select the higher category to classify your blood pressure.

These new classifications reflect growing evidence that the risk of cardiovascular disease progressively increases from normal blood pressure to elevated to stage 1 and 2 hypertension.

If you have cardiovascular disease, including coronary heart disease, congestive heart failure or stroke, your health care provider may recommend treating your blood pressure with medication and lifestyle modifications even if you are not diagnosed with hypertension.

If you are hypertensive and have begun receiving initial medication therapy, you will probably need to return for follow-up and adjustment of medications once a month until your blood pressure goal is reached. More frequent visits may be necessary for those with stage 2 hypertension.

A small number of people experience “white coat hypertension,” which is very elevated blood pressure when visiting their health care professional while blood pressure at home is normal. At home, you can check your blood pressure in a setting that’s more comfortable for you to get a more accurate reading.

Home blood pressure monitoring also gives you the opportunity to measure your own blood pressure when your health care professional’s office is not open. Inexpensive devices for home blood pressure monitoring are available at most pharmacies. Be sure to have your health care professional check your home blood pressure device when you start using it to make sure it’s providing accurate readings.

Also, don’t make any changes in your medication based on home blood pressure readings without first consulting your health care professional. Home blood pressure monitoring is an excellent adjunct to monitoring by your health care professional, but should it not be done in lieu of professional monitoring.

In addition to taking blood pressure readings from both arms, your health care professional may conduct the following during a hypertension exam:

• A complete medical history. Make sure you tell your doctor about any alternative medicines you’re taking such as herbs, over-the-counter drugs and supplements. The American Heart Association notes that some may be life-threatening when combined with medicines to treat high blood pressure.
• A physical examination. This includes checking your retinas and abdomen, listening to your lungs and heart, taking your pulse in several areas, including your feet, and looking for swelling in your ankles.
• A urinalysis. The urine is tested for elevated protein, sugar, white blood cells or other abnormalities.
• An electrocardiogram. Your health care professional will position a number of small contacts on your arms, legs and chest to connect them to an ECG machine. The results will be analyzed for any abnormalities indicating an enlarged heart or other abnormality.
• A kidney profile. The blood is tested for abnormalities such as elevated creatinine.
• A thyroid profile. The blood is tested for abnormalities such as an elevated level of thyroid hormone, and the thyroid gland is physically felt for enlargement.

Risk Factors for Hypertension

Although there are several risk factors for hypertension, family history is the primary one. High blood pressure tends to run in families.

African Americans and Hispanic Americans are more likely to develop high blood pressure than Caucasians. Studies find that having “Type A” qualities—being very driven, being a perfectionist who doesn’t cope well with stress or know how to relax and having a quick temper—increases the risk of hypertension in men and may increase the risk for women.

Other risk factors for hypertension include:

• Increasing age
• Salt sensitivity
• Obesity
• Heavy alcohol consumption, defined as more than two drinks a day for men and more than one drink a day for women.
• Use of oral contraceptives
• An inactive lifestyle
• Regular smoking or use of smokeless-tobacco, like snuff or chewing tobacco
• High uric acid levels (anything over 7 mg/ml of blood)

Unfortunately, there is no proven method of preventing preeclampsia or pregnancy-induced hypertension and no tests to diagnose or predict these conditions. The only way to ensure a safe pregnancy is with regular visits to your health care professional for checks of the level of protein in your urine and your blood pressure.

You also should do everything you can on your own to prevent pregnancy-induced high blood pressure, including regular physical activity and limiting salt intake.

Treatment

There are several drug classes to choose from when selecting a high blood pressure medication, including hundreds of single medications and combinations. Generally, all can lower your blood pressure, but often people respond differently to each drug.

You will probably have to try a few of them before finding the one that works the best for you with the fewest side effects.

The drug classes are:

• Diuretics. Diuretics, which rid the body of excess fluids and salt, are the most frequently used drugs to treat high blood pressure. However, in large doses, some diuretics may deplete the body of potassium, which can lead to irregular heartbeat and reduce your glucose tolerance, which can cause diabetes. There are, however, potassium-sparing diuretics that don’t cause this problem.

  Overall, diuretics are inexpensive and, in small doses, boost the effectiveness of many other antihypertensive drugs. National guidelines recommend that diuretics alone should be the first agent of choice provided you don’t have any other conditions that prohibit their use. Some commonly prescribed drugs in this class include amiloride (Midamar), bumetanide (Bumex), chlorthalidone (Hygroton), chlorothiazide (Diuril), furosemide (Lasix), hydrochlorothiazide (Microzide, Esidrix, Hydrodiuril), metolazone (Mykrox, Zaroxolyn) and indapamide (Lozol).

• Beta-blockers. These drugs reduce your heart rate and blood pressure and therefore your heart’s output of blood. You should not be on one of these drugs if you already have a low heart rate, an airway disease such as asthma or peripheral vascular disease.

  Beta blockers can also mask hypoglycemia, or low blood sugar, so you should use with caution if you have diabetes and take insulin or sulfonylurea drugs.

  Common side effects include fatigue, breathlessness, depression and cold hands and feet. Other, milder side effects can include sleep problems and numbness or tingling of the toes, fingers or scalp. On the plus side, beta blockers can reduce your risk for second heart attack, irregular heartbeat, angina and migraines. Some commonly prescribed drugs in this class include atenolol (Tenormin), betaxolol (Kerlone), bisoprolol (Zebeta), carteolol (Cartrol), acebutolol (Sectral), metoprolol (Lopressor, Toprol-XL), nadolol (Corgard), propranolol (Inderal), sotolol (Betapace) and timolol (Blocadren).

• Angiotensin-converting enzyme inhibitors (ACE inhibitors). These drugs interfere with the body’s production of angiotensin II, a hormone that causes the arteries to constrict. The drugs enable muscles in your arteries to relax so they can open wider.

  The most common side effect is a dry, persistent cough. An added benefit of ACE inhibitors is that they slow the rate at which your kidneys deteriorate if you have diabetes-related kidney disease. For people with high blood pressure and diabetes or kidney disease, national guidelines recommend that initial drug treatments include ACE inhibitors. However, you should not be on ACE inhibitors if you are pregnant because they can cause life-threatening complications in the baby. Some commonly prescribed drugs in this class include captopril (Capoten), enalapril (Vasotec), lisinopril (Prinivel, Zestril), benazepril (Lotensin), fosinopril (Monopril), moexipril (Univasc), perindopril (Aceon), ramipril (Altace) and trandolapril (Mavik).

• Angiotensin II receptor blockers. Angiotensin II receptor blockers work similarly to ACE inhibitors to block the hormone angiotensin II, which normally causes blood vessels to narrow. As a result, the blood vessels relax and become wider, causing blood pressure to go down. They’re more effective if you also take a diuretic. These drugs do not cause any cough like ACE inhibitors. Some commonly prescribed drugs in this class are candesartan (Atacand), eprosartan (Teveten), irbesarten (Avapro), losartan (Cozaar), telmisartan (Micardis) and valsartan (Diovan).
• Calcium channel blockers (calcium antagonists). Calcium channel blockers relax artery muscles and dilate coronary arteries and other arteries by blocking the transport of calcium into these structures, thus lowering blood pressure. There are two classes of calcium blockers—the dihydropyridines and the non-dihydropyridines—which may be used to treat high blood pressure and angina. One dihydropyridine, fast-acting nifedipine (Adalat, Procardia and others), may increase your risk of heart attack when used for acute hypertension; therefore, nifedipine should only be used in the treatment of chronic high blood pressure. It is unclear whether other calcium channel blockers share this risk, so discuss this and other potential risks with your health care professional if you receive a prescription for a calcium channel blocker. Dihydropyridines also may cause ankle swelling, rapid heartbeat and headaches and may make you flush.
• Alpha-blockers. These drugs work by relaxing certain muscles to help small vessels remain open. Alpha blockers work by stopping the hormone norepinephrine from constricting small arteries and veins, which improves blood flow and lowers blood pressure. Alpha blockers may increase your heart rate and can cause you to retain fluid, so they may be combined with diuretics or beta blockers. Other side effects include a drastic drop in blood pressure when you stand up—often seen after only one dose—and headache. However, some studies suggest alpha blockers have added benefits if you have high blood cholesterol levels or glucose intolerance. Some commonly prescribed drugs in this class include doxazosin (Cardura), prazosin (Minipress) and terazosin (Hytrin).
• Alpha-beta blockers. Alpha-beta blockers reduce nerve impulses to blood vessels, thus decreasing vessel constriction, and they slow the heartbeat to reduce the amount of blood that must be pumped through the vessels. They are typically used as an IV drip for patients in hypertensive crisis. They may be prescribed for outpatient high blood pressure treatment if a patient is at risk for heart failure. Alpha-beta blockers include caredilol (Coreg) and labetolol hydrochloride (Normodyne). Potential side effects of alpha-beta blockers include fatigue, decreased sex drive, anxiety and insomnia. More serious side effects include difficulty breathing, depression, feeling faint and swelling of the lips, tongue, throat or face.
• Vasodilators. Vasodilators work to relax the muscles in the walls of the blood vessels, which helps the vessels widen. Some commonly prescribed vasodilators include hydralazine hydrochloride (Apresoline) and minoxidil (Loniten). More serious potential side effects of vasodilators include difficulty breathing; swelling in your face, throat, lips, tongue, feet or hands; and joint pain. Less serious side effects include nausea, vomiting, diarrhea, headache and anxiety.
• Central-acting agents (or central agonists). These medications work by preventing your brain from telling your nervous system to increase your heart rate and narrow blood vessels. Some commonly prescribed drugs in this class include alpha methyldopa (Aldomet), clonidine hydrochloride (Catapres), guanabenz acetate (Wytensin) and guanfacine hydrochloride (Tenex). Potential side effects of central agonists include dizziness, dry mouth, nausea, vomiting and sleep problems. More serious side effects include allergic reaction, fast, pounding heart rate and confusion.

Prevention

Because we don’t know the cause of most cases of high blood pressure, it’s hard to say how to prevent it. However, diet and lifestyle changes can be key. You should consider these tips:

• Increase the amount of exercise you get. Regular aerobic physical activity can enhance weight loss and reduce the risk for cardiovascular disease. You can reduce your blood pressure with moderately intense physical activity, such as a 30- to 60-minute brisk walk most days. If you have cardiac or other serious health issues, you should have a thorough medical evaluation, and perhaps have a cardiac stress test, before beginning any exercise program.
• Lose weight. Losing just 10 pounds can help lower your blood pressure. Some obese people also have sleep apnea, in which they stop breathing dozens or hundreds of time a night, snore loudly and suffer from daytime sleepiness. Sleep apnea is linked with high blood pressure.
• Reduce alcohol consumption. Most men with high blood pressure shouldn’t drink more than two drinks per day, and women shouldn’t have more than one alcoholic drink per day. A drink is equal to 12 ounces of beer, five ounces of wine or one and a half ounces of 80-proof liquor.
• Reduce stress. When you relax, your heart rate slows, which reduces the amount of oxygen your body needs, reducing your pressure.
• Quit smoking. Even more than lowering your blood pressure per se, it will reduce your overall cardiovascular disease risk more than any other single move.
• Reduce your sodium intake. Salt can cause fluid retention so don’t add salt to foods. For optimum heart health, the American Heart Association recommends a limit of 1,500 mg of sodium per day. Because the average sodium intake is so excessive, even cutting back to 2,400 mg (the amount contained in about one teaspoon of salt) or less will help improve blood pressure and overall heart health.

  To cut down on sodium, steer clear of processed foods (sauces, mixes and “instant” products such as flavored rice, cereals and pasta). Get in the habit of checking labels for sodium content. If one portion has more than 300 mg, choose a lower-salt brand. Eat more vegetables that are fresh, frozen without sauce or canned with no salt. Salt substitutes may work for you, but check with your health care professional because they can be harmful if you have certain medical problems.

• Increase dietary potassium. An analysis of several studies indicates that potassium can reduce blood pressure by combatting the effects of sodium. Bananas are naturally high in potassium, and the mineral can also be purchased in supplement form. According to the American Heart Association, the average adult should aim for 4,700 mg of potassium a day. Increasing potassium intake is not recommend for patients with kidney disease, however. Ask you health care professional before increasing your potassium intake.
• Eat a healthy diet. Aim for a diet rich in fruits, vegetables and low-fat dairy products, and low in saturated and total fat.

You can make all of your lifestyle changes at the same time. Studies find the best results come from adopting the DASH diet, which is rich in fruits, vegetables and low-fat dairy products.

Fish oil (omega-3 polyunsaturated fatty acids) and calcium supplements lower blood pressure only slightly in those with hypertension. Additionally, herbal and botanical supplements, which get very little scrutiny from the FDA, have not been proven to safely lower blood pressure and may, in fact, dangerously interact with some medications.

Finally, if you have high blood pressure, be sure to inform your health care professional about all medicines you are taking, including over-the-counter drugs. It is particularly important that you mention drugs such as steroids; nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen; nasal decongestants and other cold remedies; appetite suppressants; cyclosporine; erythropoietin; antidepressants; and monoamine oxidase (MAO) inhibitors.

You should take care when choosing over-the-counter drugs for colds. Many cold remedies contain decongestants that may raise your blood pressure. These medicines can also interfere with your blood pressure drug’s effectiveness. Check with your health care professional before taking any over-the-counter drug if you have high blood pressure.

You should take care when choosing over-the-counter drugs for colds. Many cold remedies contain decongestants that may raise your blood pressure. These medicines can also interfere with your blood pressure drug’s effectiveness. Check with your health care professional before taking any over-the-counter drug if you have high blood pressure.

Facts to Know

1. About 85.7 million Americans have high blood pressure. It is a contributing factor in an estimated 410,000 deaths per year.
2. More men than women have hypertension until women reach menopause, when a woman’s risk becomes greater than a man’s.
3. About half of the 80 million Americans with high blood pressure are women, with the incidence becoming greater in women as they get older. About 30 percent of women have high blood pressure, and the risk is higher in older women and African American women.
4. Your blood pressure consists of two numbers—the systolic pressure and the diastolic pressure. The higher number, the systolic pressure, represents the pressure while the heart is beating. The lower number, the diastolic pressure, represents the pressure when the heart is resting between beats.
5. Blood pressure can fluctuate with eating, sleeping and changes in posture, but a normal blood pressure reading should be less than 120 mm Hg systolic and less than 80 mm Hg diastolic. Blood pressure between 120–129 mm HG systolic and less than 80 mm HG diastolic is considered elevated. A level of 130 to 139 mm Hg systolic or 80 to 89 mm Hg diastolic is considered stage 1 hypertension (high blood pressure). Levels of 140 mm Hg or greater systolic or 90 mm Hg or greater diastolic are classified as stage 2 hypertension. If you have systolic and diastolic readings that fall in two categories, you will be designated with the higher blood pressure category.
6. If you have elevated blood pressure, you are more likely to develop hypertension in the future and have increased risk factors for cardiovascular disease and other conditions related to hypertension. Your risk for cardiovascular diseases progresses steadily as your blood pressure rises above the normal range.
7. You may also have hypertension if either your systolic or your diastolic pressure is greater than or equal to 130 or 80 mm Hg, respectively. That is, you can have isolated systolic or diastolic hypertension. Isolated systolic hypertension is the most common form of high blood pressure in older Americans. An estimated two out of three people with hypertension over age 60 have ISH.
8. Dietary and lifestyle changes may help you control high blood pressure. If you have mild hypertension, you may be able to lower your blood pressure by reducing the amount of sodium in your diet and cutting back on alcohol consumption. If you are overweight, losing weight will help, as will physical activity.
9. Many people think high blood pressure is the result of lifestyle factors, such as stress, lack of exercise, drinking or smoking, but the cause of approximately 90 percent to 95 percent of all hypertension cases can’t be determined.
10. There is no cure for hypertension, but it is easily detected and usually controllable.
11. Many people who suffer from high blood pressure don’t know they have it because it usually produces no symptoms. And of those who have hypertension, less than half have the problem under control, defined as a level below 130/80 mm Hg.
12. If left uncontrolled, high blood pressure can have very serious consequences. The condition can lead to stroke, heart attack, hardening of the arteries, congestive heart failure and/or kidney disease. In severe cases, it can lead to blindness.
13. There are several drug classes—and hundreds of individual and combination medications—to choose from when treating high blood pressure. Generally, all can lower your blood pressure, but people often respond very differently to each drug, so you will probably have to try a few of them before finding the one that works best for you.
14. Taking birth control pills has been linked with high blood pressure in women. The combination of birth control pills and smoking may be particularly dangerous. Ask your health care professional to take your blood pressure before you start taking the pill and have it checked every six months or so after you start taking it.
15. If you already have high blood pressure and you get pregnant, your pregnancy could make the condition more severe, especially in the last three months. If it goes untreated, high blood pressure in pregnancy can be dangerous to both mother and baby. Therefore, health care professionals usually closely monitor blood pressure during pregnancy.

Questions to Ask

Review the following Questions to Ask about high blood pressure so you’re prepared to discuss this important health issue with your health care professional.

1. What does my blood pressure reading mean? Why are there two numbers and what do they measure?
2. Do I have hypertension (high blood pressure)? Am I at risk for developing it? Why?
3. Am I taking any medicines that could increase my blood pressure? Should I stop taking them?
4. What are the possible consequences of hypertension? How can I limit my risk for hypertension and its complications?
5. What medications are available to help me if I have hypertension? What are their benefits and side effects? Will these drugs interact with any other medications I am taking?
6. What if I don’t like or can’t tolerate the side effects of my medication? Is it possible for me to switch to another one?
7. My blood pressure is high, but I don’t feel uncomfortable at all. Why not? Does this mean that my hypertension is not really harmful to me?
8. I would never know I had hypertension except for the blood pressure readings. Should I keep taking my medication? Why?
9. My blood pressure is only slightly above normal. Do I really have to do anything about it?
10. Is there a cure for hypertension?
11. How often should I have my blood pressure checked?
12. Is it possible for me to lower my blood pressure by losing weight and living a healthy lifestyle? Is it possible for me eventually to lower it enough to stop taking medication?

Key Q&A

1. What exactly is hypertension?
   Hypertension is also called high blood pressure. Blood pressure is the pressure inside your arteries that harmlessly pushes the blood to your body’s organs and muscles so they can receive the oxygen and nutrients they need. Blood pressure is variable—it rises and falls during the day. When blood pressure stays elevated over time, it is called high blood pressure or hypertension. A blood pressure reading at or above 130 systolic or 80 diastolic (presented 130/80 mm Hg) is considered hypertensive.
2. What causes hypertension?
   No one knows for sure, although a number of factors are thought to contribute to it, such as family history. If you have two immediate family members who developed high blood pressure before age 60, you have two times the risk, and your risk goes up even further with each additional immediate family member with high blood pressure you have. Other risk factors include increasing age, salt sensitivity, obesity, heavy alcohol consumption, use of oral contraceptives, an inactive lifestyle, regular smoking or use of smokeless-tobacco (like snuff or chewing tobacco) and high uric acid levels.
3. Are there different types of hypertension?
   Yes, there are two types of hypertension: Primary hypertension and secondary hypertension. Primary hypertension, the most common type, is also called essential hypertension. There is no known cause. About 5 percent to 10 percent of people with high blood pressure have it as a result of another condition or problem, such as such as kidney disease, or the use of certain medications, such as birth control pills. This is secondary hypertension.
4. Can hypertension lead to other serious medical problems?
   Yes. All stages of hypertension are associated with risk of cardiovascular disease. Even slightly elevated blood pressure levels can double your risk for coronary heart disease. Consistent high blood pressure also increases your risk for congestive heart failure and can lead to other problems such as atherosclerosis, eye damage, heart enlargement or failure and kidney damage and failure.
5. Who develops high blood pressure?
   African Americans and Hispanic Americans are more likely to develop high blood pressure than Caucasians. More men than women have hypertension until women reach menopause, when a woman’s risk surpasses a man’s.
6. How often should I have my blood pressure checked?
   You should have your blood pressure checked whenever you see a health care professional&mdash;but every two years at the least.
7. What can I do to prevent hypertension?
   Diet and lifestyle changes are key. You should increase your exercise, maintain a healthy weight and reduce alcohol consumption. Most men shouldn’t drink more than two drinks per day and women shouldn’t drink more than one drink per day. (One drink is defined as 12 ounces of beer, five ounces of wine or an ounce and a half of 80-proof liquor). You should also reduce your stress levels and lower your sodium intake, as well as follow a diet rich in fruits, vegetables and low-fat dairy products, and low in saturated and total fat.
8. How is hypertension treated?Your health care professional has several drug classes from which to choose when selecting a hypertension drug for you. Generally, all can lower your blood pressure, but often people respond very differently to each drug. You will probably have to try out a few of them before finding the one that works the best for you, with the least amount of side effects.

Organizations and Support

For information and support on coping with Heart Disease, please see the recommended organizations, books and Spanish-language resources listed below.

American College of Cardiology (ACC)
Website: https://www.acc.org
Address: Heart House
2400 N Street, NW
Washington, DC 20037
Hotline: 1-800-253-4636
Phone: 202-375-6000
Email: [email protected]

American Heart Association (AHA)
Website: http://www.americanheart.org
Address: 7272 Greenville Avenue
Dallas, TX 75231
Hotline: 1-800-AHA-USA-1 (1-800-242-8721)
Email: [email protected]

Medivizor
Website: https://medivizor.com

National Heart, Lung, and Blood Institute (NHLBI) – NHLBI Health Information Center
Website: http://www.nhlbi.nih.gov
Address: Attention: Website
P.O. Box 30105
Bethesda, MD 20824
Phone: 301-592-8573
Email: [email protected]

Pulmonary Hypertension Association
Website: http://www.phassociation.org
Address: 801 Roeder Road, Suite 400
Silver Spring, MD 20910
Hotline: 1-800-748-7274
Phone: 301-565-3004
Email: [email protected]

Sister to Sister: The Women’s Heart Health Foundation
Website: http://www.sistertosister.org
Address: 4701 Willard Avenue, Suite 223
Chevy Chase, MD 20815
Hotline: 1-888-718-8033
Phone: 301-718-8033
Email: [email protected]

WomenHeart: National Coalition for Women with Heart Disease
Website: http://www. womenheart.org
Address: 818 18th Street, NW, Suite 930
Washington, DC 20006
Hotline: 1-877-771-0030
Phone: 202-728-7199
Email: [email protected]

Women’s Health Initiative (WHI)
Website: https://www.whi.org/
Address: Clinical Coordinating Center
Fred Hutchinson Cancer Research Center
1100 Fairview Ave N, M3-A410
PO Box 19024
Seattle, WA 98109-1024
Phone: 800-218-8415
Email: [email protected]

Women’s Heart Foundation
Website: http://www.womensheart.org
Address: P.O. Box 7827
West Trenton, NJ 08628
Phone: 609-771-9600

Books

Good News About High Blood Pressure: Everything You Need to Take Control of Hypertension…and Your Life
by Thomas Pickering

Healing Hypertension: Uncovering the Secret Power of Your Hidden Emotions
by Alan Rees

Heart of the Matter: The African American’s Guide to Heart Disease, Heart Treatment, and Heart Wellness
by Hilton M. Hudson, Herbert Stern PhD

High Blood Pressure: Practical, Medical, & Spiritual Guidelines for Daily Living With Hypertension
by Mark Jenkins

High Blood Pressure: The Black Man and Woman’s Guide to Living with Hypertension
by Hilton M. Hudson II MD FACS, James R. Reed

Mayo Clinic on High Blood Pressure
by Sheldon Sheps M.D.

Spanish-language resources

MedlinePlus: Hypertension
Website: http://www.nlm.nih.gov/medlineplus/spanish/ency/article/000468.htm
Address: Customer Service
8600 Rockville Pike
Bethesda, MD 20894
Email: [email protected]

90,000 What is the danger of low blood pressure, doctors explained

Low pressure is as dangerous as high pressure. The brain suffers the most.

The doctors explained that low blood pressure is no less dangerous than high blood pressure. The brain suffers the most.

Oxygen starvation may occur. It will lead to unpleasant side effects. In some cases, this can lead to a stroke.

When blood pressure is below 100 to 70, doctors diagnose “arterial hypotension”.The disease can be divided into several grades:

• pressure 100 to 70
• pressure 90 to 60
• pressure below 70 at 60

The first degree does not bode well. But patients are advised to be regularly examined and give up bad habits.

The second and third degrees can result in not very pleasant consequences. This is the development of various complications, for example, cerebrovascular accident.

Low blood pressure may seem desirable and may not cause any problems for some people.However, for many people, abnormally low blood pressure (hypotension) can cause dizziness and fainting. In severe cases, low blood pressure can be life-threatening.

Blood pressure readings below 90 millimeters of mercury for the upper number (systolic) or 60 mm Hg. Art. for the lower number (diastolic) is usually considered low blood pressure.

The causes of low blood pressure can range from dehydration to serious medical or surgical problems.It is important to find out what is causing your low blood pressure so that it can be treated.

Symptoms

For some people, low blood pressure signals a hidden problem, especially when it drops suddenly or is accompanied by signs and symptoms such as:

• Dizziness or dizziness
• Fainting
• Blurred vision
• Nausea
• Fatigue
• Lack of concentration

Shock

Extreme hypotension can lead to a life-threatening condition.Signs and symptoms include ::

• Confusion, especially in the elderly
• Cold, clammy, pale skin
• Rapid, shallow breathing
• Weak and fast pulse

When to see a doctor

Seek emergency medical attention if you have signs of shock.

If you have persistent low blood pressure but are feeling well, your doctor will likely just check you during your appointments.

Even occasional dizziness can be a relatively minor problem – the result of mild dehydration from too much time in the sun or in the hot tub, for example. However, it is important to see your doctor if you have signs or symptoms of hypotension because they may indicate more serious problems.

Reasons

Blood pressure is a measurement of the pressure in your arteries during the active and resting phases of your heartbeat.

• Systolic pressure. The top number in your blood pressure reading is the amount of pressure your heart creates as it pumps blood through your arteries to the rest of your body.
• Diastolic pressure. The bottom number in your blood pressure reading refers to the amount of pressure in your arteries when your heart is at rest between beats.

Current guidelines define normal blood pressure as lower than 120/80 mm Hg.Art.

Blood pressure changes throughout the day depending on body position, breathing rate, stress level, physical condition, medications taken, what you eat and drink, and the time of day. Blood pressure is usually at its lowest at night. It rises sharply upon awakening.

Conditions that can cause low blood pressure

Medical conditions that can cause low blood pressure include:

• Pregnancy.Since the circulatory system expands rapidly during pregnancy, blood pressure is likely to drop. This is normal and blood pressure usually returns to your pre-pregnancy level after childbirth.
• Heart disease. Some heart conditions that can lead to low blood pressure include extremely low heart rate (bradycardia), heart valve problems, heart attack, and heart failure.
• Endocrine problems.Thyroid conditions such as parathyroid disease, adrenal insufficiency (Addison’s disease), low blood sugar (hypoglycemia) and, in some cases, diabetes can cause low blood pressure.
• Dehydration. When your body loses more water than it takes in. This can cause weakness, dizziness, and tiredness. Fever, vomiting, severe diarrhea, overuse of diuretics and intense physical activity can lead to dehydration.
• Blood loss. Loss of large amounts of blood, such as from serious injury or internal bleeding, decreases the amount of blood in your body, resulting in a severe drop in blood pressure.
• Severe infection (septicemia). When an infection in the body enters the bloodstream, it can lead to a life-threatening drop in blood pressure called septic shock.
• Severe allergic reaction (anaphylaxis). It can be triggered by food, certain medications, insect poisons.Anaphylaxis can cause breathing problems, hives, itching, a swollen throat, and a dangerous drop in blood pressure.
• Lack of nutrients in your diet. A lack of vitamins B-12 and folate can prevent your body from producing enough red blood cells, causing low blood pressure.

Types of low blood pressure

Doctors often categorize low blood pressure (hypotension) based on cause and other factors.Some types of low blood pressure include:

• Low blood pressure on standing (orthostatic or postural hypotension). This is a sudden drop in blood pressure when you get up from a sitting position or after lying down.
• Gravity makes blood build up in your legs when you stand. Usually, your body compensates for this by increasing your heart rate and constricting your blood vessels, thereby ensuring that enough blood is returned to your brain.
• But in people with orthostatic hypotension, this compensatory mechanism does not work and blood pressure drops, which leads to dizziness, weakness, blurred vision and even fainting.
• Orthostatic hypotension can occur for a variety of reasons, including dehydration, prolonged bed rest, pregnancy, diabetes mellitus, heart problems, burns, excessive heat, varicose veins, and certain neurological disorders.

• Low blood pressure after meals (postprandial hypotension).This sudden drop in blood pressure after eating affects mainly the elderly.
• Blood enters your digestive tract after eating. Usually, your body increases your heart rate and constricts certain blood vessels to help maintain normal blood pressure. But in some people, these mechanisms fail, leading to dizziness and fainting.
• Postprandial hypotension most commonly affects people with high blood pressure or autonomic nervous system disorders such as Parkinson’s disease.
• Lowering your blood pressure medication dose and eating small, low-carb meals may help reduce symptoms.

• Low blood pressure from faulty brain signals (neuralli mediated hypotension). This disorder, which causes a drop in blood pressure after prolonged standing, mainly affects young adults and children. This appears to be due to a misunderstanding between the heart and the brain.

• Low blood pressure due to damage to the nervous system (multiple system atrophy with orthostatic hypotension).Also called Shy-Drager syndrome. This rare disorder causes progressive damage to the autonomic nervous system, which controls involuntary functions such as blood pressure, heart rate, breathing, and digestion. This is due to having very high blood pressure while lying down.

Risk factor

Low blood pressure (hypotension) can occur in anyone, although some types of low blood pressure are more common depending on your age or other factors:

• Age.The decrease in blood pressure when standing or after eating occurs mainly in adults over 65 years of age. Neurally mediated hypotension mainly affects children and younger adults.
• The use of drugs. People who take certain medications, such as drugs for high blood pressure such as alpha blockers, have a greater risk of low blood pressure.
• Certain diseases. Parkinson’s disease, diabetes, and some heart conditions put you at greater risk of developing low blood pressure.

Complications

Even mild forms of low blood pressure can cause dizziness, weakness, fainting, and the risk of injury from falls.

A severely low blood pressure can deprive your body of enough oxygen to perform its normal functions, resulting in damage to your heart and brain.

Source: https://glavufa.ru/

Three ways to raise blood pressure without drugs are named

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Named three ways to raise blood pressure without drugs

Named three ways to raise blood pressure without drugs raise the pressure without using … RIA Novosti, 04.06.2020

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MOSCOW, June 4 – RIA Novosti. Doctor and TV presenter Sergei Agapkin on the air of the program “On the most important” on the TV channel “Russia 1” told how you can raise blood pressure without using medication. He noted that the problem of hypotonic patients is the weak tone of the vascular wall, which does not allow maintaining pressure. with this, he advised to increase the amount of water consumed by one and a half times, for example, drink it 30 minutes before a meal.You can also increase pressure with one or two cups of coffee and salty foods in the morning. “This combination will lead to the fact that salt will retain fluid and, accordingly, increase pressure, and caffeine will stimulate the tone of blood vessels,” Agapkin said In addition, the use of a wrist expander can normalize pressure. It is necessary to do the exercises for ten seconds on each hand for five to ten passes. “After a short period of time, your pressure will rise to such values ​​as that of an astronaut.& lt; … & gt; You will feel very cheerful, “the doctor said.

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health, health is society, pressure, society

MOSCOW, June 4 – RIA Novosti. Doctor and TV presenter Sergei Agapkin on the air of the program “On the most important” on the TV channel “Russia 1” told how you can raise blood pressure without using medication.

He noted that the problem of hypotonic patients is the weak tone of the vascular wall, which does not allow maintaining pressure.

June 2, 2020, 14:54

Myasnikov told how to deal with pressure surges

To cope with this, he advised to increase the amount of water consumed by one and a half times, for example, drink it 30 minutes before a meal.

You can also increase your blood pressure with one or two cups of coffee and salty foods in the morning.

“This combination will lead to the fact that salt will retain fluid and, accordingly, increase pressure, and caffeine will stimulate the tone of blood vessels,” Agapkin said.

In addition, the use of a wrist expander can normalize pressure. It is necessary to do the exercises for ten seconds on each hand for five to ten passes.

“After a short period of time, your pressure will rise to such values ​​as that of an astronaut.<…> You will feel very cheerful, “the doctor said.

May 20, 2020, 08:00 AM The cardiologist named the five most dangerous foods for the heart

Hypotension – low blood pressure

Lectures

Photo: FA Bobo / PIXSELL / PA Images

What does low blood pressure mean?

Elena Kovalenko

March 11, 2016 11:00

Blood pressure is the pressure exerted by blood moving along the walls of blood vessels.It depends on the resistance of the vessels, the amount of blood and the strength of the heart.Any jump or drop in pressure affects breathing rate, body temperature, and heart rate. Most often, such a difference hides a disturbance in the work of internal organs and does not pass without a trace.

Pressure below 90 to 60 is considered to be reduced pressure. It is important to understand that even if one of the indicators is below normal, then you should think about visiting a doctor.

Symptoms of low blood pressure:

• Pulsating headache (most often in the temporal or occipital regions)
• Sudden onset of nausea and vomiting
• A sharp deterioration in well-being during a change of weather
• Darkening of the eyes
• Fainting
• Weakness and fatigue
• Feeling of lack of air
• Coldness of hands and feet, acute sensitivity to temperature changes

Types of low pressure:

1. Orthostatic hypotension

The main symptom of this disease is a decrease in pressure with a sharp rise. For example, a person lay on the bed for a long time, got up and immediately experienced dizziness or even loss of coordination when lifting. Causes of orthostatic hypotension include pregnancy, fever, and neurological diseases. The key risk group is people over 65.

2. Shay-Drager syndrome

This syndrome is also called multisystem atrophy with orthostatic hypotension or myeloencephalopathy.

The cause of the disease lies in disorders of the nervous system and begins to manifest itself in acute vascular insufficiency. The syndrome is currently incurable. The average life expectancy after diagnosis is 10 years.

3. Postprandial hypotension

The first sign is a sharp drop in blood pressure immediately after eating. The risk group is people with Parkinson’s disease.

4. Dystonia or vegetative-vascular hypotension

A pressure jump occurs after a long standing in one place.Most often, people who are in stuffy and hot rooms suffer from this type of low pressure. This disease is caused by a disruption in the blood communication between the brain and heart. Blood rushes to the lower extremities, and the brain decides that the pressure is increasing, sends a signal to the heart to lower the heart rate, thereby lowering the pressure even more. The risk group includes adolescents aged 12 to 18 years.

5. Accelerated pulse at low pressure

If you know that you have problems with low blood pressure, and the pulse at rest has jumped above 80 beats per minute, you should immediately consult a doctor in order to avoid serious consequences for the whole body.

What is the threat of low blood pressure?

It is generally accepted to consider hypotension as a less dangerous disease in comparison with the disease of high blood pressure – hypertension, but one should not assume that these problems can be solved on their own and will not bring harm to health.

Hypotension causes a sharp decrease in blood flow to the brain and heart, causing sudden fainting and dizziness. Such situations can lead to physical injury and loss of performance.

Most often, hypotension occurs in the elderly, children and adolescents suffer from vegetative-vascular dystonia.It can also occur as a concomitant disease with Parkinson’s disease or diseases of the cardiovascular system.

How to normalize low blood pressure?

1. First aid preparations

The most common drugs for low blood pressure are citramone, tinctures of Eleutherococcus and ginseng, pantocrine, Chinese magnolia vine. These drugs should be taken systematically, since the full effect will manifest itself only after their accumulation in the body.

2. Visit a doctor

A general practitioner will select the best combination of medications for you based on blood tests, age and concomitant diseases. Remember, an individual approach can significantly shorten the duration of treatment.

3. Don’t drink coffee.

Avoid caffeine and caffeine-containing products. It is he who first of all contributes to an increase in heart rate.

4. Drink plenty of water

Large amounts of fluid thin the blood and improve its circulation throughout the body.

5. Rest

Yes, the world is fast and cruel, but remember that first of all you need to take care of yourself. Take time to rest and recuperate.

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City Polyclinic 2 Blagoveshchensk – Prevention of cardiovascular diseases

Prevention of cardiovascular diseases

To minimize the risk of developing hypertension, coronary heart disease, atherosclerosis and, accordingly, such formidable complications of these diseases as myocardial infarction and acute cerebrovascular accident (stroke), everyone should know the risk factors, the elimination of which will increase life expectancy and make it more comfortable.

What are these risk factors?

1. High blood pressure (above 140/90 mm Hg)

2. Elevated blood cholesterol (upper limit of normal 5.0 mmol / l).

3. Increased fasting blood sugar (normal blood glucose from 3.3 to 5.5 mmol / l).

4. Smoking.

5. Overweight. To a greater extent, abdominal obesity, which can be determined by the circumference of the waist, negatively affects health.For men, the waist circumference should not exceed 102 cm, and for women – 88 cm.

6. Sedentary lifestyle.

7. Alcohol abuse.

8. Excessive intake of fatty and salty foods. It is necessary to reduce the consumption of animal fats to a minimum (lard, little butter, sour cream, a lot of animal fats in sausages), and limit the consumption of salt to 3-5 g per day (a teaspoon without a “pea”).

In terms of preventing cardiovascular accidents, it is especially necessary to highlight the need to control the level of blood pressure, since high blood pressure increases the risk of stroke and myocardial infarction several times.The optimal blood pressure is 120/80 mm Hg.

According to studies conducted in the Kirov region, the prevalence of arterial hypertension among the adult population of the region is 40.9%. The level of their blood pressure is known to 67.9%. Among people suffering from hypertension, more than half receive antihypertensive therapy, but only one seventh of them are treated effectively. Against the background of treatment, only one in seventeen among the population of patients with arterial hypertension reaches and for a long time (years) maintains normal blood pressure figures.The male part of the population treats its health especially badly.

The low efficiency of treatment is primarily due to the fact that there is still a widespread misconception about the course of treatment of hypertension, when drugs are canceled when normal blood pressure values ​​are reached. Hypertension is a chronic disease, therefore, treatment should be daily and long-term, and normal blood pressure figures indicate that the treatment is selected correctly and must be continued.

The World Heart Federation recognizes that it is critical that efforts to tackle cardiovascular disease go beyond policy and health professionals. People around the world can reduce the risks of cardiovascular disease for themselves and their loved ones. The household, as the center of everyone’s family and daily life, is a great place to start taking action to improve heart health.By making small adjustments to household practices and behaviors at home to prevent heart disease and stroke, people around the world can live longer and better lives.

The World Heart Federation has identified four simple steps to follow in daily life:

– Do not allow smoking in the house. By quitting smoking, you will improve your health and the health of your loved ones. Establish a rule: for each cigarette smoked, the smoker does additional housework.

– Stick to a healthy diet. Your diet should contain vegetables and fruits. Avoid fatty, fried, and high-calorie foods.

– Encourage physical activity. Limit the amount of time you and your family members spend watching TV and computers. Organize family walks, hikes and outdoor games.

– Know your numbers. Visit a medical institution, for example, a Health Center, where your blood pressure will be measured, your blood glucose and cholesterol levels will be determined, and your body mass index will be calculated.Knowing your risk of developing cardiovascular disease can help you develop a specific action plan to improve your heart health.

By adhering to these rules, you can reduce the risk of developing cardiovascular diseases. However, not all heart diseases can be prevented. Over 70 percent of all heart attacks and strokes requiring urgent care occur at home with a family member nearby who can help the patient. Therefore, it is important to know what measures to take if a heart attack or ischemic stroke develops at home. If you suspect your family member is having a heart attack or stroke, seek immediate medical attention. Always have emergency phone numbers on hand.

Signs of a heart attack:

– Discomfort in the chest, including constricting pain in the chest or behind the sternum.

– Discomfort and / or pain that spreads to other areas of the upper body, such as one or both arms, under the shoulder blades, back, neck, upper or lower jaw, or stomach.

Shortness of breath with or without discomfort in the chest.

– Other signs include unexplained weakness or tiredness, restlessness or unusual nervousness, cold sweats, nausea, vomiting, dizziness, and fainting.

Stroke Signs:

– Sudden weakness in the face, arm or leg, most often on one side of the body.

– Sudden clouding of consciousness, problems with speech or understanding speech.

– Sudden vision problems in one or both eyes.

– Sudden gait disturbance, dizziness, loss of balance or coordination.

– Sudden severe headache for an unknown reason.

If you see any of these symptoms, which may be transient, call an ambulance immediately. Remember, the earlier treatment is started, the more effective it is.

As you celebrate World Heart Day, take responsibility for the health of your heart and the heart of your loved ones.Make your home a place where healthy food is available, where tobacco is not allowed, and where physical activity is encouraged to reduce the risk of heart disease and stroke. It is in your power to create conditions for a healthy lifestyle in the house!

90,000 IN THE REGIONAL HEALTHCARE FOR THE FIRST TIME APPLIED SYSTEM OF REMOTE BLOOD PRESSURE MONITORING

In the Ilek district hospital, a new project has been launched based on information technologies and patient-oriented approaches. The system of remote monitoring of blood pressure has been used in the regional healthcare for the first time.

With the help of compulsory medical insurance, the medical institution purchased 10 blood pressure monitors with the function of transmitting data via GSM channels. Medical equipment allows automatically, using a local operator’s SIM card, to transfer data on the patient’s blood pressure level to the computer of the dispatcher of the district ambulance and emergency medical service.

As the chief physician of the Ilek regional hospital Yevgeny Bashmalukh comments, such devices were issued to patients who need constant monitoring of blood pressure.At home, in accordance with the recommendation of the local therapist, patients take blood pressure measurements several times a day, and the data is sent to the medical service. This ensures constant medical monitoring as well as the possibility of an emergency response.

The innovation is very convenient for patients: it became possible to measure blood pressure more often, without having to visit the clinic again. The reception of the district therapist is unloaded.If necessary, in the event of a “jump” in blood pressure, lack of effect from the drugs used, the dispatcher can promptly send an emergency or ambulance team.

The remote blood pressure monitoring system is aimed at improving the provision of emergency and urgent medical care to patients suffering from arterial hypertension, preventing heart attacks and strokes, and reducing mortality from cardiovascular diseases.

“The project is being implemented by the hospital together with the medical insurance company Capital,” notes Evgeny Bashmalukh. – its experts monitor the effectiveness of the project, provide consultative and methodological assistance to district doctors.

In the future, in order to promote the project to all settlements, it is planned to equip all medical outpatient clinics and FAPs with such tonometers in the region. Currently, a computer program is being developed to transfer monitoring data directly to an electronic patient record.

Heart after covid

The pandemic has managed to push aside many of our most important health problems. Even the eternal leaders – cardiovascular diseases – are perceived without the usual relevance. But pandemics – I want to believe it – end sooner or later. Are diseases of the heart and blood vessels our eternal companions? Today we are talking about them with the chief cardiologist of four regions of Russia, director general of the National Medical Research Center of Cardiology of the Ministry of Health of Russia, Academician of the Russian Academy of Sciences Sergei Boytsov.

Sergey Anatolyevich! You are in charge of the world famous center, which is usually called Chazovsky. For the simple reason that an outstanding cardiologist, the chief Kremlin doctor, academician Yevgeny Chazov, created this center and led it for many years. Gathered within its walls a unique team of the best representatives of Russian cardiology. Do you think that repurposing a center of the same level as yours for covid was justified?

Sergei Boytsov: At that time, I think so.Our center was one of the first federal centers to be converted into a covid hospital. A “red zone” was created, more than 300 beds were used.

There are 400 beds in the center. It turns out that almost everything was given to the virus?

Sergei Boytsov: All beds to which oxygen is supplied.

And those who suffered from heart pains? Who urgently needed heart and vascular surgery? ..

Sergei Boytsov: You may be surprised by my answer.But it is true. And, by the way, it concerns not only Russia. Globally, at the onset of the pandemic, there was a marked reduction in emergency calls for cardiovascular disease. Cause? It is obvious: among people, the fear of getting infected has become above all. The fear of the virus turned out to be stronger than heart pains.

But really?

Sergei Boytsov: They didn’t actually leave. And if the condition was very serious, then people asked for help.And Moscow had the opportunity to provide it in a timely manner. If you can use the rostrum of the Rossiyskaya Gazeta, I would like not only to say thank you, but to express my admiration for the work of the Moscow ambulance.

How long has Chazovsky been a covid center?

Sergei Boytsov: Two months. At the very peak of the first wave. During this time, 759 people received help in our center.

For men, a critical waist – 102 cm. For women – 88 cm. Belly fat is the most dangerous for the cardiovascular system. Do you insist on the accuracy of these figures?

Sergei Boytsov: I insist.In our digital time, it cannot be otherwise.

Notice that you said this about digital time. Are modern technologies, “digital” registered in the Chazovsky center? I am not asking the question by chance. Sometimes doctors, and not only them, are accused of being old-fashioned, of insufficient use of the latest technologies in practice, and so on …

Sergei Boytsov: Medicine, healing without preserving, respecting traditions are unthinkable. But one cannot do without moving forward, without using the latest technologies.And the Chazovsky Center has a tradition: as soon as something new, and even more revolutionary, appeared somewhere in the world, it invariably became a real practice of our center. The same medical information system was created in our country at the beginning of the 2000s. All endovascular technologies, cardiac surgery technologies for cardiac arrhythmias, resuscitation aids – these are all digital technologies, which are coupled with manual skill.

Your center is federal. Which Russian has the right to receive help in it under the compulsory medical insurance system?

Sergei Boytsov: More than half of our patients are not Muscovites, but residents of other regions of the country.

Sergey Anatolyevich! In addition to managing the Chazovsky Center, you are also the chief cardiologist of Russia in four federal districts. The rest are commanded by your colleague from St. Petersburg Academician Yevgeny Shlyakhto. And if a patient is not from your region, but wants to get help in your center, what should you do? Does the patient have the right to choose the place of treatment and the doctor who wants to be treated?

Sergei Boytsov: Definitely yes! Yes Yes! Has the right to. And he should have such an opportunity.Moreover, he has it.

Are you sure about this? Then why do applicants for help often turn to me with just such requests?

Sergei Boytsov: This may be the result of the patient’s ignorance of his rights or the clumsiness of the local health authorities.

So, let’s say I want Academician Renat Suleimanovich Akchurin to operate on me? I live, registered in Moscow. What should I do to get exactly to Chazovsky, exactly to the operating table for Renat Suleimanovich?

Sergei Boytsov: It is necessary to get a referral for consultation to our center in the district clinic.True, the most difficult and difficult cases are usually sent to us. This is probably how it should be.

I do not agree with you! In theory, you are probably right. But for a patient, his disease is the most difficult, the most difficult. And he has the right to count on the best help …

Sergei Boytsov: But I cannot agree with you either! I affirm: in recent years, the level of rendering cardiological and cardiac surgery care has increased in the country. This is a fact that cannot be disregarded.If you don’t mind, I will name some of the addresses of such centers. They are in St. Petersburg, Novosibirsk, Krasnodar, Tomsk, Krasnoyarsk, Nizhny Novgorod, Penza, Astrakhan, Yekaterinburg …

Aren’t you afraid that Chazovsky is losing its relevance?

Sergei Boytsov: On the contrary, it makes us happy and makes us stay in good shape. For example, in the past, hybrid cardiac surgery was the property of only a few clinics. Now it becomes a practice. Now it is used in a number of centers for the most severe and difficult cases.In our center, we conduct special educational courses, which teach such the latest technologies.

What does it mean to run such an institution? Is Chazovsky at a decent level today?

Sergei Boytsov : To be honest: it is very difficult to manage and very responsible. It helps that before this director’s chair I went through the school of Yevgeny Ivanovich himself – I was in his deputies for five years.

The optimal pressure with which you can live normally is less than 140 to 90.And it is better to strive for a pressure of 130 to 80 and even lower. This is the term. Moreover, I know how scrupulous Yevgeny Ivanovich himself has always been in personnel selection. Probably, the fact that you have behind you the Leningrad Military Medical Academy, the Pirogov Medical Center and the National Center for Preventive Medicine helped you. By the way, this center was created by Evgeny Ivanovich. So the way up – to the present center, one might say, was predetermined. And still . Sergey Anatolyevich, how to work with a team, which is almost entirely composed of stars of Russian cardiology and cardiac surgery?

Sergei Boytsov: First of all, you need to comply with it.And help. So that colleagues have the opportunity to realize their scientific, clinical, and pedagogical ideas.

Are you okay? To be honest again: do they love you in the team or? ..

Sergei Boytsov: About love … Somehow I didn’t think. But for almost four years of work with the team, I have, thank God, no conflicts. But there is already a common history. Including passing the covid test.

The key question Evgeny Ivanovich Chazov is invariably associated with the so-called Kremlin medicine.The Kremlin’s postulates are indeed very effective and justified: prevention, the availability of assistance, a high level of its provision, and so on. Although, out of malice, sometimes they talked about her: the floors are parquet, the doctors are questionnaires. But by and large: all the best doctors took place in the Kremlin medicine. Although officially they were sometimes listed in completely different medical institutions. But the very principles of helping, I think, were the best.

Sergei Boytsov: I absolutely agree with you. But you did not name one, and, in my opinion, the main quality of this service: an individual approach to each patient.Fidelity to the eternal postulate: it is necessary to treat not the disease, but the patient. And this is necessary in the age of digital medicine. Now the terminology itself is changing somewhat. They talk about a personalized approach based on the principles of evidence-based medicine. And in fact, this is the very rule that, in my opinion, will never become outdated: it is not the disease to heal, but the patient.

Especially when it comes to the heart, blood vessels, when, according to you, cardiologists, almost by the age of 35-45, most of us begin to have all kinds of cardiovascular problems.All over the world, they are the first among all ailments. This was also the case when there was no covid. So, apparently – at least in the foreseeable future – it will be after it.

Sergei Boytsov: This is most likely the case. The population is aging. And that’s a plus. But with age, blood vessels first of all begin to suffer. Arterial hypertension declares itself. And since we are talking about numbers today, I will refer to them again. At the age of 25 to 65, 48% of men are affected by hypertension. There are fewer women.And for those over 65, hypertension reaches 70-80-90%. She is the main, the main culprit of heart attacks, strokes, premature deaths.

But for some reason, the same hypertension does not cause, for example, we have such fear as covid. A familiar lady weighing 140 kilograms cannot deny herself the pleasure of eating another piece of cake. At the same time, she informed that in recent weeks her working blood pressure is 160 to 100. And she feels fine.

Sergei Boytsov: Allow me a tiny educational program? In medicine, the concept of “working blood pressure” does not exist at all.And 160 to 100 practically excludes the possibility of normal well-being.

Once an educational program and numbers, then name the optimal ones with which you can live without fear of a heart attack or stroke.

Sergei Boytsov: Less than 140 to 90. And it is better to strive for a pressure of 130 to 80 and even lower.

You will not advise drugs. Nowhere in the world is there an optimal remedy for hypertension. Let’s say he took a course of their admission and got rid of her high numbers …

Sergei Boytsov: I won’t.Hypertension is a chronic condition. It is impossible to completely get rid of it. But you can, by taking the drugs prescribed by a specialist for you, keep the disease under control, maintain a high quality of life. This is not one or two courses of therapy. This, I will disappoint, is often for the rest of your life. The drugs themselves vary depending on the condition, age, season. That is, I will repeat once again: to treat in our digital time, the time of the onset of artificial intelligence, you need not a disease, but a patient.

I think, not only now, but in all, including post-like times.

By the way

Recipe from Academician

1. Get a flat stomach. To do this, you can look in the mirror, or you can use a measuring tape. For men, the critical waist width is 102 cm and more. For women – 88 cm and more. Belly fat is the most dangerous for the cardiovascular system.

2. Physical activity is required. Working muscles are a proven remedy for hypertension.

3. Do not abuse salt. Try to avoid salting your meals when you cook. Try to remove the salt shaker from the table so as not to add salt to the finished meals.

4. Stop smoking. Including from electronic cigarettes.

5. Less alcohol. There are no useful doses of it.

Source: https://rg.ru/

September 29 – World Heart Day

Every year, for more than 20 years, on September 29, World Heart Day is celebrated.

It was established in 1999 at the initiative of the World Heart Federation, supported by the World Health Organization, UNESCO, etc.Currently, this holiday is celebrated in many countries around the world.

In our country, World Heart Day in 2020 opens the Russian National Healthy Heart Week. The motto for World Heart Day 2020 is “Heart for Life”. This date is intended to draw public attention to the issues of maintaining health, to emphasize the importance of the prevention of cardiovascular diseases (hereinafter – CVD). We are talking, among other things, about preventive measures in relation to ischemic disease, acute heart attack and cerebral stroke, which are considered one of the most dangerous cardiovascular catastrophes.

The risk factors for cardiovascular diseases include, first of all, high blood pressure, high levels of cholesterol and glucose in the blood, smoking, drinking alcohol, insufficient intake of vegetables and fruits, excess weight and physical inactivity.

According to experts from the World Heart Federation, 80% of premature deaths from heart attacks and strokes can be prevented if you lead a healthy lifestyle.