Lowering High Blood Pressure

Written by Dr Harold Gunatillake
Health Writer

In the past, doctors would say that the highest healthy systolic blood pressure should be estimated as below 100 plus your age. On that calculation, if your age is 50 years, systolic blood pressure should be calculated as 100 plus 50, or below 150 mm of mercury. On that basis, doctors would reassure you by saying, "for your age your BP is okay". You hear this from many individuals who boast saying, "for my age the doctor said the blood pressure was okay". That belief has been discarded for good.

The blood pressure of an adult male at any age should normally be recorded as –systolic 130mm of mercury or below, and the diastolic, varying between 60 to 80 mm of mercury, checked on a sphygmomanometer (mercury blood pressure apparatus). A female's normal systolic should be about or below 120mm mercury and the diastolic, varying between 60-70 mm mercury.

If the systolic blood pressure in a male is between 130 and 140 mm of mercury (Hg) and female, between 120 and 130mm mercury (Hg), then you come into the category of a moderate hypertensive or 'Pre-hypertensive'. They have the same complications as the full blown uncontrolled hypertensive and need to take remedial measures without postponing.

How does one get high blood pressure?
Of course, there are primary and secondary causes of hypertension. This discussion is on primary high blood pressure, sometimes the doctors refer to as 'Essential hypertension'. By primary, we mean no pre-existent cause. Gradually, with age, the flexible, elastic arteries tend to get hardened (arteriosclerosis) resulting in increased peripheral resistance. (Do not mix up arteriosclerosis with atherosclerosis). The heart needs to pump (left ventricle) with more force, resulting in high blood pressure. Smoking, fatty foods, obesity, lack of exercise, chronic infections and genetic factors tend to accelerate this process. Omega – fish oil 2000mg taken daily tend to retard the process.

Test: Role your radial artery just above the wrist with index and middle fingers. Hardening or flexibility and softness of the artery can be assessed with this maneuver. Radial artery is felt on the front (ventral) side, inner to the outer border of the forearm, just above the wrist crease lines.

Checking your blood pressure
To obtain your blood pressure measurement, your health care provider will wrap the blood pressure cuff snugly around your upper arm, positioning it so that the lower edge of the cuff is one inch above the bend of the elbow.

The health care provider will locate the large artery (radial) on the inside of the elbow by feeling for the pulse and will place the head of the stethoscope over this artery, below the cuff. It should not rub the cuff or any clothing because these noises may block out the pulse sounds. Correct positioning of the stethoscope is important to get an accurate recording.

Digital BP apparatus is more popular today, even in hospitals for its convenience and reading the pulse rate simultaneously. They are more sensitive and the readings may vary unless one is aware. Always follow the instructions on the brochure.

Your health care provider will close the valve on the rubber inflating bulb and then will squeeze it rapidly to inflate the cuff until the dial or column of mercury reads 30 mmHg higher than the usual systolic pressure. If the usual systolic pressure is unknown, the cuff is inflated to about 210 mmHg. Next, t

he valve is opened slightly, allowing the pressure to fall gradually (two to three mmHg per second). As the pressure falls, the level on the dial or mercury tube at which the sound of blood pulsing is first heard is recorded. This is the systolic pressure.

As the air continues to be let out, the sounds will disappear. The point at which the sound disappears is recorded. This is the diastolic pressure (the lowest amount of pressure in the arteries as the heart rests). The procedure may be performed two or more times.

Repeated measurements are important. A single high measurement does not necessarily mean you have high blood pressure. On the other hand, a single normal measurement does not necessarily mean that you don't have high blood pressure.

Blood pressure readings taken at home can provide important information to your doctor. Such readings may be a better measure of your current blood pressure than those taken at your doctor's office, as long as you make sure your machine is accurate. You can ask your health care provider to compare readings in the office. Many people become nervous at the doctor's office and have higher readings that they normally would at home. This is called white coat hypertension.

Check your blood pressure weekly at home; much better than checking in a doctor's office. People who check their BP at home tend to be more successful at keeping it under control.

A study showed that people who checked their blood pressure at home and emailed the results to your doctor who offered advice were far more likely to keep their blood pressure in check than those who merely measured it at home or those who had it taken by a doctor every now and then.

Consult your provider if your blood pressure measurements are consistently high or low or if you have symptoms at the same time as the high or low reading.

Variations in BP
Checking your BP in the morning may show a spike. Don't be alarmed. It takes a while for your morning blood pressure tablets to act, if you are considered as an hypertensive. If you are concerned check your BP about two hours later after morning medication.

Pattern of hypertension
The onset is very gradual, and you are without symptoms (asymptomatic) for years and years, being a slow progressing process. Early indications would be when the systolic pressure rises to over 180 mm to 200 mmHg or the diastolic pressure rising over 100, consistently.

Early indications could be:
Tiredness at the end of the day
Feeling of giddiness and or mild headache
Faintish attacks
Weakness on one side of the body, and unsteady walking
Palpitations (heart going fast and feeling the rapid beats) and signs of heart failure (doctor's finding)
Sudden stroke
Signs of kidney failure (late side effect)
These symptoms and signs are preventable by keeping the blood pressure within the normal range.

Natural way of controlling high BP
Fully relaxing your body and your mind for a few minutes a day could lower your systolic blood pressure by 10 points or more—at no cost, and with no side effects.

Researchers with the Benson-Henry Institute for Mind-Body Medicine at Harvard-affiliated Massachusetts General Hospital compared a stress management technique called the relaxation response with education about lifestyle changes such as sodium reduction, weight loss, and exercise.

They found: Blood pressure decreased more in the relaxation response group. 32% of the volunteers in that group were able to eliminate one blood pressure medication and still keep their blood pressure under control, compared with 14% of the lifestyle group.

The relaxation response, developed by Harvard's Dr Herbert Benson, has been shown to reduce heart rate, blood pressure, breathing rate, and muscle tension. Here's how to do it:

Select a word (such as "one" or "peace", or "manthra"), a short phrase, or a prayer to focus on. Sit quietly in a comfortable position and close your eyes, possibly in a darker room. Relax your muscles, progressing from your feet to your calves, thighs, abdomen, and so on, up to your neck and face. Breathe slowly through your nose, silently saying your focus word, phrase, or prayer to yourself as you exhale. When other thoughts come to mind, don't worry. Simply return your attention to your focus word, phrase, or prayer.

Do this for 10–20 minutes. Sit quietly for a minute or so, then open your eyes. Practice this technique daily. People who meditate regularly have a lower blood pressure than others.

Music and laughter helps lower blood pressure
The author find music, dancing and 'silly talk' (not serious), and a glass of wine tend to lower the blood pressure when checked after reaching home following a revelers night.

Middle aged men and women may be able to lower their blood pressure readings by laughing more and listening to music they enjoy, new research indicates.

Researchers at Osaka University in Japan set out to determine whether music and laughter interventions would reduce blood pressure in one of two situations: immediately after listening to music or laughing and after three months of one-hour interventions that took place once every two weeks.

The scientists signed up 79 people between 40 and 74, who were randomly assigned to one of three groups. Thirty-two listened to music, 30 were assigned to a laughter group, and 17 neither listened to music nor participated in laughter sessions. Those in the music group sang, listened, and stretched to music. The participants were urged to listen to music at home. Those in the laughter group were entertained by "laughter yogis" and participated in laughter yoga, which combines breathing exercises with laughter stimulated through playful eye contact. They also watched traditional Japanese sit-down comedy called Rakugo.

Blood pressure was taken before and after each music or laughter session.

Impact on Blood Pressure
After three months, researchers said, blood pressure significantly decreased, by nearly 6 mmHg, among those who listened to music. It decreased by 5 mmHg among those who took part in sessions designed to make them laugh. Blood pressure readings taken immediately after music sessions were lower by nearly 6 mm.Hg, and by 7 mm.Hg immediately after laughter sessions. People in the comparison group showed no change in blood pressure readings.(ref: WebMD Health news reviewed by Laura J.Martin.MD

The bottom line is stay slim, exercise, do not smoke, eat less salt and fatty foods, relaxation therapy, music, dancing and keeping away from stress factors as much as possible, would be the pre-requisites, to maintain a normal blood pressure and live long through good health. Start today.

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