Blood Pressure (BP) and Hypertension (HTN)
There are two classes of hypertension, primary and secondary.  Primary hypertension is mostly due to familial genetics and/or environmental factors.  Secondary hypertension is caused by a pathology in one of our other organs, the hypertension thus being reactionary to the disease process.  The most common form of secondary hypertension is from kidney disease (Diabetes) and/or heart disease (coronary artery disease, atherosclerosis).  Both primary and secondary forms can be affected by dietary and lifestyle treatments (and are potentially caused by them; sedentary lifestyle, poor diet, poor stress management, etc.)


Keep a log of your blood pressure to bring in to your next appointment.

1. Each day take your blood pressure in the morning (1-2 hours after rising)
   
   
2. And in a stressful situation (or right after)
   
   
3. Record these two readings each day and bring them to your next appointment.
   
   
4. Bring in your blood pressure cuff so we can calibrate it.
   
   
5. If you do not have a blood pressure cuff- you can get your readings done at any drug store (they normally have a machine near the pharmacy) or at any fire station (some handsome firefighter/paramedic will take it for you).  If you don’t have a cuff at home, you only need to do one reading a day (for up to one week).
   
   

Tips

1. Sometimes our blood pressure can elevate due to the foods we eat (especially if we are intolerant/allergic to them).  Keeping a diet diary alongside your BP log can be helpful.
   
   
2. Stressful situations naturally raise our blood pressure.  One abnormally high reading is nothing to be alarmed about if the rest of the readings are normal.  It is normal for our blood pressure to fluctuate throughout the day.
   
   
3. If you have an elevated reading, try some deep breathing exercises for 30 seconds to 1 minute and then retest.  Concentrate on your breath, with slow inhalations for 3-6 seconds and controlled exhalations for the same amount of time.
   
   

Treatments

Hypertension can be a direct result of dietary and lifestyle factors.  

• Adding adequate fiber to your diet in the form of fruits and vegetables can help to lower/control weight, inadvertently lowering blood pressure.  Maintaining a healthy body weight is important to all aspects of health.  You can also add a fiber supplement, 2Tbsp/d.
  
  
• The DASH diet is specific for lowering blood pressure, but mainly focuses on the addition of fruits and vegetables to the diet (increase in potassium, decrease in sodium).  You can find more information about the DASH diet here.
  
  
• EXERCISE!  Moderate activity is essential for health.  The more we work out our heart, the stronger it becomes.  Typical guidelines encourage >150 minutes of moderate activity per week.  I encourage DAILY movement.  Try to get your heart rate up to 70-80% of its max [0.70(220-your age)-0.80(220-age)].  We can calculate this in the office if you are having difficulties.
  
  
• Reduce stress.  There are many different techniques to stress reduction (deep breathing, meditation, counseling, life transitions, etc.)  If you are concerned with your stress level, we can talk about this and the therapies that help treat the specific stressors in your life.
  
  
• Herbal therapy.  There are a number of herbal products that can help lower blood pressure.  If you are newly diagnosed, have pre-hypertension, or stage 1 hypertension, this may be a good option for you before jumping to medications.
  
  
• Typical conventional BP medications include ACE inhibitors, Calcium channel blockers, Beta blockers, Angiotensin-Renin blockers (ARBs) and diuretics.  We can go over these in greater detail if you are already on one, or are considering starting.