ormal blood pressure

Blood pressure (BP) is the forcethat moving blood puts on theartery walls. As the heartpumps out blood, pressure onthe arteries is at its highest.This peak pressure is thesystolic pressure.

Between heartbeats, the arteries are more relaxed,but they stay tense enough forsmooth blood flow to all parts of the body. This tension is the diastolic pressure.

Stages of BP for adults 18 years and older:

NN

peak pressure (systolic)

diastolic pressure

* Very low blood pressure readings should be checked by your doctor.

1

Systolic Diastolic(top number) (bottom number) (check one) (check one)

Normal* less than120 and less than 80

Pre Hypertension 120–139 or 80–89

Stage 1 Hypertension 140–159 or 90–99

Stage 2 Hypertension 160 or more or 100 or more

My target BP range is

My present BPrange is

TT

HH

2

igh blood Pressure (HBP)

Most people with chronic HBP have what is calledessential hypertension. Though this type of HBP tends to “run in the family,” most of the time the cause is not known.

Sometimes HBP is caused by a medical problem such as a kidney disease. This type is called secondaryhypertension. Treating the main problem can cause the blood pressure to go down.

Some drugs or other compounds can raise bloodpressure at times in some people. (Examples: birthcontrol pills, some arthritis medicines, some “cold”remedies, caffeine, chewing tobacco) When a personstops using these, blood pressure can sometimes go down.

reatment

Treatment to control high blood pressure or itscomplications will includemaking good choices about:

• what you eat and drink

• body weight

• regular exercise

• stress management

• not smoking

• medicines

hat you eat and drinkMaking good choices about what you eat will play a

big part in your efforts to control high blood pressure.Follow the “DASH” diet plan. Choose foods, drinks and seasonings that are:

• low in sodium, fat and cholesterol

• high in fiber, potassium, calcium and magnesium

• moderately high in protein

Sodium

Sodium is an important mineral. It helps your bodybalance the level of fluids inside and outside of the cells.To keep up this balance, the body needs no more than200 mg of sodium a day. Yet, most of us eat 3,000 to 6,000 mg of sodium each day. (Our mostcommon source of sodium is table salt.)

People with high blood pressure should limit their sodium to 2,400 mg a day or less. We can’t prove that toomuch salt in the diet causes high blood pressure, but we can tell you that in countries where a lot of salt is eaten, bloodpressures are the highest.

W

One level teaspoon of salt equals about 2,000 mg of sodium.

3

How to fix low-sodium foods:• Rinse foods before cooking or eating them. This can remove some of the sodium from frozen or canned foods.

• Season foods with fresh dried herbs, vegetables, fruits or no-salt seasonings.

• Do not cook with salt or add salt to foods at the table.

• Make your own breads, rolls, sauces, salad dressings, vegetable dishes and desserts when you can.

• Prepare fresh or use canned, unsalted vegetables. These have less sodium than most processed foods. For example:*

• Buy water-packed tuna and salmon.Break up into a bowl of cold water, and let stand for 3 minutes. Rinse, drain and squeeze out water.

• Bake, broil, steam, roast or poachmeats without salt.

*Sodium contents of foods from USDA Handbook #456.

4

Instead of: Use:1 cup of cooked 1 cup of fresh,canned peas: cooked peas:400 mg of sodium 2 mg of sodium

1⁄2 cup of Minute Long 1⁄2 cup of Grain and Wild Rice: cooked rice:570 mg of sodium 1 mg of sodium

1⁄2

1 cup

1⁄2

1 cup

Fat & cholesterol

Many people with high bloodpressure also have high bloodcholesterol. Having a high bloodcholesterol level puts you at risk for heart disease.

Choose foods that are low in fat andcholesterol. Saturated fat is the mostharmful to your body. Animal foods likesteak, butter and cheese have a lot of saturated fat. These foods also have cholesterol in them.

Cutting the fat in your diet will also help cut calories.So if losing weight is one of your treatment goals, low-fat, low-cholesterol eating will help.

How to fix low-fat, low-cholesterol foods:• Bake, broil, steam, roast or poachfoods. Serve without fatty sauces.

• Cook more fish and poultry (lightmeat). Trim off all excess fat before cooking.

• Drain all meats on a paper towel aftercooking. The towel will soak up extra grease or fat.

• Season foods with herbs, fruits and vegetables. Do not cook with saturated fat(butter, lard, bacon, etc.).

• Cook with small amounts of vegetableoils (monounsaturated or polyunsaturated).Make salad dressings with small amounts ofthese oils.

5

6

The DASH diet

This eating plan can help you control high blood pressure.

Food Group DailyServings Serving Size Sample Foods Notes

Grains & grain products

7–8

1 slice bread1 oz dry cereal1/2 cup cooked rice, pasta or cereal

whole wheat bread, English muffin, pitabread, bagel, cereals, grits, oatmeal,crackers, unsalted pretzels and popcorn

major source ofenergy & fiber

Vegetables

4–5

1 cup raw, leafy vegetable1/2 cup cooked vegetable6 oz vegetable juice

tomatoes, potatoes, carrots, peas, squash,broccoli, turnip greens, collards, kale,spinach, artichokes, beans, sweet potatoes

rich sources of potassium, magnesium & fiber

Fruits

4–5

6 oz fruit juice1 medium fruit1/4 cup dried fruit1/2 cup fresh, frozen or canned fruit

apricots, bananas, dates, grapes, oranges,orange juice, prunes, raisins, grapefruit,grapefruit juice, mangoes, melons, peaches, pineapples, tangerines and strawberries

important sourcesof potassium, magnesium & fiber

Low-fat or nonfat dairyfoods

2–3

8 oz milk1 cup yogurt11/2 oz cheese

skim or 1% milk, skim or low-fat buttermilk, nonfat or lowfat yogurt,lowfat and nonfat cheese

major sources of calcium & protein

Meats, poultry& fish no more

than 2

3 oz cooked meats, poultry or fish

select only lean meats; trim away visiblefats; broil, roast or boil instead of frying; remove skin from poultry

rich sources of protein & magnesium

Nuts, seeds &dry beans 4–5

a week

11/2 oz or 1/3 cup nuts1/2 oz or 2 Tbsp seeds1/2 cup cooked dry beans

almonds, filberts, mixed nuts, peanuts, walnuts, sunflower seeds, kidney beans, lentils

rich sources of energy, protein magnesium, potassium, fiber

Fats & oils

2–3

1 tsp soft margarine2 Tbsp lowfat mayonnaise2 Tbsp light salad dressing1 tsp vegetable oil

soft margarine, lowfat mayonnaise, lightsalad dressing, vegetable oil (such asolive, corn, canola, or safflower)

DASH has 27% ofcalories as fat, including fat in oradded to foods

Sweets5 a week

1 Tbsp sugar1 Tbsp jelly/jam1/2 oz jelly beans8 oz lemonade

maple syrup, sugar, jelly, jam, fruit-flavored gelatin, jelly beans, hard candy, fruit punch, sorbet, ices

Sweets should below in fat

Food labels

One way to buy foods with less fat, cholesterol,sodium or sugar is to check the Nutrition Factson the label. Fats and sugar will be given in grams (g).Sodium and cholesterol will be in milligrams (mg).

Buy foods that list 140 mg of sodium or less on thelabel. This list will help you read sodium labels:

sodium free 5 mg or less/serving

very low sodium 35 mg or less/serving

low sodium 140 mg or less/serving

low sodium meal 140 mg or less of sodium per

31/2 oz (100g)

reduced sodium At least 25% less sodium than

the regular version

light in sodium 50% less sodium than the

regular version

no salt added, no salt added during

unsalted, without processing (only used for

added salt foods that usually have

salt added)

7

Some other helpful terms for you to know:

fat free less than 0.5 g/serving

low-fat 3 g of fat or less/serving

low saturated fat 1 g of saturated fat or less/serving

reduced fat at least 25% less fat than the regular version

light in fat 50% less fat than the regular version

low-cholesterol less than 20 mg/serving

low-calorie 40 calories or less/serving

MealDiary

8

9

Alcohol

Drinking too much alcohol can raise blood pressure. It can also make HBP harder to control, even with medicines. Most of the time, even people with high blood pressure can have a drink now and then. But if you don’t drink, it’s best not to start. If you do drink, limit your intake to no more than two servings of alcohol in any one day.

The Dietary Guidelines for Americans suggests that for overall health, women should limit their alcohol to no more than one drink a day.

And if you are trying to lose weight, keep in mind that alcoholic drinks have calories. There are about 70 to 180 calories in a drink, depending on the kind.

Potassium

If you are taking a diuretic (water pill), you may beadvised by your doctor to eat more potassium and/or takea potassium supplement. You may need to prevent theloss of too much potassium when fluids pass out of thebody. Ask your doctor about potassium if he or she hasgiven you a diuretic. Do not take a potassiumsupplement unless your doctor tells you to.

One serving of alcohol is:

• 11⁄2 oz of 80

proof whiskey

or 1 oz of

100 proof or

• 5 oz of wine or

• 12 oz of beer

These foods are high in potassium:

apricots dried beans and peas fish

bananas green beans fresh pork

orange juice potatoes peaches

spinach prunes & prune juice squash

milk and yogurt tomatoes

10

Body weight

If you weigh 10 to 20% more than you should, yourdoctor will most likely tell you to lose weight.

The DASH diet lets you lose weight slowly withoutlosing your health. On the DASH diet you learn what toeat and in what amounts. Your body thinks “all is well,”and weight comes off and stays off. Regular exercise atthe same time makes a good diet work even better. Hereare some tips to help you get started.

• Choose a good variety of foodsfrom all the basic food groups.

• Control serving sizes.

• Find a good cookbook or two that contain healthy, tasty recipes for somefoods that you like.

• Watch the fats and oils.Salads are great, but manysalad dressings are very high in fat (and calories).

• Avoid foods and drinkssweetened with sugar.These are high in calories.

There is no magic formula for losing weight. But if you change your eating habits to follow theDASH diet and limit your sodiumand sugar use, you can lose weight and keep it off for life.

egular exerciseRegular exercise can do many things for you. It can:

• help lower high blood pressure

• help you lose weight

• relieve stress

• improve your self-image

• reduce your risk of having a heart attack

Since you have high blood pressure, your doctorshould prescribe the amount and type ofexercise that is safe for you. Most of the time bloodpressure has to be controlledbefore you add exercise toyour treatment. Your doctormay also suggest that you join a medically supervisedexercise program for the best results.

11

R

You do not have to do hard

exercise to begin to benefit

from physical activity.

Many activities (such as

walking) if done for about 30

minutes most days can help.

a aaa aaa a aa aa

12

Once your doctor has approved a type and amount of exercise for you, here are some tips to help you stickto it:

1. Start off slowly. Pay attention to howyour muscles and body feel.

2. Do something you enjoy. You simplywon’t keep doing an exercise if you don’tlike it.

3. Choose an exercise partner. This mayhelp you enjoy it more.

4. Warm up and stretch before and cooldown and stretch after you exercise.

Warm up

Walk slowly for

5–10 minutes, then

stretch your muscles.

Exercise

Brisk walking, cycling

or swimming for 30–45

minutes most days.

Cool down

Walk slowly for 5–10

minutes, then stretch

your muscles again.

13

tress managementStress can raise blood pressure sharply and may make

your HBP level worse. We all feel stress in our lives attimes. When you feel the tension rising, try one of theseto ease the stress:

• breath slowly and deeply to relax

• take a brisk walk

• soak in a warm bath

• watch a funny video

• meditate or do a relaxation exercise

ot smokingIf you don’t already know what smoking

can do to your health, here are some of the risks that smokers face:

• more heart disease and heart attacks

• more lung disease and lung cancer

• more fatty buildup in the arteries

• poor blood flow

If you have HBP and are also a smoker, your risks for heart disease and lung disease are doubled. So think about it, and try anything to quit smoking. Most towns now have stop-smokingclinics to help you. Your own hospital is a good place tocall about such a group.

N

S

14

edicinesIf changes in eating habits and other lifestyle changes do not

lower blood pressure enough, then medicine is needed. Mostpeople need to stay on a blood pressure medicine for life. Butsome may only need to take pills for a while. It depends onhow well the other parts of your treatment work. These are thekinds of drugs used most often to lower high blood pressure:

If you need HBP medicine, ask your doctor or druggist how itworks to help lower your blood pressure. Write the drug namehere and what it does for you:

M

diuretic helps the body get rid of excess salt and fluid

(water pills)

beta blocker slows down the heart rate; helps keep the

heart from beating too forcefully

calcium relaxes blood vessels

channel blocker

vasodilator relaxes artery muscles and opens blood vessels

alpha blocker acts on the nervous system to relax the

blood vessels

nervous system relaxes blood vessels by controlling

inhibitor nerve impulses

angiotensin blocks the making of a hormone that narrows

converting enzyme the blood vessels

(ACE) inhibitor

Always take your medicine just as your doctor tellsyou. If there are side effects from the drug, be sure to letyour doctor know right away. He or she may need tochange the dose or change to another drug. Be patient.Sometimes you may have to try 2 or 3 drugs beforefinding the right one for you—one that lowers yourblood pressure without unpleasant side effects.

Also, as changes occur in your life (moves, marriage,divorce, children, job changes, weight gain, etc.), theadded stress may cause a need for an increase in yourmedicine for a time. When this happens, your doctorwill adjust your medicine to keepyour blood pressure withinthe desired range.

Over-the-counter-drugs

People with HBP should use over-the-counter drugs only asapproved by their doctor or druggist.Some non-prescription drugs contain sodium or vasoconstrictors. Vasoconstrictors can raise blood pressure by causing blood vessels to narrow.

CAUTION: Never reduce the dose or stop taking your medicine unless your

doctor tells you to. This could

cause serious problems.

Check your blood pressure

regularly. Your doctor may suggest

you buy a device to check your blood

pressure at home.

15

16

ome final words

High blood pressure is called the“silent killer” because you may nothave any symptoms while the damageis being done. Long-term high bloodpressure can lead to other diseasessuch as kidney failure, heart attack,heart failure or stroke.

You now know what treatment of high blood pressure includes. Youand your doctor are partners in yourtreatment. Keep in touch with him orher to check your progress and know if your treatment needs to be changed.

Learn to eat right, watch your weight, take medicines as prescribed, exercise regularly,manage your stress, don’t smoke and check your blood pressureregularly. These will increase your chances for a full, healthy life.

SS

LESS STRESS

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Copyright © 1997, 1998, 2004by Pritchett & Hull Associates, Inc.All rights reserved. No part of this book may be photocopied, reprinted or otherwise reproduced without written permission from Pritchett & Hull Associates, Inc.

Throughout this book, where Pritchett & Hull Associates, Inc. was aware of names of products for which a trademark has been claimed, such names have been printed in initial capital letters (e.g., Medic Alert).

Published and distributed by:Pritchett & Hull Associates, Inc.

Printed in the U.S.A.

®

This book is to help you learn and should not be used to replace any of your doctor’s advice or treatment.

Pritchett & Hull Associates, Inc.Unique Health Education Materials Since1973

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e believe that you have the right toknow as much as you can about yourhealth. Our goal is to give you enough factsto get the main points clearly in mind. Wedo this with medical accuracy, warmth andhumor. The result for you: less tension,more healing and a good idea of what to ask your doctor, nurse or others.

W

Pritchett & Hull Associates, Inc.3440 Oakcliff Road, NE, Suite 110 Atlanta, GA 30340-3079 1-800-241-4925

®

pecial thanks to:pecial thanks to:

W. Dallas Hall, MDProfessor of Medicine andDirector of The Division of Hypertension (Retired)Emory University Schoolof Medicine and Grady Memorial Hospital,Atlanta, GA

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