Tag Archives: hypertension

Exercise five hours a week to protect against hypertension later in life

Current public health guidelines should be updated to recommend around 5 hours of moderate exercise per week, a new paper reports. This exercise regime, especially if maintained throughout our 30s, 40s, and 50s, can prevent the onset of conditions caused by hypertension later in life.

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New research led by the UCSF Benioff Children’s Hospitals reports that the current recommendation of two-and-a-half hours of moderate exercise per week isn’t quite enough to reap maximum benefits. However, updating this to five hours per week could help reduce the risks of medical complications later on in life. More to the point, maintaining this level of physical exercise through to our 50s or older reduces the risk of developing high blood pressure — a condition that may lead to heart attack and stroke.

Running from your problems

“Results from randomized controlled trials and observational studies have shown that exercise lowers blood pressure, suggesting that it may be important to focus on exercise as a way to lower blood pressure in all adults as they approach middle age,” said senior author Kirsten Bibbins-Domingo, MD, Ph.D., of the UCSF Department of Epidemiology and Biostatistics.

“Teenagers and those in their early twenties may be physically active but these patterns change with age. Our study suggests that maintaining physical activity during young adulthood — at higher levels than previously recommended — may be particularly important.”

The study followed roughly 5,000 adults (ages 18 to 30) for 30 years, who were in the Coronary Artery Risk Development in Young Adults (CARDIA) study. They came from urban backgrounds in Birmingham, AL, Chicago, Minneapolis, and Oakland, CA. The study recorded their exercise habits, medical history, alcohol intake, and smoking status. Each participant’s blood pressure, weight, cholesterol, and triglyceride levels were also monitored during this time. It was considered that a participant had hypertension if their blood pressure was 130 over 80 mmHg or higher, in line with the threshold established by the American College of Cardiology/American Heart Association.

Approximately half the participants were Black (51.6%) and the remainder were White. Slightly under half (45.5%) were men.

Black men were found to be the most active group in early adulthood, exercising slightly more than White men, and significantly more than Black and White women. By age 60, Black men’s physical exercise, on average, dropped to under half (from 560 exercise units to around 300 units), which is equivalent to the recommended two-and-a-half hours a week of moderate-intensity activity. Still, this was less than what White men managed to get in (approximately 430 units), slightly more than what White women achieved on average (320 units), and significantly more than what Black women managed by this age (around 200 units per week). However, Black men reported the highest rates of smoking, which may preclude physical activity over time.

Physical activity for White men declined in their twenties and thirties, stabilizing at around age 40. For White women, physical activity hovered around 380 exercise units, decreasing in their thirties, and remaining constant to age 60.

“Although Black male youth may have high engagement in sports, socio-economic factors, neighborhood environments, and work or family responsibilities may prevent continued engagement in physical activity through adulthood,” said first author Jason Nagata, MD, of the UCSF Division of Adolescent and Young Adult Medicine.

Hypertension at age 60 was diagnosed in around 80% to 90% of Black men and women, around 70% of White men, and around 50% of White women. These figures align well with the average reported exercise rates among the different groups, the team explains. Furthermore, it also aligns well with previous research which found that exercise can help lower blood pressure. The results, therefore, showcase the importance of maintaining an active lifestyle that includes at least five hours of moderate exercise per week even as we grow older.

The almost 18% of participants who maintained moderate levels of exercise for at least five hours a week during early adulthood (which is double the current recommended minimum) had an 18% lower likelihood of developing hypertension compared to those who exercised less, further supporting the team’s conclusions.

“Nearly half of our participants in young adulthood had suboptimal levels of physical activity, which was significantly associated with the onset of hypertension, indicating that we need to raise the minimum standard for physical activity,” Nagata said. “This might be especially the case after high school when opportunities for physical activity diminish as young adults transition to college, the workforce and parenthood, and leisure time is eroded.”

The paper has been published in the American Journal of Preventive Medicine, and will be available online shortly.

What’s the ideal blood pressure by age

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Ideally, we should all strive to have a blood pressure below 120/80mmHg. However, most people have blood pressure readings in the range of 120/80mmHg or 140/90mmHg.

What is blood pressure anyway?

Pressure is simply the amount of physical force exerted on an object. In this case, blood pressure refers to the force exerted by blood pushing against the walls of blood vessels.

When blood pressure is too high, a person’s arteries are subjected to a continuous strain that, in time, can lead to life-threatening cardiovascular disease.

What do the readings of blood pressure mean?

Blood pressure is measured in ‘millimeters of mercury’ (mmHg) and is read for two values. For instance, the optimal blood pressure is 120 over 80 or 120/80mmHg.

The first value represents the systolic blood pressure, which is the highest pressure that the blood reaches when the heartbeats.

The second value is the diastolic blood pressure, which corresponds to the lowest level of blood pressure that occurs when the heart’s muscles relax between beats.

Measuring your blood pressure with a blood pressure monitor is important because having a high reading (hypertension) is not something you can notice or feel.

However, if blood pressure is measured just once and found to be high, it doesn’t necessarily mean that it’s always too high. In order to get a reliable reading, blood pressure has to be measured on several different days while you are resting.

Signs and symptoms of high blood pressure

Usually, people cannot tell they have high blood pressure unless they have it measured. Anything above 140/90 is considered high blood pressure. However, occasionally people with high blood pressure report frequent headaches.

It’s important to note that your blood pressure will vary significantly and a single high blood pressure reading isn’t necessarily a cause for concern. If the reading is above this threshold after weeks of constant measurement, then you can safely presume that you may indeed suffer from hypertension.

Why blood pressure is so important to health

Although a blood pressure of 140 over 90 is considered normal, everyone should strive to lower it even further in order to stave off heart disease and strokes.

For instance, someone with a blood pressure reading of 135/85 is twice as likely to have a heart attack or stroke as someone with a reading of 115/75

An optimal blood pressure is paramount to the structural integrity of your arteries. Imagine a copper pipe in a water supply system — after many years, it will corrode and form micro-wears from all the friction between the water flow and the pipe’s walls. Eventually, it will break, but its operating life can be extended if the water pressure doesn’t cross a critical threshold.

While this analogy isn’t perfect (arteries don’t corrode and some damage can be healed), your arteries will naturally weaken with age after countless liters of blood flowing through them.

High blood pressure increases the risk of having a heart attack, which can cause heart failure. However, poor health outcomes extend beyond the cardiovascular system.

Why your blood pressure is too high

There are a number of reasons why a person may suffer from hypertension.

As we age, blood pressure typically increases due to the wear and tear accumulated by blood vessels over the years. There are also genetic factors that may influence blood pressure. For instance, African-Caribbean and South Asia communities tend to be at a higher risk of high blood pressure. High blood pressure can also run in the family.

All other things being equal, high blood pressure is typically the result of lifestyle choices, particularly diet. Too much salt, not enough fruits and vegetables, and drinking too much alcohol can increase blood pressure. Being overweight and not exercising can also substantially increase the risk of hypertension.

Blood pressure chart

If you made it this far then you now know how to correctly read your blood pressure but perhaps you’re not entirely sure how to interpret the measurement. The chart below is a good place to start, as it shows the ranges of high, low, and normal blood pressure readings.

You may have noticed that only one of the two values needs to be higher or lower to count as either high blood pressure or low blood pressure. For instance, if your top number (systolic blood pressure) is higher than 140, then you have high blood pressure regardless of your bottom value (diastolic blood pressure). Likewise, if your bottom number is higher than 90, then you have high blood pressure regardless of the top number’s reading.

What constitutes high blood pressure by age?

It’s normal for your blood pressure to increase as you age. The table below should give you a rough estimate of what healthy levels should look like.

1 – 280/34 – 120/7583/38 – 117/76
Ideal blood pressure by age.

Can your blood pressure ever be too low?

Low blood pressure, also known as hypotension, is generally anything below 90/60 mmHg. If any of the two values is lower than 90 or 60 for systolic and distolic blood pressure, respectively, this counts as having low blood pressure.

Generally, this is a good thing, because it means that the risk of a stroke or heart disease is minimal. Most people with hypotension do not require treatment.

There may be instances when a person’s blood pressure is low temporarily due to medication. And, sometimes, people can have low blood pressure naturally but this is no reason for concern in and of itself — although, in some instances, low blood pressure has been associated with depression.

However, if a patient feels dizzy or like fainting and blood pressure is low, a doctor’s appointment is warranted.

How to lower your blood pressure

You might be worried by your high blood pressure, but the good news is that it can be lowered to optimal levels with some proper foresight.

Although medication may be prescribed by a doctor in order to lower blood pressure, the safest course of action is to make long lasting lifestyle changes.

Diet is extremely important in this context. First and foremost, patients suffering from hypertension should be mindful of their salt intake. In fact, you may want to cut it out entirely out of your diet. Just remember that most of the salt you eat is actually found in products that are already prepared, such as breakfast cereals, ready-made meals, and bread. Be sure to check the nutritional facts label on the products you select from the supermarket.

Eating more fruits and vegetables can also help to lower blood pressure. A healthy amount is five portions of fruit and vegetables per day, where a portion weighs roughly 80 grams. Watch out for added salts when buying frozen or tinned fruits and vegetables from your local supermarket.

A healthy diet will also help you to mitigate another important risk factor for hypertension: being overweight. Exercising and a low-calorie diet can help you reduce your weight to more healthy levels — your blood pressure drops along with those extra pounds. Additionally, doing cardio also keeps the heart healthy.

Finally, be mindful of your alcohol intake. Both men and women should limit their alcohol consumption to 14 units per week, where a unit is equivalent to a small glass of wine or half a pint of beer.

High blood pressure medication is safe for COVID-19 patients

Credit: Wikimedia Commons.

Since there are many unknowns about the novel coronavirus and how it affects the human body, cardiologists have voiced important concerns surrounding high blood pressure medication. Their calls for urgent research have been met by scientists at the New York University (NYU) Grossman School of Medicine, who thankfully found that high blood pressure medication doesn’t seem to increase the risk of infection or of developing severe forms of COVID-19.

High blood pressure medication is surprisingly safe

The researchers led by Harmony Reynolds, Associate Director at the Cardiovascular Clinical Research Center at NYU, studied the medical history of 12,594 COVID-19 positive patients. Specifically, the researchers analyzed COVID-19 outcomes for those taking medication for high blood pressure.

There was no link between treatment with four common drug classes for high blood pressure — angiotensin-converting enzyme (ACE) inhibitors, angiotensin receptor blockers (ARBs), beta blockers, or calcium channel blockers  — and the likelihood of becoming infected with the coronavirus.

What’s more, there was no additional risk of developing more severe forms of COVID-19 that might require hospitalization in an intensive care unit or the use of mechanical ventilators. The findings appeared in the New England Journal of Medicine.

“With nearly half of American adults having high blood pressure, and heart disease patients more vulnerable to COVID-19, understanding the relationship between these commonly used medications and COVID-19 was a critical public health concern,” said Reynold.

“Our findings should reassure the medical community and patients about the continued use of these commonly prescribed medications, which prevent potentially severe heart events in their own right.”

The drugs included in the study regulate blood pressure by acting upon the renin-angiotensin-aldosterone hormonal system. One important component of this system is angiotensin II, a signaling protein that narrows blood vessels, thereby increasing blood pressure.

Levels of angiotensin II are controlled by the angiotensin-converting enzyme (ACE), which is also the target of many drugs for hypertension.

One version of ACE, ACE2, is abundantly present in the outer membrane of lung cells. The general consensus is that the novel coronavirus attaches itself to ACE2 receptors in lung cells using its ‘spike’ protein.

The use of ACE inhibitors boosts the expression and abundance of ACE2 receptors, and thus potentially increases the number of portals for SARS-CoV-2 to enter cells throughout the body.

This is why many cardiologists were concerned about the impact that medication designed to inhibit ACE might have on the prognosis of COVID-19 patients.

Fortunately, this doesn’t seem to be the case. In fact, ACE inhibitors might actually reduce lung injury.

Earlier last week, researchers at the University of California San Diego School of Medicine launched a clinical trial to investigate whether a drug approved for treating high blood pressure, heart failure, and diabetic kidney disease might also reduce the severity of COVID-19 infections. The trial will include participants from various sites across the United States, including New York, New Jersey, California, Massachusetts, Washington, Texas, and Illinois.

Exercise is as good as medicine for lowering blood pressure in patients with hypertension

Exercising could lower blood pressure in patients with hypertension by just as much as medication.

Credit: Pixabay.

British researchers at the London School of Economics and Political Science combed through the results of more than 400 randomized clinical trials that assessed the effects of drugs or exercise had on blood pressure. The meta-analysis found that, overall, both types of interventions lowered blood pressure by approximately 9 mmHg (millimeters of mercury) in patients with high blood pressure.

All in all, the researchers analyzed data on 10,461 participants in exercise trials and 29,281 in medication trials. None of the studies, however, compared the effects of medication to exercise — that’s where this meta-analysis came in.

According to the results, medication was more effective than exercise at lowering systolic blood pressure — which measures the pressure in your blood vessels generated by your beating heart — in participants with normal, elevated, and high blood pressure. But, when the British researchers zoomed in on a sub-group of patients who had hypertension (140 mmHg or higher), they found that exercise was just as effective as a medicine.

All types of exercise, including cardio and strength training, offer a benefit for patients dealing with hypertension, even at a lower intensity. However, people 55 and older see fewer benefits from exercising because their arteries get stiffer with age.

The authors hope that their results renew interest in finding new strategies for promoting exercise. The researchers say that physicians ought to suggest an exercise regime for their patients, perhaps alongside medication. For some patients, if the exercise lowers blood pressure enough, they would then be able to cut down on some of their medication.

But even if exercising doesn’t lower your blood pressure enough to take you off medication, there are other upsides that make it worth it anyway. This includes weight loss, loss of visceral belly fat, improved mood and cognitive health, protection against stroke, and other cardiovascular problems, and the list could go on.

The findings appeared in the British Journal of Sports Medicine.

1 in 5 young adults suffering from high blood pressure in the US

Researchers at the University of North Carolina-Chapel Hill have found that more and more young adults are suffering from a condition that has traditionally been the problem of older adults – high blood pressure.

The researchers believe that general problems, such as an unbalanced diet, coffee, and obesity are the main causes for this surge in heart related issues amongst this category of people. Published in this week’s edition of the online journal Epidemiology, the study states that they tested over 14.000 people between the ages of 24 and 32, and found that almost twenty percent were suffering from high blood pressure, a number five times bigger than the generally accepted one.

The thing is, high blood pressure is extremely easy to overlook, especially if you don’t expect it – like anyone in their 20s. Kathleen Mullan Harris, co-author of the paper and interim director at the University of North Carolina Carolina Population Center believes that the findings are results of a dormant epidemic.

“We tend to think of young adults are rather healthy, but a prevalence of 19 percent with high blood pressure is alarming, especially since more than half did not know that they had high blood pressure,” she said.

It is yet another sign of the huge problems obesity brings with itself, especially teamed up with a sedentary and unhealthy lifestyle.