With age, comes an increased risk for systolic hypertension which can be aggravated by severe atherosclerosis. According to one study, the diuretic chlorthalidone (Hygroton) had significant benefit in elderly patients with systolic hypertension. Along with a diuretic, some calcium channel blockers, ACE inhibitors and angiotensin II receptor blockers may also be good choices. However, beta blockers may not be as effective for hypertension in those over 60; though they may be good choices if co-existing heart disease is present. It also may be preferable in elderly patients to give two high blood pressure medications at a low dose versus one at a higher dose.
While you shouldn't shrug off the change, there's also no need to panic. "Obviously, nothing happened overnight inside a woman's body or to her health with the release of the guidelines," says Dr. Naomi Fisher, director of hypertension service and hypertension innovation at the Brigham and Women's Hospital Division of Endocrinology, Diabetes, and Hypertension, and associate professor of medicine at Harvard Medical School.
The new guidelines stem from the 2017 results of the Systolic Blood Pressure Intervention Trial (SPRINT), which studied more than 9,000 adults ages 50 and older who had systolic blood pressure (the top number in a reading) of 130 mm Hg or higher and at least one risk factor for cardiovascular disease. The study's aim was to find out whether treating blood pressure to lower the systolic number to 120 mm Hg or less was superior to the standard target of 140 mm Hg or less. The results found that targeting a systolic pressure of no more than 120 mm Hg reduced the chance of heart attacks, heart failure, or stroke over a three-year period.
Dietary changes: The health care provider might recommend a diet that includes more vegetables (especially leafy green vegetables), fruits, low-fat dairy products, and fiber-rich foods, and fewer carbohydrates, fats, processed foods, and sugary drinks. He or she also might recommend preparing low-sodium dishes and not adding salt to foods. Watch out for foods with lots of hidden salt (like bread, sandwiches, pizza, and many restaurant and fast-food options).
Exercise stress test: More commonly used for patients with borderline hypertension. This usually involves pedaling a stationary bicycle or walking on a treadmill. The stress test assesses how the body's cardiovascular system responds to increased physical activity. If the patient has hypertension this data is important to know before the exercise test starts. The test monitors the electrical activity of the heart, as well as the patient's blood pressure during exercise. An exercise stress test sometimes reveals problems that are not apparent when the body is resting. Imaging scans of the heart's blood supply might be done at the same time.
The drug of choice for hypertensive, pregnant women is one of the oldest high blood pressure medications on the market. Methyldopa, which works to lower blood pressure through the central nervous system, has the lowest risk of harming the mother and developing fetus. Other possible safe options include labetalol, beta blockers, and diuretics. Two classes of drugs which should never be used during pregnancy include the ACE inhibitors and the angiotensin II receptor blockers.
Electrocardiogram (ECG): This tests the heart's electrical activity. This test is more commonly used for patients at high risk of heart problems, such as hypertension and elevated cholesterol levels. The initial ECG is called a baseline. Subsequent ECGs may be compared with the baseline to reveal changes which may point to coronary artery disease or thickening of the heart wall.
Primary (or essential) hypertension is when the cause is unknown. The majority of hypertension cases are primary. When there is an underlying problem such as kidney disease or hormonal disorders that can cause hypertension, it is called secondary hypertension. When it is possible to correct the underlying cause, high blood pressure usually improves and may even return to normal.
While the words “blood pressure-lowering diet” may conjure images of unseasoned egg whites and limp steamed veggies, getting your blood pressure into a healthy range is more than just doable —it can be downright delicious. Start by adding the Eat This, Not That!-approved list of blood pressure-lowering foods into your regular routine and watch your numbers go from scary to stellar in no time.
There was a time when the high blood pressure medication list was very short indeed. In the 1950s, reserpine was one of the few products on the market to treat hypertension. It is rarely used due to its numerous side effects and drug interactions. The peripheral adrenergic inhibitors work in the brain to block signals that tell blood vessels to constrict. They are mostly used when other high blood pressure medications fail to solve the problem. Guanadrel (Hylorel), guanethidine monosulfate (Ismelin), and reserpine (Serpasil) are peripheral adrenergic inhibitors.
Other exercise options that don’t require a gym membership include body weight exercises, like pushups, squats, and jumping jacks. These exercises can be done at home or outside. For people who like going to the gym or running, these can be good ways to build community, notes Parker. Apps like Fitbit and MapMyRun can be helpful if you like keeping track of your steps, calories burned, weight, or number of miles run.
Whelton PK, Carey RM, Aronow WS, et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol. 2018;71(19):e127-e248. PMID: 29146535 www.ncbi.nlm.nih.gov/pubmed/29146535.
Many leafy greens, including everything arugula and kale to spinach and collard greens, contain potassium and magnesium which are key minerals to control blood pressure, according to Harvard Medical School. These nutrients are an important part of the DASH diet (Dietary Approaches to Stop Hypertension, or high blood pressure), which suggests a variety of foods that lower blood pressure. A potassium-rich diet helps the body become more efficient at flushing out excess sodium, which can raise blood pressure, and magnesium helps promote healthy blood flow, according to nutritionist Joy Bauer.
Not only the degree of obesity is important, but also the manner in which the body accumulates extra fat. Some people gain weight around their belly (central obesity or "apple-shaped" people), while others store fat around their hips and thighs ("pear-shaped" people). "Apple-shaped" people tend to have greater health risks for high blood pressure than "pear-shaped" people.
While fatty foods may seem like they have no place in a high blood pressure-fighting meal plan, fatty fish like salmon are a major exception to that rule. Salmon is loaded with heart-healthy omega-3 fatty acids, which can help reduce inflammation, lower your risk of heart disease, and get your blood pressure into a healthy range. Research published in the June 2012 edition of the British Journal of Nutrition reveals that omega-3 supplementation reduced blood pressure among older patients and those with hypertension, making this tasty protein-rich fish a must-eat for anyone whose blood pressure has crept into a concerning range.
If your blood pressure readings are consistently high, you and your doctor will probably discuss treatment strategies. Treatment for high blood pressure often begins with lifestyle changes such as a weight loss and exercise program as well as a low sodium diet. In fact, the AHA recommends adopting these strategies as a means of preventing the development of high blood pressure and heart disease. If these strategies are not successful in lowering your blood pressure, medications may be recommended.
Healthy blood pressure in adults is a reading below 120 systolic and 80 diastolic. Blood pressure between 120 to 129 systolic and under 80 diastolic is considered elevated. Elevated blood pressure means you have a greater risk of developing high blood pressure later on. Your doctor may suggest eating less salt, eating a heart healthy diet, or living a more active lifestyle.
Making some stuffed peppers for dinner tonight could be the first step on a journey toward a healthier heart and lower blood pressure. Bell peppers are an excellent source of vitamin C, with more of the potent antioxidant than even citrus fruits, which has been shown to improve cardiac function and lower blood pressure. Research published in the American Journal of Clinical Nutrition reveals that loading up on vitamin C reduced blood pressure by 5 millimeters of mercury in patients with hypertension, making these versatile veggies a smart addition to any meal plan.
Blood pressure rises as we get older but some people defy this seemingly inevitable development. Regular exercise, maintaining a healthy weight, a low fat (especially saturated animal fat) and low salt diet, quitting smoking and reducing the amount of alcohol consumed will all have an effect. Even allowing for all that, the blood pressure of vegetarians doesn’t increase in the same way as meat eaters’ – in fact, it goes up little with age. It’s not surprising, then, that a vegetarian diet can be used to treat high blood pressure. It is the totality of the vegetarian diet that works, not any specific ingredient. Vegetarians’ lower risk of high blood pressure is considerable and can be anywhere between 33-50 per cent. There is an inescapable link with meat and a Californian study as long ago as 1926 showed this.
Diuretics can lead to an increase in potassium loss, known as hypokalemia, which, in turn can affect muscular function -- including the muscles of the heart. There is also an increased risk for gout with diuretics -- as well as the possibility of weakness, thirst, dehydration, and increased urination. Changes in blood sugar levels are also possible. Skin reactions, some severe, are possible with thiazide diuretics (such as hydrochlorothiazide). Potassium-sparing diuretics, such as spironolactone (Aldactone) may cause breast enlargement in males.