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Early diagnosis of hypertension leads to avoidance or delaying the effects of hypertension on the body.
Blood pressure normally rises and falls throughout the day, but it can cause health problems if it stays high for a long time like yours. Having high blood pressure raises your risk for heart disease and stroke, leading causes of death in the world.(1)
For your information blood pressure readings are usually given as two numbers -- for example, 120 over 80 (written as 120/80 mmHg). One or both of these numbers can be too high. The top number is called the systolic blood pressure, and the bottom number is called the diastolic blood pressure. Normal blood pressure is when your blood pressure is lower than 120/80 mmHg most of the time.
High blood pressure (hypertension) is when your blood pressure is 140/90 mmHgor above most of the time. If your blood pressure numbers are 120/80 or higher, but below 140/90, it is called pre-hypertension. If you have pre-hypertension, you are more likely to develop high blood pressure.(2)However, for diabetic and chronic kidney disease patients, the normal blood pressure should not cross 130/80 mmHg.
(A) (B)
Fig.1. Diagram of (A) Blood Pressure (B) Measurement
Signs and Symptoms: Hypertension itself usually has no signs or symptoms. Rarely, headaches may occur.
You can have hypertension for years without knowing it. During this time, the condition can damage your heart, blood vessels, kidneys, and other parts of your body.
Some people only learn that they have hypertension after the damage has caused problems, such as coronary heart disease, stroke, or kidney failure.(3)
Self-care instructions:
You can do many things to help control your blood pressure, including:(2)
Eat a heart-healthy diet, including fibres, and drink plenty of water.
Hypertension is a chronic life-long condition. Do not forget to take medicines if your doctor has prescribed medicines to control the blood pressure. Ask your doctor for the side effects of the medicines and signs and symptoms to look out for.
Exercise regularly - at least 30 minutes of aerobic exercise a day. Find an exercise buddy.
If you smoke, quit - find a program that will help you stop.
Limit how much alcohol you drink. Try to stop it altogether.
Limit the amount of sodium (salt) you eat -aim for less than 1,500 mg per day. (< 1 tbsp/ day)
Reduce stress - try to avoid things that cause you stress. You can also try meditation or yoga.
Stay at a healthy body weight -find a weight-loss program to help you, if you need it. Keep a track on your weight
When blood pressure stays high over time, it can damage the body. On long term and if untreated, Hypertension can cause:
The heart to get larger or weaker, which may lead to heart failure.
Aneurysms to form in blood vessels. An aneurysm is an abnormal bulge in the wall of an artery. Common spots for aneurysms are the main artery that carries blood from the heart to the body; the arteries in the brain, legs, and intestines; and the artery leading to the spleen.
Blood vessels in the kidneys to narrow. This may cause kidney failure.
Arteries throughout the body to narrow in some places, which limits blood flow (especially to the heart, brain, kidneys, and legs). This can cause a heart attack, stroke, kidney failure, or amputation of part of the leg.
Blood vessels in the eyes to burst or bleed. This may lead to vision changes or blindness.
How to prevent the complications:
Adults over 18 years should have their blood pressure checked regularly like once every year or as doctor consults.
Lifestyle changes may help control your blood pressure.
Follow your health care provider's recommendations to modify, treat, or control possible causes of high blood pressure.
You should consult with your doctor after 1, 3, 6, 9 and 12 months once your hypertension is detected. An ECG should be done every time you visit your doctor. After 6 and 12 months, along with ECG, some more tests like 2D Echo, fasting blood sugar, serum creatinine, lipid profile, and micro-albumin needs to be done.
Schedule for Consultations/Diagnostic tests: You will receive automatic reminders upto 1 week prior to when your consultation and lab tests become due. ...more
Being active and taking regular exercise lowers blood pressure by keeping your heart and blood vessels in good condition. Regular exercise can also help you lose weight, which will also help lower your blood pressure.
Maintain a healthy BMI (a measure of body fat) of less of 23. This will aid maintaining weight and stable blood pressure levels. BMI is calculated by
BMI = Weight in Kg / (Height in meter)2
Adults should do at least 150 minutes (2 hours and 30 minutes) of moderate-intensity aerobic activity (i.e. cycling or fast walking) every week. For it to count, the activity should make you feel warm and slightly out of breath. The normal heart rate range 60-100 beats per minute. Aim to stay within a target heart rate zone that is 55 to 70 percent of your maximum heart rate to exercise moderately. Calculate your max heart rate by subtracting your age from 220. Someone who is overweight may only have to walk up a slope to get this feeling. Physical activity can include anything from sport to walking and gardening.
Exercises which can be followed:
A. Marching on the spot with dumbbells
Stand upright and carry lightweight dumbbells by your sides.
March continuously on the spot, keeping your knees low and avoid swinging your arms.
Do this continuously for 30 to 60 seconds before taking a short break.
Do the exercise four to six times.
B. Marching on the spot with hammer curl
Stand upright and carry lightweight dumbbells by your sides.
March on the spot, with your knees lifted high. To do so, flex your right hip and left arm at the same time till the knee and elbow are each bent at 90 degrees. Return to the starting position and repeat with the left hip and right arm. Do this continuously. Breathe normally and do not hold your breath when lifting the weights.
Depending on your fitness level, start with 30 to 60 seconds for each set of marching. Then, slow down by marching on the spot with dumbbells by your side for another 30 to 60 seconds.
Do the exercise four to six times.
C. Squat with bicep curl
Carrying dumbbells at your sides, march continuously on the spot for 30 to 60 seconds.
Then stop and do a quarter squat, with your legs shoulder-width apart and your arms by the side.
Stand upright again and flex both arms upwards to perform bicep curls. Breathe normally while doing this exercise and do not hold your breath when lifting the weights. Then return both arms to your sides.
Depending on your fitness level, start with 10 repetitions and progress to 20.
Then march on the spot, holding the dumbbells by your sides, for 30 to 60 seconds.
Do the exercise four to six times
D. Walking lunge
Carrying dumbbells at your sides, march continuously on the spot for 30 to 60 seconds.
Take one step forward with your right leg and lower your body slightly. At the same time, flex the left elbow upwards fully till the dumbbell is parallel to the floor. Return to the starting position, lowering the left arm back to the side. Repeat with the other leg and arm. Breathe normally while doing the exercise. Do not hold your breath when lifting the weights.
Depending on your fitness level, start with 10 repetitions and progress to 20 repetitions on each leg.
Then march on the spot, holding the dumbbells by your sides, for 30 to 60 seconds.
Do the whole sequence of 10 to 20 repetitions on each leg and marching on the spot four to six times.
Maintaining an Ideal Weight is crucial as obesity is a big risk factor for hypertension.Even losing 5 kilos can reduce blood pressure (BP). Calculate your Body Mass Index (BMI) here and aim to keep it below 23.
Physical Activity
A moderate intensity workout lasting 30 -60 minutes daily can help lower BP and also help maintain a healthy weight.
Alcohol
Abstinence is the best policy
Alcohol is high in calories and known to increase blood pressure. Talk to your doctor to know more about how much alcohol can be consumed.
Tobacco and Smoking
Quit!
Tobacco and second-hand smoke as it can lead to other cardiovascular diseases (CVD). Call - the Quit Line, 1800-22-77-87. For more-
Stress Management
Stress can increase BP. Incorporate a daily routine to relax and rejuvenate - try to listen to soothing music, chant, read a book or meditate.
Yoga can also help, check out (it is in Hindi language) -
Caffeine
Limit intake of tea, coffee, colas and chocolate to only 1 Cup a day. Lowered caffeine intake is known to induce a better sleep during the night and reduce BP
Some lifestyle changes can prove beneficial in lowering BP. The measure of how much can be lowered is listed in the table below-
To avoid the state of hypertension and high BP, it is necessary to combine positive dietary and lifestyle changes with the recommended medications. Typically, food items can be classified into six major groups as shown in the Healthy Heart pyramid.(7)
Immediate Diet Plan
Do's
Include lots of fresh, seasonal, local and if possible organic Fruits and Vegetables.
Add plenty of Whole Grains (whole wheat flour, brown rice, whole beans).
Choose foods high in Good Fat such as olive oil, peanut oil, fatty fish, walnuts, flax seeds. If you do not eat fish, talk to your doctor about taking fish supplements like cod liver oil capsules.
Don'ts
Say NO to all Sugary beverages and foods. Do not add any extra sugar to beverages like tea coffee etc. Especially if you are diabetic.
Refined ingredients like white rice, white flour, maida should be completely omitted from diets. Especially if you are diabetic.
Avoid combination of sugary and refined foods like cakes, pies, ice creams as they do the most harm. Especially if you are diabetic.
Avoid Unhealthy Fats such as Cholesterol, Saturated and Trans Fat. Stay away from egg yolks, cream, butter, ghee, coconut, deep fried items, whole milk, dalda, vanaspati. No Carbonated, Caffeinated and Alcoholic beverages.
Curb Salt intake, as it can increase blood pressure. Don't add salt while cooking and reduce packaged food consumption.
Sample Diet Plan (patient with Hypertension) Check portion sizes for each food by going to these links.(9),(10)Do not add SALT or SUGAR while cooking or as seasoning. For cooking, use only Olive oil or Peanut oil.
Early Morning
- 1 Cup (250ml) lukewarm water with 1 Tbsp. freshly squeezed lemon juice and 1/2 tsp. honey
Breakfast
- 1 Ragi Dosa (Recipe) OR 1 Moong Dal Dosa (Recipe)
Early Morning Snack
- 1/2 Cup boiled Sweet potatoes, sprinkled with lemon juice OR Brown rice Poha
Mid-Morning Snack
- 2 dried Figs and 1 whole Walnut
Lunch
- 1 large bowl of tossed Salad (carrots, cucumbers, beets, tomatoes and onions)
- 1 Multigrain phulka OR Jowari Roti
- 1 Cup Palak/Plain Dal OR 1 Cup Rajma
- 1 Cup Buttermilk
(Dressing - mix Olive oil, lemon juice and pepper)
Mid Afternoon Snack
- 1/2 Cup Mixed sprouts OR Chole salad (Recipe)
- 1 Cup Green Tea (no milk added)
Early Dinner Snack
- 2 Ragi Biscuits
- 1/2 Cup cubed Papaya OR Musk melon
Dinner
- 1/2 Cup Brown rice with 1 Cup Mixed vegetable sambar OR 1 Cup Brown rice Khichadi with 1 small bowl of Raita made with low fat yoghurt - 1 Cup Cabbage curry OR Bottle gourd (Lauki) curry
- 1 Cup Buttermilk
Late Night Snack
- 1/2 Cup Skim milk infused with Saffron
Life Long Instructions
It is never too late to adapt a healthy lifestyle.
Maintain a balanced diet and perform regular physical activity.
Eat foods that are low in saturated fats and cholesterol.
Avoid foods high sodium content.
If overweight or obese, loose the extra kilos and maintain a healthy weight. Quit smoking and cut down on alcohol.
Check your blood pressure regularly.
Eat Right and Exercise your way to a Healthy Heart.
