To Your Health: A Silent Killer, Hypertension!

29 Nov To Your Health: A Silent Killer, Hypertension!

Part-time Telluride local, Dr. Alan Safdi, is a world-renowned internist and gastroenterologist with encyclopedic knowledge of mind-body wellness and preventative medicine. He posts regularly on Telluride Inside… and Out under the banner of “To Your Health.” Dr. Alan’s blogs feature the most current information in his fields: health, wellness and longevity.

Links to Dr. Alan’s other podcasts and narratives on COVID-19 and more are here.

This week, Dr. Alan talks about hypertension, the silent killer. His podcast on the subject is here.

For more information about hypertension, read on.

An estimated 46% of U.S. adults have consistently high blood pressure that could lead to a diagnosis of hypertension. Hypertension can increase your risk for heart disease and stroke, so people with hypertension often wonder how they got it, and many without hypertension ask if they are at risk of getting it later in life.

Here, we’ll look at things that might cause blood pressure to go up, including risk factors and causes for hypertension.

Please remember that high blood pressure, or hypertension, is common and most often silent until it results in a catastrophic consequence. It can damage the heart, blood vessels, and kidneys. Over time, it can result in heart attack, heart failure, stroke, or chronic kidney disease.

The best way for people to lower their blood pressure is by following a healthful lifestyle. Doing this involves eating a healthful diet that is rich in all of the nutrients that the body needs to stay healthy. Unfortunately it also may require medical therapy. Please consult your healthcare provider for screening and if needed treatment. Do not ignore this silent disease.  Blood pressure measurement is the cheapest, simplest and perhaps most important of all medical tests. Even small changes in your average blood pressure, up or down, can affect your cardiovascular risk.

American Heart Association’s most recent guidelines for diagnosing and treating heart-related diseases identify the following issues as causes of hypertension.

1) Genetics

Some researchers believe that certain genes in your DNA can cause hypertension. Although there is little we can do to change our genetics at this time, telling your healthcare provider if your parents, grandparents, or siblings have hypertension can help them know if it runs in your family and if you might be at risk.

2) Being overweight or obese

Multiple studies show that people who are overweight or obese tend to have higher blood pressure than those who are not. Some have even suggested that significant excess weight is behind almost 40% of all hypertension diagnoses. If you are overweight, the best thing to do to reduce your risk is to lose weight by maintaining a healthy diet and exercising regularly.

3) Eating too much sodium

Regularly eating too much sodium (such as from table salt or the salt in processed foods) is known to increase your risk of hypertension. Americans seem to over-consume salt. The Association recommends eating less than 1500 mg of salt a day, but on average, Americans eat over 3400 mg daily! Reducing that by just 1000 mg can have great benefits.

Long-term, high-salt intake can increase your risk for stroke, heart problems, and other health issues. Older adults, African Americans, and people with diabetes or kidney problems may need to aim for even lower salt intake than the 1500 mg per day recommendation, as research shows that blood pressure in these groups tends to respond more strongly to salt.

If you regularly consume a lot of salt, lowering your intake can help lower your risk for hypertension and other related heart problems.

4) Eating too little potassium

While high sodium intake can cause high blood pressure, not enough potassium can also be a problem. People who regularly eat a healthy amount of potassium may have lower blood pressure. The Association recommends eating 3500 mg to 5000 mg of potassium a day. Eating too much potassium can also be bad and cause heart problems, so make sure to talk to your health care provider about your potassium levels and what kinds of potassium-containing foods you should eat.

5) An inactive lifestyle

The less active you are, the higher your risk of developing hypertension, regardless of age. This seems to be especially true for Caucasian men. To reduce your risk, ask your healthcare provider about an exercise routine that suits your age and overall health.

6) Chronic, excessive alcohol consumption 

We’ve known for over a century that excessive alcohol consumption can cause hypertension. In fact, almost 10% of the U.S. population may have hypertension due to drinking excessive amounts of alcohol. Not only does alcohol cause your blood pressure to rise, but high amounts of alcohol can increase cholesterol levels, which can also be bad for your heart. For these and other health reason, it is important to limit your alcohol intake to fewer than two drinks a day for men and one drink a day for women*.

*One drink is defined as 12 oz. beer, 4 oz. of wine, 1.5 oz. of 80-proof spirits, or 1 oz. of 100-proof spirits.

7) Medication side effects: Many hypertensive patients may be inadvertently taking medications that raise blood pressure (BP). Nearly 1 in 5 people with hypertension take BP raising meds. The most common ones taken by in a recent study were antidepressants (8.7%), prescription nonsteroidal anti-inflammatory drugs (NSAIDs; 6.5%), steroids (1.9%), and estrogens (1.7%).

Some common medications that can cause high blood pressure or make hypertension worse are:

Non-steroidal anti-inflammatory drugs (NSAIDs). This family of drugs includes many over-the-counter pain relievers like ibuprofen, naproxen, and aspirin. Taking them daily for extended periods of time can lead to high blood pressure, and if you have hypertension, you should double check with your doctor before taking them.

Oral and injectable steroids. Steroids like prednisone, dexamethasone, and methylprednisolone are used to help with inflammation, allergic reactions, lung infections, and joint conditions. They also come with a lot of side effects, including high blood pressure.

Decongestants. Even when some of these are taken for just a few days, they make your heart beat faster and can cause temporary high blood pressure. An example of these medications are ones that contain pseudoephedrine (Sudafed), phenylephrine PE (Sudafed PE), or ephedrine (Primatene) Always discuss these medications with your provider before taking them, especially if you have been diagnosed with hypertension.

Some people may have an underlying health problem that can cause them to have high blood pressure. Treating these conditions can help to lower blood pressure or even reverse hypertension. Below are a few examples.

8) Kidney problems

The kidneys are very important organs, responsible for getting rid of many waste products and toxins when you urinate. Unfortunately, when the kidneys don’t work well, it can cause your body to retain fluid, leading to higher blood pressure and possibly, hypertension. Many things can cause kidney dysfunction. If your doctor suspects you have kidney dysfunction, they may have you take some blood tests to see if your kidneys are challenged in any way.

9) Obstructive sleep apnea

Surprisingly, many people with sleep apnea have high blood pressure, which can lead to hypertension. We think sleep apnea causes hypertension by interfering with your body’s normal breathing rhythm and oxygen supply. If you find out that you experience disrupted sleep (either on your own or from someone who has observed you sleeping), it is important to talk to your doctor about that. A sleep study can help you determine if you have sleep apnea and if you need a breathing device (known as a CPAP machine) at night. Treating sleep apnea can help lower your blood pressure so you don’t need hypertension medications.

10) Hormone imbalances

Many hormones in your body help to control your blood pressure. When the balance of these hormones is off, you might experience a change in your blood pressure. For instance, too much thyroid hormone or aldosterone in your bloodstream can lead to high blood pressure. Your doctor can help you confirm if your hormone levels are off with some simple blood tests.

A couple of examples are adrenal gland tumors and thyroid problems.

11) New information about diabetes and hypertension

Lowering blood pressure – known to prevent the vascular complications of type 2 diabetes – can also stop the onset of diabetes itself, although the effects vary according to antihypertensive drug class, results from a new meta-analysis show.

Angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers (ARB) – so-called renin-angiotensin system (RAS) blockers – showed the strongest association with preventive effects, while conversely, beta-blocker and thiazide diuretic antihypertensives were linked to an increased risk of new-onset diabetes.

Lifestyle changes are an integral part in the management of hypertension.

• Eating a healthful, balanced diet

• Reducing salt consumption

• Exercising regularly

• Maintaining a moderate weight

• Limiting alcohol consumption

• Quitting smoking, if applicable

• Managing stress levels

As you can see, some causes of hypertension can be managed with healthy lifestyle habits, such as keeping a balanced diet and exercising regularly. Other causes, like medication side effects or an underlying health problem, may require more clinical guidance from your healthcare provider.

Dr. Alan Safdi, more:

Dr. Alan Safdi is board-certified in Internal Medicine and in Gastroenterology and is a Fellow of the American College of Gastroenterology. A proven leader in the healthcare arena, he has been featured on the national program, “Medical Crossfire” and authored or co-authored numerous medical articles and abstracts.

Safdi, a long-time Telluride local, has been involved in grant-based and clinical research for four decades. He is passionate about disease prevention and wellness, not just fixing what has gone wrong.

Dr. Alan is an international lecturer on the subjects of wellness, nutrition and gastroenterology.