DASH diet

Types of Hypertension – Understanding the Differences

Eli Ben-Yehuda

Written by Eli Ben-Yehuda

On July 2, 2019

Being newly diagnosed with high blood pressure your physician may decide to start you on medication to lower your high blood pressure, depending on the severity. Your physician may decide to start you on an ACE inhibitor. One such ACE Inhibitor is “Lisinopril”.

When people are discussing hypertension they are usually referring to primary hypertension or secondary hypertension. These two types of hypertension account for about 90% of all hypertension cases.

Primary hypertension is hypertension which the cause is unknown, this is also called essential hypertension. Secondary Hypertension is caused by another disease.

In this type of hypertension, once the root cause is treated, blood pressure usually returns to normal or is significantly lowered. Diseases that might be a cause of hypertension may be chronic kidney disease, sleep apnea, alcohol addiction, thyroid dysfunction and others.

However, there are several types of hypertension that are less common but are not less important. This means it is important to know how to monitor your hypertension based on its type.

Types Of Hypertension:

Malignant Hypertension

High blood pressure is usually called the “Silent Killer”. It is called this because it does not always have obvious signs or symptoms. Unlike moderate high blood pressure, malignant hypertension has very noticeable symptoms such as:

  • Changes in vision including blurry vision.
  • Chest Pain.
  • Anxiety.
  • Nausea or vomiting.
  • Numbness or weakness in the arms or legs.
  • Shortness of breath.
  • Headaches.
  • Reduced urine output.
Resistant Hypertension

So you have made lifestyle changes. You’re taking a diuretic and at least 2 hypertensive medications but your blood pressure is not budging. This is called resistant hypertension.

Simply put, it means your high blood pressure is hard to treat and may also have an underlying secondary cause.

Resistant hypertension may have one or more underlying medical conditions. In addition to treating resistant hypertension with medications, doctors usually investigate secondary cause such as:

  • Abnormalities in the hormones that balance and control blood pressure.
  • The accumulation of artery-clogging plaque in blood vessels that nourish kidneys, a condition known as renal artery stenosis.
  • Sleep issues such as a breath-holding type of snoring known as obstructive sleep apnea.
  • Obesity or a heavy intake of alcohol or other substances that interfere with blood pressure.
Pulmonary Hypertension

Some forms of pulmonary hypertension are serious conditions that progressively become worse and are sometimes fatal. Although some forms of pulmonary hypertension are not curable, treatment can help lessen symptoms and improve the quality of life.

There are several types of pulmonary hypertension and the treatment plan depends on the type. Symptoms can include but are not limited to:

  • Shortness of breath during routine activity, such as climbing two flights of stairs.
  • Fatigue.
  • Chest pain.
  • A racing heartbeat.
  • Pain in the upper right quadrant of the abdomen near the liver.
  • Decreased appetite.
Pseudo-Hypertension

This type of blood pressure usually appears in senior citizens. Non-compressibility, and Osler’s sign of pseudohypertension is a falsely elevated blood pressure reading obtained by the blood pressure machine. This is due to calcification of the blood vessels which cannot be compressed.

White coat hypertension

This is a fairly common phenomenon whereby blood pressure is only elevated when a patient is in the doctor’s surgery. People with white coat syndrome have normal readings at home, and only have high readings when their BP is taken by a doctor.

Isolated systolic hypertension

It’s not uncommon for patients to have either a systolic number that’s elevated while the diastolic number remains normal.

It’s less common to have an elevated diastolic number. This condition is known as isolated systolic hypertension, usually affects older people and tends to result from a clear and defined condition somewhere else in the body.

As a general rule of thumb, the systolic reading tends to be very high in these cases, often close to 200. If it isn’t then general high blood pressure is usually diagnosed. Where the systolic reading is especially high treatment options are generally different to treating general high blood pressure.

This type of blood pressure needs urgent treatment too since recent research carried out at The Heart Disease Prevention Program, University of California uncovered evidence to suggest that the higher the systolic pressure the greater the risk of death from heart disease.

Conclusion

There are various types of hypertension. Getting the correct diagnosis is vital in the treatment of your high blood pressure and getting control over it. Being educated and informed is the best thing you can do to help yourself in any medical matter. With a plethora of information available today we do not need to be misinformed.

Further Reading on types of hypertension:

References used for this Article:


Written by Eli Ben-Yehuda
Eli is a licensed Registered Nurse with 17 years experience. Eli graduated with a major in nursing and a minor in psychology. His postgraduate training was in trauma, oncology, and cardiology.

With a passion for health advocacy Eli researches and writes many articles concerning improving the lives of people diagnosed with high blood pressure and the complication they experience. He believes educating people is the best way to improve their overall health.

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What are the Causes of High Blood Pressure?

Eli Ben-Yehuda

Written by Eli Ben-Yehuda

On July 2, 2019

Imagine an intricate collection of both big and small hoses running throughout every single part of your body, from the top of your head to the tips of your fingers and toes. These are the blood vessels and arteries.

The arteries and blood vessels are tasked with the job of guiding our precious life-giving blood to circulate throughout the body, supplying all our cells and organs with the oxygen and nutrients they need to function optimally.

The heart is the pump that influences the level of pressure exerted. As the heart contracts, the pressure in the vessels and arteries increases (this is “systolic pressure,” the top number – eg: 120/). As the heart relaxes, the pressure decreases (this is “diastolic pressure,” or the bottom number – eg: /80).

But aside from the basic mechanisms that keep blood circulating through the body, there are also intricate neurological and physiological systems that collectively control blood pressure balance in your body. So interestingly, the actual causes of high blood pressure are largely unknown. However, we do know that there are many risk factors that contribute to the breakdown of these systems that regulate blood pressure levels. And the good news is, you can directly influence many of these systems through diet, lifestyle and behavioral changes.

What are the causes of high blood pressure?
Age

It is an unfortunate fact that our body ages. And as it does, progressive changes occur in the structure and function of our cardiovascular system, which can lead to changes in blood pressure, causing it to rise. Although you can’t reverse the clock, you can make lifestyle changes and look after yourself the best you can to assist your body to regulate blood pressure more efficiently, and therefore, reduce your risk of hypertension.

Family history

It is true that your genetics can place you at higher risk for developing hypertension as it is one of the major causes of high blood pressure. However, don’t fall into the trap of being the victim. If you engage in healthy lifestyle behaviors, you can reduce much of the risk associated with genetic factors.

Lack of sleep

In recent years, increasing workloads, stress, and technologies all make quality sleep a difficult thing to achieve. But in terms of blood pressure regulation, you really need good quality sleep.

In a study published in Artery Research, participants were required to complete two different sleep cycles. During the first cycle, they had a regular sleep-wake schedule. During the sleep-deprived cycle, they had less than 3 hours of quality sleep during a night shift schedule. The researchers discovered that after 7 days of sleep deprivation, blood pressure levels significantly increased (a rise of more than 3 mmHg) and so did heart rate (by more than 40 beats per minute).

Similar studies have also connected the lack of sleep to obesity, type 2 diabetes, heart disease, and stroke. The National Sleep Foundation recommends 7 to 9 hours of quality sleep each night. If you aren’t getting that amount, evaluate ways you can improve your sleep quality.

Weight gain

Carrying around extra weight every day places extra pressure on your cardiovascular system. Quite simply because it has to pump extra hard to circulate blood to where it needs to go. Aside from this, researchers suggest that neurons and inflammation in the hypothalamus (a part of the brain that acts as one of our key physiological and hormonal controllers), alters the sympathetic and central nervous systems, which may then contribute to the development of hypertension in obesity.

If you’re overweight, focus on weight loss with an aim to achieve a healthy BMI and a waist circumference under 40 inches for men and 35 inches for women. causes of high blood pressure bmi chart

Alcohol

Due to its effects on various physiological systems of the body, the consumption of alcohol leads to acute blood pressure increases. And if you continue to consume more than the recommended amount of alcohol each day, your risk for hypertension increases.

The National Heart Foundation recommends a maximum of two drinks per day for men and one drink per day for women. One drink is equivalent to one 12 oz. beer, 4 oz. of wine, 1.5 oz. of 80-proof spirits or 1 oz. of 100-proof spirits.

Diet

Research has shown that the higher a person’s sodium intake the more likely they are to develop high blood pressure. Americans get 71% of their daily sodium from “added” salt intake, much of which comes from processed and restaurant-bought foods. The American Heart Association recommends no more than 2,300 mg of sodium a day, though the ideal is no more than 1,500 mg. Read food labels and cut down on “added” salt in your diet. Sugar may also be a contributing factor.

In a study evaluating sugar-sweetened beverage (SSB) intake in children, researchers found that SSB intake significantly increased systolic blood pressure levels. Researchers suggest that because fructose in sugar is metabolized in the liver, it produces more uric acid. This uric acid has effects on cells in the artery wall, on the smooth muscle cells in the heart, and on the production of inflammatory molecules, all of which could influence blood pressure levels.

TIP: The World Health Organization recommends no more than 5% of calories comes from added sugar. In a 2,000 calorie diet that equals no more than 100 grams per day, which is equivalent to just 5 teaspoons.

OVERALL DIET TIP: The best thing you can do in terms of diet is to eat natural whole foods. Studies show that fresh food diets such as the Mediterranean and DASH can help reduce blood pressure and improve heart health.

Physical activity

causes of high blood pressure physical activityRegular exercise helps strengthen the cardiovascular system. Therefore, a lack of activity has the opposite effect – it can increase your risk of hypertension and heart disease.

The recommendation is 30 minutes of moderate exercise 5 days of the week. And it doesn’t have to cost a penny in gym fees – just get outside and go for a brisk walk in the fresh air – it’s one of the best forms of exercise to improve cardiovascular health!

Ethnicitye

More than 40% of non-Hispanic African-Americans have high blood pressure, even in early age. And while the exact cause is unknown, research indicates that obesity and diabetes are contributing factors. Additionally, African-Americans appear to have a gene that makes them more salt sensitive.

TIP: If you are of African-American descent, the importance of limiting your intake of processed foods and following a fresh food diet is even more important. Also, make sure you engage in regular exercise and practice healthy lifestyle behaviors.

Medications

causes of high blood pressure medication By way of the chemicals they contain, some medications can cause blood pressure increases.

These include non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen; antidepressants; corticosteroids; estrogens including birth control pills; cough, cold and asthma medications; migraine medications; nasal decongestants; and steroids or performance-enhancing substances.

TIP: If you’re concerned about medications affecting your blood pressure levels, speak to your doctor about options.

Medical conditions

In a small number of cases, other health conditions may contribute to the development of secondary hypertension. This includes medical conditions such as sleep apnea, certain heart defects, pregnancy-induced hypertension, kidney disease, and disorders.

While the causes of high blood pressure are not entirely clear, the most important thing to recognize is that high blood pressure is a serious condition because it can lead to heart attack and stroke. And because high blood pressure symptoms are often non-existent, those heart attacks and strokes often hit people out of the blue, which is why hypertension is called the silent killer!

Be sure to have your blood pressure measurements taken regularly by your physician or pharmacist. Because thankfully, with diet and lifestyle changes, along with the assistance of medications or natural alternatives, you can prevent hypertension and cardiovascular disease.

Further reading on the causes of high blood pressure:

Written by Jedha Dening Jedha is a qualified nutritionist (MNutr), researcher, author, freelance writer, and founder of type 2 diabetic nutrition site.

She has millions of words published in the health industry across various print and online publications. Having been in the field for over 15 years, she’s incredibly passionate about the latest research surrounding nutrition and health.


 

Reviewed by Alon Gitig, M.D., F.A.C.C.

Dr. Alon Gitig is a senior cardiologist in Mount Sinai Doctors Westchester and an assistant professor of medicine at the Mount Sinai Medical Center.

 

About RESPeRATE – Lower Blood Pressure Naturally.

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RESPeRATE lowers blood pressure by relaxing constricted blood vessels which is one of the major causes of high blood pressure. RESPeRATE does so by harnessing the therapeutic power of slow-paced breathing with prolonged exhalation in a way that is virtually impossible to achieve on your own. All you have to do is breathe along with RESPeRATE’s guiding tones.

Learn More…

What is Normal Blood Pressure?

Eli Ben-Yehuda

Written by Eli Ben-Yehuda

On July 2, 2019

Blood pressure falls into five general categories, ranging from normal blood pressure to hypertensive crisis (This is very dangerous).

The level of your blood pressure will determine the course of treatment your physician may require. To get an accurate blood pressure measurement, your doctor should evaluate your readings based on the average of two or more blood pressure readings at three or more office visits.

What’s a Normal Blood Pressure?

An optimal normal blood pressure level is reading under 120/80 mmHg.

120 represents the ‘top’ number, known as systolic blood pressure. Systolic: The blood pressure when the heart is contracting. It is specifically the maximum arterial pressure during contraction of the left ventricle of the heart. The time at which ventricular contraction occurs is called systole.

80 represents the bottom number, known as the diastolic blood pressure. Diastolic: Referring to the time when the heart is in a period of relaxation and dilatation (expansion). The diastolic pressure is specifically the minimum arterial pressure during relaxation and dilatation of the ventricles of the heart when the ventricles fill with blood.

For many years, readings over 120/80 mmHg and up to 139/89 mmHg were classified as ‘pre-hypertension,’ within the normal to high range. However, the American Heart Association and the American College of Cardiology have recently changed the blood pressure guidelines.

Now, anything between 120-129 systolic pressure with diastolic pressure under 80, is considered ‘pre-hypertension.’ This is when your doctor will recommend you get proactive and make diet and lifestyle changes because, during this early time, you can greatly reduce your risk of cardiovascular problems.

Blood pressure over 130/80 mmHg is now considered to be high.

A hypertensive crisis is blood pressure above 180/120 mmHg. If you experience blood pressure this high it is a medical emergency, so do not delay in visiting the hospital or calling 911.

How to check blood pressure?

When taking blood pressure reading, you should follow these simple rules:

  1. Make sure your feet are flat on the floor, and legs are uncrossed.
  2. Ensure your arm and back are properly supported.
  3. If you need to use the restroom go so you will feel comfortable
  4. Ensure your arm is bare, and the blood pressure cuff is on the skin, not over any clothing.
  5. Make sure you do not talk and that you have at least three minutes of quiet time prior to the measurement.

According to research, your blood pressure can elevate between 2-40mmHg by not following the simple guidelines for checking blood pressure. This can result in you being prescribed medication that you did not need.

Did you know?

  • When you have a full bladder – your BP can appear higher by 10-15mmHg
  • When you have an unsupported back or feet – your BP can appear higher by 5-10mmHg
  • When you have crossed legs – your BP can appear higher by 2-8mmHg
  • When you have the cuff over clothing – your BP can appear higher by 10-40mmHg
  • When you have an unsupported arm – your BP can appear higher by 10mmHg
  • When you are talking during reading – your BP can appear higher by 10-15mmHg

Now can you see why it is so important? Please, when you visit your doctor ensure they follow these guidelines while you are getting your blood pressure checked. I have seen medical technicians checking a patients blood pressure when the patient was laughing.

Blood Pressure Chart

The blood pressure chart used to look like this:

normal blood pressure chart

Under the new blood pressure guidelines, the blood pressure chart now looks like this:

new normal blood pressure chart

NOTE: Under these new guidelines, normal blood pressure has not changed, it is still below 120/80 mmHg. Only the higher ranges have changed to provide earlier intervention, with the goal of reducing the incidence of heart disease.

False high blood pressure reading

Elevated blood pressure is difficult to determine from one single reading. For instance, many people get what’s called ‘white coat hypertension.’ This is anxiety produced by the thought of visiting the doctor’s office.

Sudden or increased anxiety can temporarily increase blood pressure levels, which can give an inaccurate reading. Therefore, your physician may recommend you have regular blood pressure checks or use a home blood pressure monitor to record several readings.

How to take blood pressure reading at home

To help ensure accurate blood pressure monitoring at home:

  1. Check your device’s accuracy. Before using a monitor for the first time, have your doctor check its accuracy against the office model. Also, have your doctor watch you use the device to see if you’re doing it properly. If you drop the device or damage it, have it checked before using it again.
  2. Measure your blood pressure twice daily. The first measurement should be in the morning before eating or taking any medications, and the second in the evening. Each time you measure, take two or three readings to make sure your results are accurate. Your doctor might recommend taking your blood pressure at the same times each day.
  3. Don’t measure your blood pressure right after you wake up. You can prepare for the day, but don’t eat breakfast or take medications before measuring your blood pressure. If you exercise after waking, take your blood pressure before exercising.
  4. Avoid food, caffeine, tobacco, and alcohol for 30 minutes before taking a measurement. Also, go to the toilet first. A full bladder can increase blood pressure slightly.
  5. Sit quietly before and during monitoring. When you’re ready to take your blood pressure, sit for five minutes in a comfortable position with your legs and ankles uncrossed and your back supported against a chair. Try to be calm and not think about stressful things. Don’t talk while taking your blood pressure.
  6. Make sure your arm is positioned properly. Always use the same arm when taking your blood pressure. Rest your arm, raised to the level of your heart, on a table, desk or chair arm. You might need to place a pillow or cushion under your arm to elevate it high enough.
  7. Place the cuff on bare skin, not over clothing. Rolling up a sleeve until it tightens around your arm can result in an inaccurate reading, so you may need to slip your arm out of the sleeve.
  8. Take a repeat reading. Wait for one to three minutes after the first reading, and then take another to check accuracy. If your monitor doesn’t automatically log blood pressure readings or heart rates, write them down.

Blood pressure varies throughout the day, and readings are often a little higher in the morning. Also, your blood pressure might be slightly lower at home than in a medical office, typically by about five points.

Contact your doctor if you have any unusual or persistent increases in your blood pressure. Ask your doctor what reading should prompt an immediate call to the medical office.

Blood pressure by age

Average readings tend to be lower at a younger age and increase with age. During late adolescence years (around 17-19 yrs old) doctor typically begins to follow the standard adult guidelines for high blood pressure.

As we age, our bodies become more susceptible and at higher risk of developing high blood pressure.

In normal blood pressure for elderly & adults over 50, increased systolic blood pressure is a major risk factor for heart disease. Systolic blood pressure tends to increase steadily over time due to stiff arteries, a build-up of plaque, and a higher rate of cardiac and vascular disease. This means older adults need to be even more vigilant about monitoring their blood pressure.

According to the National Institute on Aging, males are more likely to have high blood pressure before age 55, while normal blood pressure for women tends to see a rise in after menopause. Women are less likely than men to experience complications associated with high blood pressure.

However, regardless of differences in the prevalence and complications of high blood pressure between the sexes, treatment and diagnosis are the same for both men and women.

Normal blood pressure for men and women

Refer to the below chart for Prevalence of hypertension among adults aged 18 and over, by sex and age

normal blood pressure prevalence chart by age and gender

Source: NCHS Data Brief No. 289, October 2017

Men are at greater risk for cardiovascular and renal disease than are age-matched, premenopausal women. Recent studies using the technique of 24-hour ambulatory blood pressure monitoring have shown that blood pressure is higher in men than in women at similar ages

After menopause, however, blood pressure increases in women to levels even higher than in men. Hormone replacement therapy in most cases does not significantly reduce blood pressure in postmenopausal women, suggesting that the loss of estrogens may not be the only component involved in the higher blood pressure in women after menopause. In contrast, androgens may decrease only slightly, if at all, in postmenopausal women.

Why is normal blood pressure so important?

Maintaining normal blood pressure is essential for heart health. When your blood pressure is high, your heart and arteries can become overloaded.

High blood pressure can accelerate the buildup of plaque on the artery walls (atherosclerosis), clogging blood flow to your heart muscle, putting you at risk of heart attack. It also weakens the walls of arteries in your brain which can cause a stroke.

It can affect arteries to other parts of your body too, such as the eyes, kidneys, and legs. Long-term high blood pressure is known as hypertension and is one of the main risk factors for heart disease.


Further Reading:


Dr. Cynthia Thaik

Reviewed by Dr. Cynthia Thaik, M.D.

Dr. Cynthia is a Harvard-trained Los Angeles cardiologist.

White Coat Hypertension or High Blood Pressure: Which Do You Have?

Eli Ben-Yehuda

Written by Eli Ben-Yehuda

On July 2, 2019

George, a 54-year-old general contractor, has been under a great deal of stress. With building contracts taking longer to do George is losing money. At his doctor’s appointment, his blood pressure was 140/86 at the nurse’s station.

When the doctor checked his blood pressure it spiked to 160/94. George was afraid the doctor will find something wrong with him during his exam. George was stressed when he arrived. His doctor has recommended that George start on a hypertension medication.

Clara has always the nervous type. She has recently moved to a new town and needs to find a new physician. At 27 she has always been afraid of doctors ever since an extensive illness as a child.

Every time she sees a physician her blood pressure spikes. The nurse checking Clara in recorded a blood pressure of 130/84. When the doctor took her blood pressure Clara’s blood pressure was 154/90. At home that morning it was 117/75. Her doctor wants to start her on a hypertension medication.

Visiting Your Doctor’s Office

Across the nation, this scenario plays out thousands of times every day.

Doctors routinely record blood pressure levels that are significantly higher than levels recorded by nurses, the first thorough analysis of scientific data has revealed. A systematic review has discovered that recordings taken by doctors are significantly higher than when the same patients are tested by nurses.

A systematic review led by the University of Exeter Medical School, and supported by the National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care in the South West Peninsula (NIHR PenCLAHRC), has discovered that recordings taken by doctors are significantly higher (by 7/4mmHg) than when the same patients are tested by nurses.

Dr. Christopher Clark, of the University of Exeter Medical School, said the findings, published in the British Journal of General Practice, should lead to changes in clinical practice. “Doctors should continue to measure blood pressure as part of the assessment of an ill patient or a routine check-up, but not where clinical decisions on blood pressure treatment depend on the outcome.

The difference we noted is enough to tip some patients over the threshold for treatment for high blood pressure, and unnecessary medication can lead to unwanted side-effects. Some patients may be erroneously asked to continue to monitor their own blood pressure at home, which can build anxiety. These inappropriate measures could all be avoided by the simple measure of someone other than a doctor taking the blood pressure recording.”

The phenomenon of doctors recording higher blood pressure is known as the “White Coat Hypertension,” and is thought to result from the patient’s physical response to being assessed by a doctor. It has previously been noted in a number of studies, but Dr. Clark’s research is the first comprehensive analysis of available data to quantify this effect.

The team examined the blood pressure levels of 1,019 individuals whose measurements had been taken by both doctors and nurses at the same visit. Dr. Clark said: “Our results were pooled from different settings across ten countries, so we can be confident that they can be generalized to any healthcare environment where blood pressure is being measured.

What Is White Coat Hypertension?

The 2005 American Heart Association guidelines for the measurement of blood pressure in humans defined white coat hypertension (WCHT) as persistently elevated blood pressure (BP) ‘in the presence of a healthcare worker, particularly a physician’ (≥ 140/90 mmHg) in patients not taking medication, with an average awake ambulatory blood pressure monitoring (ABPM) < 135/85 mmHg.

In 2007, the European Society of Hypertension and European Society of Cardiology published guidelines for the management of hypertension and recommended WCHT should be diagnosed when office BP ≥ 140/90 on at least three occasions, with normal 24 h (< 125– 130/80 mmHg) and day ABPM (< 130–135/85 mmHg) or homeBP (average of several readings < 130–135/85 mmHg).

Office blood pressures recorded by medical practitioners give higher readings on average compared with readings obtained by nurses or non-medical trained health professionals.

Arlene has just had her blood pressure checked, “But it was fine when I took it at home,” is what office nurses often hear as they unwrap the blood pressure cuff from a patient’s arm. White coat hypertension is no myth, says Mary Bauman, a physician on staff with Intergris Family Care Central in Oklahoma City.

“If you run up the stairs to the doctor’s office, if you’re in traffic and you’re trying to get there, your blood pressure may be elevated,” Bauman says. “Everybody’s blood pressure goes up at certain times. It’s supposed to.”

Do You Really Have High Blood Pressure?

In both scenarios at the beginning of our article, both patients where prescribed hypertension medicine after a single reading. Seem farfetched? It isn’t. It happens every day.

If you have been prescribed a blood pressure medication based on a single high number at your doctor’s office, you may want to ask if you really need it. That blood pressure reading might be misleading, according to an influential panel of government experts.

In its draft recommendation, the U.S. Preventive Services Task Force has concluded that a hypertension diagnosis made at a clinic or doctor’s office should be verified by a series of readings taken as you go about your day. Here’s why ambulatory monitoring – done away from a medical setting – gives a truer picture of your blood pressure.

The Benefits of Home Blood Pressure Monitoring

“When you have your blood pressure checked in the doctor’s office, you’re in an artificial environment that is not reflective of the vast majority of the time when your blood pressure is going through its daily excursions,” says cardiologist Dr. Elliott Antman, professor of medicine at Harvard Medical School. Throughout the course of a day, the average person’s systolic blood pressure (the first number in the reading) may fluctuate considerably.

Some people get very anxious in medical settings, which can cause their blood pressure to rise—a phenomenon known as white-coat hypertension. Others may feel like they’re in a protected, safe place where they can sit back and relax, which may cause their blood pressure to be lower than normal. If their blood pressure is high at other times, however, they may have a condition called masked hypertension.

The U.S. Preventive Services Task Force, a federally sponsored group that draws up medical guidelines, recommends that people measure their blood pressure outside of the medical setting to confirm a diagnosis of high blood pressure before starting treatment.

It has been found that home blood pressure monitoring readings are often lower than readings taken in the office and closer to the average blood pressure recorded during 24-hour ambulatory blood pressure monitoring. Home blood pressure monitoring allows increased numbers of readings, achieves more reproducible readings than office readings

What Is Ambulatory Blood Pressure Monitoring?

Ambulatory Blood Pressure Monitoring (ABPM) is when your blood pressure is being measured as you move around, living your normal daily life. It is normally carried over 24 hours. It uses a small digital blood pressure machine that is attached to a belt around your body and which is connected to a cuff around your upper arm. It small enough that you can go about your normal daily life and even sleep with it on.

By measuring your blood pressure at regular intervals over 24 hours, your doctor is able to get clear pictures of how your blood pressure changes throughout the day. There are a number of reasons why your doctor might suggest this test:

  • They may want to find out if your high blood pressure readings in the clinic are much higher than they are away from the clinic (called the “white coat effect”).
  • They may want to see how well your medicines are working, to make sure they are controlling your blood pressure through the day.
  • They may want to see if your blood pressure stays high at night. If this is the case, they may need to change or adjust your medicines.
Bio-Feedback and the Relaxation Response

Early in his career as a cardiologist, Herbert Benson M.D in his book, “The Relaxation Response” Stated the following. “I was intrigued by the observation that patients had higher blood pressure during times of stress. That connection, in fact, was a part of popular folklore. The notion that you’ll raise your blood pressure if you get upset, was common among physicians and laymen alike.”

If your doctor found that your blood pressure was elevated you would be treated with medication. That meant that people who had high blood pressure only during times of stress were needlessly being treated. At the time doctors did not understand that by distressing the person their blood pressure would go down

According to Kranitz and Lehrer et al…”Biofeedback appears to be a promising alternative or adjunct therapy for a variety of cardiovascular disorders. Biofeedback could be particularly useful when traditional therapies are contraindicated when psychologic factors, including stress, are complicating contributive factors. It could also be an effective way to reduce the risk of developing more serious problems such as myocardial infarction or stroke, in which risk factors such as reactivity or hypertension are already present.”

In general, larger and more consistent antihypertensive effects have been found for biofeedback therapies that have included respiratory retraining and slow breathing than for biofeedback or relaxation therapies that have excluded this component.

In an earlier study that was consistent with Patel’s earlier work demonstrating that participants’ in the practice of yoga, which included a breathing exercise, and biofeedback effectively managed their blood pressure. Among medicated hypertensives, Patel found that drug requirements had decreased by 41%.25

According to the “Journal Of The American Society Of Hypertension” January 2015, Volume 9, Issue 1, pages 38-47. In an article entitled RESPeRATE: the role of paced breathing in hypertension treatment. The following was written: Despite a good adherence to lifestyle modifications and antihypertensive drugs, hypertension remains resistant in more than one–third of patients, thus creating the need for additional strategies, including non–pharmacologic approaches.

Slow and deep breathing (“paced breathing”) associated in the past with meditation has a direct antihypertensive effect by increasing baroreflex sensitivity. With the method of guiding the pace of breathing, a US Food and Drug Administration–certified device, RESPeRATE, may offer an easy, efficient, inexpensive, and noninvasive option for treating hypertension.

Multiple studies showed a significant reduction of blood pressure when RESPeRATE was evaluated in a home and office setting. In conclusion, this review outlines the pathophysiologic background of paced respiration, describes RESPeRATE clinical trials, and presents briefly other guided breathing alternatives.

So this morning I spoke with Dr. Benjamin Gavish about the role RESPeRATE could play in treating “White Coat Syndrome” Dr. Gavish is a world-renowned multidisciplinary biophysicist, an active researcher in blood vessels and blood-pressure-related phenomena… He explained to me that “White Coat Syndrome” is a real physiological syndrome and not a phantom. “White Coat Syndrome” is a personal reaction to a stressful situation usually entailing medical staff.

When I asked for his clinical advice for the treatment of “White Coat Syndrome” he explained to me that he found three ways to effectively assist a patient experiencing this phenomenon:

  • Having the patient press the start button on the blood pressure machine while the nurse or physician is not in the room. Without there presence, the patient can generally feel more relaxed.
  • More importantly, taking repeated blood pressure measurements at home during the first few weeks usually “kills” the: White Coat Syndrome effect. This, in turn, makes such measurements more reliable than the ones taken in the physicians’ office, especially in patients known to have “White Coat Syndrome”.
  • Using RESPeRATE.Because RESPeRATE using slowed device-guided breathing, it is able to access the patients’ parasympathetic nervous system. This is the rest and digest side of our nervous system. Once accessed the patient becomes completely relaxed, decreasing all stress. This will thus result in the lowering of the blood pressure both in clients with white coat syndrome and normative high blood pressure

From my own personal experience of using RESPeRATE I have found not only has it dramatically reduced my blood pressure but it has also decreased my incidence of anxiety and panic attacks. When I feel a panic attack beginning I can go to my bedroom and start a RESPeRATE session. At the end of the session, my body has returned to normal.

In addition, we have published another article “White Coat Syndrome: Causes and Treatments“. You are welcome to read it as well.

In Conclusion

High blood pressure is a serious medical condition that does have to be treated. But in light of the current research, are to many people being put on medication too soon? Have we become so used to treating everything with pills that we no longer stop to ask should it be done now? Many physicians are now reluctant to start treating hypertension of the first sign of elevation.

Many physicians are siding with caution and allowing clients to begin home monitoring. This requires diligence an honesty on the part of the patient. By doing this and maybe including ambulatory blood pressure monitoring it may be determined whether you are suffering from white coat syndrome or you have high blood pressure.

References used for this article:

  1. The Relaxation Response. Herbert Benson M.D
  2. Biofeedback Applications in the Treatment of Cardiovascular Diseases
  3. RESPeRATE: the role of paced breathing in hypertension treatment

Posted by Eli Ben-Yehuda

 

 

Eli is a licensed Registered Nurse with 12 years experience. Eli graduated with a major in nursing and a minor in psychology. His postgraduate training was in trauma, oncology, and cardiology.

 

With a passion for health advocacy Eli researches and writes many articles concerning improving the lives of people diagnosed with high blood pressure and the complication they experience. He believes empowering people, through education, is the best way to improve their overall health.

About RESPeRATE – Lower Blood Pressure Naturally.

RESPeRATE is the only non-drug, FDA-Cleared device for lowering blood pressure naturally. It is clinically proven, doctor recommended and has no side effects.

RESPeRATE lowers blood pressure by relaxing constricted blood vessels which cause high blood pressure. RESPeRATE does so by harnessing the therapeutic power of slow-paced breathing with prolonged exhalation in a way that is virtually impossible to achieve on your own. All you have to do is breathe along with RESPeRATE’s guiding tones.

 

Learn More…

Download RESPeRATE’s Printable Clinical Brochure

 

High Blood Pressure: Could Diet Replace Medication?

Eli Ben-Yehuda

Written by Eli Ben-Yehuda

On July 2, 2019

Researchers suggest that people with high blood pressure, or hypertension, may see a similar or greater reduction in systolic blood pressure after following a Dietary Approaches to Stop Hypertension (DASH) and low-salt diet as people who take antihypertensive drugs.

Study co-author Stephen Juraschek — who works in the Beth Israel Deaconess Medical Center at Harvard Medical School in Boston, MA, as well as the Johns Hopkins University School of Medicine in Baltimore, MD — and colleagues say that their findings suggest that a change in diet should be the first line of defense for adults at increased risk of high blood pressure.

Everyone talks about DASH Diet, but what exactly is it?

Today there are a plethora of diets to choose from that claim to lower blood pressure. But with so many different diets and fads to choose from, which is the best for you? In today’s blog, I want to take a look at the DASH diet. DASH is an acronym for, “Dietary Approaches to Stop Hypertension”. One question we want to consider is, “Does a dietary approach arrest, and reverse hypertension?” We will answer that question after reviewing the DASH diet.

What Is High Blood Pressure?

<dash diet high blood pressureHigh blood pressure is blood pressure higher than 140/90 mmHg** Blood pressure is usually measured in millimeters of mercury, or mmHg. , and pre-hypertension is blood pressure between 120/80 and 139/89 mmHg.

But high blood pressure can be prevented and lowered if you take these steps: Follow a healthy eating plan, that includes foods low in sodium. Maintain a healthy weight and be moderately physically active for at least 2 and a half hours per week. If you drink alcoholic beverages, do so in moderation. If you already have high blood pressure and your doctor has prescribed medicine, take your medicine, as directed, and follow these steps.

Dash Diet – How does it work?

dash diet exerciseWhen following a specific diet some require that you buy this supplement, that powder, and cleanse. This can be costly to your wallet and can actually add more stress and cause you to quit before you see any changes. In this case, you become more frustrated than before.

With the DASH diet eating plan there are no special foods and no hard fast rules to follow. Seems simple already. It seems that hard fast rules are harder to follow, which is another tipping point for people. I myself find that I can only maintain the hard fast rules for so long and then I crash. The end result is much worse than when I started.

The DASH eating plan is rich in fruits, vegetables, fat-free or low-fat milk and milk products, whole grains, fish, poultry, beans, seeds, and nuts. It also contains less sodium, sweets, added sugars, and beverages containing sugar; fats; and red meats than the typical American diet. This heart-healthy way of eating is also lower in saturated fat, trans fat, and cholesterol and rich in nutrients that are associated with lowering blood pressure—mainly potassium, magnesium, calcium, protein, and fiber.

dash diet vegan vegetarianEven if you are vegan or vegetarian you can follow the DASH diet. Beans, seeds, nuts are all important parts of the DASH diet. Substitutions of meat/fish/poultry can be made using any acceptable protein-rich non-animal products. The DASH diet itself is a compromise, designed to provide the blood pressure-reducing benefits of healthy vegetarian and vegan diets in an eating plan designed to be acceptable to a broad range of people.

Making A DASH For It:

The DASH diet outline how many servings are needed each day from various food groups, based on calorie levels. The standard DASH plan is based on 2,000 calories a day. If you are trying to lose weight and want to eat fewer calories, the 1600-calorie version might be a better place to start. The following chart lists the food groups and daily servings recommended by the DASH diet, as well as portion sizes and tips to incorporate them into your meals.

dash diet planAgain we must reiterate the DASH eating plan requires no special foods and has no hard-to-follow recipes. It simply calls for a certain number of daily servings from various food groups. The number of servings depends on the number of calories you’re allowed each day.

Your calorie level depends on your age and, especially, how active you are. Think of this as an energy balance system—if you want to maintain your current weight, you should take in only as many calories as you burn by being physically active. If you need to lose weight, eat fewer calories than you burn or increase your activity level to burn more calories than you eat.

Caloric Chart For The DASH Diet:

Again think of food as fuel. If you are driving long distances you will need to fill the tank more often than if you are just going for a drive to a friends house. Too many times we see eating as a comfort, a release, an excuse. Eating is a very social activity so we often overeat causing ourselves to increase our weight. I had to mentally make the switch over because too many times I would find myself eating when I was not hungry.

What is your physical activity level?
  • Sedentary? You do only light physical activity that is part of your typical day-to-day routine.
  • Moderately active? You do physical activity equal to walking about 1 to 3 miles a day at 3 to 4 miles per hour, plus light physical activity.
  • Active? You do physical activity equal to walking more than 3 miles per day at 3 to 4 miles per hour, plus light physical activity.

  • Depending on your physical activity there is a corresponding amount for caloric intake. The more active a person is the more calories they will burn throughout the day. The less active you are the fewer calories you need to consume. It goes back to the gas tank analogy.

    Shaking Off The Salt:

    dash diet salt intakeChoose and prepare foods with less sodium and salt, and don’t bring the salt shaker to the table.

    Be creative—try herbs, spices, lemon, lime, vinegar, wine, and salt-free seasoning blends in cooking and at the table. And, because most of the sodium that we eat comes from processed foods, be sure to read food labels to check the amount of sodium in different food products. Aim for foods that contain 5 percent or less of the Daily Value of sodium. Foods with 20 percent or more Daily Value of sodium are considered high. These include baked goods, certain cereals, soy sauce, and some antacids —the range is wide.

    Rome Wasn’t Built In A Day:

    dash diet graduallyMaking changes to your lifestyle is not easy and it does not happen overnight. Make these changes over a couple of days or weeks to give yourself a chance to adjust and make them part of your daily routine.

    Add a serving of vegetables at lunch one day and dinner the next, and add fruit at one meal or as a snack. Increase your use of fat-free and low-fat milk products to three servings a day. Limit lean meats to 6 ounces a day—3 ounces a meal, which is about the size of a deck of cards. If you usually eat large portions of meats, cut them back over a couple of days—by half or a third at each meal. Include two or more vegetarian-style, or meatless, meals each week.

    Increase servings of vegetables, brown rice, whole wheat pasta, and cooked dry beans. Try casseroles and stir-fry dishes, which have less meat and more vegetables, grains, and dry beans. For snacks and desserts, use fruits or other foods low in saturated fat, trans fat, cholesterol, sodium, sugar, and calories—for example, unsalted rice cakes; unsalted nuts or seeds; raisins; graham crackers; fat-free, low-fat, or frozen yogurt; popcorn with no salt or butter added; or raw vegetables. Use fresh, frozen, or low-sodium canned vegetables and fruits.

    Our Final Thoughts:

    The best way to combat high blood pressure is with lifestyle modifications. Always remember that at times we will have setbacks. But even with occasional setbacks, we do not want to through in the towel and quite. Every day will present its own challenges. If possible join an online support group. Having compassionate people around you to encourage you is a must. We do not want to surround ourselves with people who question why we are even trying. We must try for our health depends upon it.

    The DASH diet has proven that it can reduce high blood pressure if the guidelines are followed. it isn’t a cabbage soup fade to losing weight only to gain it back again. No DASH is sensible and it is not so much a diet as it is a lifestyle food and changing the relationship we have with food. They say every journey begins with a single step. I encourage you to take that first step, enjoy the journey, and most of all be patient and kind to yourself as you make these changes. If you have any suggestions for future article drop me a to me at [email protected]

    More articles and recipes of DASH Diet:

     

    About RESPeRATE – Lower Blood Pressure Naturally.

    RESPeRATE is the only non-drug, FDA-Cleared device for lowering blood pressure naturally. It is clinically proven, doctor recommended and has no side effects.

    RESPeRATE lowers blood pressure by relaxing constricted blood vessels which cause high blood pressure. RESPeRATE does so by harnessing the therapeutic power of slow-paced breathing with prolonged exhalation in a way that is virtually impossible to achieve on your own. All you have to do is breathe along with RESPeRATE’s guiding tones.

    Learn More…