February 28, 2016
New Blood Pressure Guidelines Could Save Lives – Part II
BY Mary Mahoney
One in three U.S. adults suffer hypertension, or high blood pressure. According to the American Heart Association, it is the number-one cause of death, and high blood pressure can lead to serious heart damage, heart attacks, strokes and kidney damage.
Recent developments have been both good and bad: Heart.org reported a 30 percent drop in the cardiovascular disease death rate from 2001 to 2011. Unfortunately, “the high blood pressure death rate increased 13.2 percent over that same time.”
A groundbreaking new study, the Sprint Hypertension Trial, could affect millions of people with high blood pressure and save many lives.
This large national study concludes that lowering the systolic blood pressure– the top number in a blood pressure reading – to 120 instead of the commonly accepted 140 would in reduce heart attacks by 30 percent and deaths related to heart disease by 25 percent.
When you consider that 79 million people have hypertension, that is a very big deal.
How do we get there? Challenges remain on multiple fronts. While there are quite a few effective drugs to lower blood pressure, not everyone responds to the standard treatments.
Meanwhile, high blood pressure, diabetes andobesity in children all are on the rise. Additionally, blood pressure increases with advanced age, and as people livelonger, more face high blood pressure. But if blood pressure is forced down too low, side effects and other health risks arise, including dizziness and fainting.
There is no permanent, one-shot cure for high blood pressure, but much can be done to help prevent high blood pressure in some people, and much can be done to get the number down and manage it with regular lifestyle changes or medications or both.
Sodium, found in salt, has long been found to contribute to high blood pressure. While there is some controversy as to how much sodium reduction will significantly lower blood pressure, it is a safe and inexpensive way to see if it could work for you.
Two large sodium trials in the 1980s and 1990s in the U.S. showed a marked reduction in hypertension when salt intake was lowered. An international study called Intersalt, supported similar results. A 2012 meta-study on sodium looked at results from 167 trials.
Apparently, Americans on average consume an unhealthy amount of sodium. Where is it coming from? Mostly it’s in processed foods, but a surprising top spot on the list of popular high-sodium foodsis breads and rolls. That’s because baking soda, a leavening agent, contains sodium. Poultry is also among the top six culprits. Most of the raw chicken in supermarkets has been injected with sodiumto make it more flavorful and juicier. More obvious sources of sodium are cured meats, cold cuts, canned soups and, of course, snack foods.
According to Centers for Disease Control and Preventionwe eat about 3,300 mgs of sodium a day. The recommendation is 2,300 mgs of sodium for healthy people and 1,500 mgs for those with high blood pressure (That’s a paltry three-quarters of a teaspoon per day).
According to an article in the Harvard Newsletterthat examined long-term benefits of sodium restriction: “Volunteers learned how to look out for hidden salt and avoid it; those who were able to reduce their salt intake by one-third to one-half a teaspoon per day reaped the cardiovascular benefits.”
Of course, there are also numerous medications to lower blood pressure. However, though to lower it to 120, three drugs may be required, which can lead to complications. Each patient should carefully weigh the risks.
Finally, about 10 percent of hypertensive patients who do not respond to diets, exercise or medication, which translates to about 8 million people. A once-promising surgical intervention called renal denervationhas had a rocky history but is being investigated again as an alternate treatment. The premise is based on debilitating the renal sympathetic nervesthat have a role in affecting blood pressure.
Good habits are, of course, much easier to keep if started early. The Centers forDisease Control and Preventioncounts nearly nine in ten U.S. children who consume more sodium than recommended, and about one in six children with elevated blood pressure, which is a major risk factor for heart disease and stroke. As an adult it’s not easy to change your taste preferences, but if you can have a low-salt diet in childhood, you will have instilled a lifetime of better nutrition.