When I began my career I worked in clinical inpatient and outpatient nutrition. For many years, “High blood pressure” was anything over 140/90. However since 2017 it’s been defined as any reading that’s over 130/80 (reflected in the 2nd edition of DASH Diet For Dummies®).
Back in the 1990s I used to teach “Lifestyle Management” classes. It’s been well known that certain lifestyle behaviors and choices (smoking, drinking, lack of physical activity, increase your risk for health problems. Furthermore, social determinants of health play a big role in overall risk for heart disease and other health issues.
Making healthy lifestyle choices (eating well, not smoking, staying fit, managing stress, limiting or avoiding alcohol and recreational drugs) has always been important when it comes to reducing your risk of the most common chronic diseases – heart disease and diabetes. Finding support, or helping your patients find support, is crucial to adopting lifestyle changes.
Reducing Your Risk
The recently released guidelines hope to offer a more holistic approach. They seem to embrace what we now know to be true: Heart health is brain health!
Managing blood pressure can reduce the toll of heart disease, kidney disease, Type 2 diabetes and dementia. The updated guidelines focus further on diet and lifestyle – particularly reducing total sodium in the diet, avoiding or reducing alcohol consumption, and improving physical fitness.
In addition the American Heart Association developed a new tool that helps assess risk – the PREVENT™ calculator. This tool uses equations that estimate 10-year and 30-year risk for total cardiovascular disease. (Note – this tool is to be used with a health provider and is only as accurate as the information entered.) The calculator also considers social determinants of health. Unfortunately, a person’s zip code is correlated to their health outcomes (and access to care).
New Blood Pressure Guidelines in a Nutshell
I have to say that these new guidelines recommend a very challenging sodium reduction. It may help you put sodium counts into perspective. For instance, if the sodium content of one fast food item or meal is over 1100 milligrams – you know you are overboard in daily sodium.
Interestingly the guidelines do not call out the the DASH (Dietary Approaches to Stop Hypertension) but the dietary prescription is based on the DASH clinical trials. DASH supports your lifestyle framework to help manage blood pressure, even though you may still need medication.
In addition, managing stress and exercising regularly are important components of a lifestyle that supports healthy blood pressure.
- Sodium Reduction: The new guidelines recommend a more aggressive approach to sodium, setting it at 1500 milligrams per day.
- Alcohol: Not drinking or limiting it to one drink daily for women and two for men.
- Stress Management: Managing stress through exercise, meditation, yoga or other healthy techniques.
- Body Weight: Maintaining a healthy weight, with a goal of at least 5% weight loss for people with overweight or obesity.
- DASH Diet: Adopting a heart-healthy diet that adds more veggies, fruits, whole grains, legumes, nuts and seeds; and is low in saturated fat (low- or non-fat dairy, lean meats, skinless poultry and fish).
- Fitness: Increasing physical activity to at least 75-150 minutes a week, including both aerobic exercise and strength training.
Get Checked – Know Your Numbers
Do you know what your blood pressure reading is? If not, make an appointment with a doctor or walk into a pharmacy and ask for a reading. Checking it at home is easier than ever with home-monitors that are fairly inexpensive to purchase.
Don’t deny or walk around with high blood pressure – it truly is the “silent killer”.
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