Highly Treatable with Proper Monitoring and Treatment Approach

By Kylie Blanchard

High blood pressure, or hypertension, is considered a silent killer, because it often doesn’t present symptoms until complications arise. But with knowledge of medical and family history, proper monitoring, a healthy lifestyle, and medication, if necessary, high blood pressure can be managed and even prevented.

“Hypertension is certainly more common the older we get,” says Jennifer Beckwith, MD, family physician with Sanford North Mandan Clinic. “But we do see hypertension in all age groups.”

In general, blood pressure is considered normal if systolic blood pressure, the measure of blood pressure when the heart is contracting, is less than 120 mmHg, or millimeters of mercury, the measurement used to gauge the pressure of the blood on the vessels. A normal diastolic blood pressure, the measure of pressure in the vessels when the heart relaxes, is less than 80 mmHg.

“Prehypertension is if systolic pressure ranges from 120 to 139 or diastolic pressure is 80 to 89. State 1 hypertension is diagnosed if systolic pressure is 140 to 159 or diastolic pressure is 90 to 99,” says Beckwith. “This is the point at which we usually recommend significant lifestyle changes and later medication, if lifestyle changes do not lower blood pressure.”

Jennifer Beckwith, MD

Jennifer Beckwith, MD

A blood pressure reading greater than or equal to 160 systolic pressure or a diastolic pressure of greater than or equal to 100 is considered Stage 2 hypertension, and Beckwith says medication, along with lifestyle changes, are the recommended treatment.

She notes the ideal blood pressure range in women can depend on past medical history and age, and individuals with a history of diabetes, cardiovascular disease or chronic kidney disease will have a lower goal blood pressure.

Lifestyle changes used to treat high blood pressure include weight loss, regular cardiovascular exercise, smoking cessation, moderation of alcohol and dietary changes, including sodium restriction. “Medications are necessary when lifestyle changes are not enough to lower blood pressure or there is a past medical history that requires certain blood pressure medication,” says Beckwith. “We have several groups of blood pressure medication that work in different ways to lower blood pressure. Treatments can range from one medication to several depending on severity.”

Cheryl Neu, 61, began experiencing high blood pressure readings in her 50s, but not consistently. “I would sometimes have normal readings, while other times I had a reading of 140/80. Because I worked out regularly and led a healthy lifestyle, my doctor wasn’t too concerned about it at that time.”

But a blood pressure reading of 160/98 at her physical last fall was cause for concern. “After that reading, my doctor said it was time to go on a blood pressure medication,” says Neu.

“When I found out how high my blood pressure was, it was kind of scary,” she continues. “I didn’t have any symptoms and didn’t realize it had risen so high. I think that is why it is so dangerous, because until something happens, no one knows.”

Neu’s high blood pressure can largely be attributed to heredity. Her father has been on blood pressure medication for many years and two of her three sisters are also on medication to lower their blood pressure.

Along with continuing a regular exercise routine and active lifestyle, Neu has more closely monitored her salt intake. The use of the blood pressure medication and a low dose diuretic has lowered her blood pressure significantly. She continues to monitor her blood pressure with regular readings and says she doesn’t mind having to take the treatment measures. “I’ll take a pill each day as opposed to the alternative,” she says.

“Hypertension is more common in men than women, but the risk for women rises after menopause, or if you are on birth control or pregnant,” says Dr. Faye Johnson, ND, LAc, LMT, a naturopathic doctor, licensed acupuncturist and licensed massage therapist at Dakota Natural Health Center.

Johnson notes, while high blood pressure is mostly an asymptomatic disease, when complications arise warning signs include headaches, sweating, rapid pulse, shortness of breath, dizziness and visual disturbances. “According to the National Stroke Association, hypertension is the most important controllable risk factor for stroke, and high blood pressure puts an individual at a seven times higher risk for stroke.”

There are a variety of natural remedies for high blood pressure, says Johnson, which include herbs, natural products and oils. “People with high blood pressure often suffer from sleep apnea and treatment of this condition may also reduce blood pressure,” she notes.

Beckwith says when she talks to patients about the importance of monitoring and maintaining healthy blood pressure levels, she likens the blood vessels to pipes in a house. “If you have one house that has lower water pressure going through it for several years, those pipes are going to have far less damage and last many more years than in a house in which the water pipes are under high pressure all day, every day.”

“It is similar with blood vessels,” Beckwith continues. “Particularly, the blood vessels supplying your heart, brain, eyes and lower extremities. The body responds to the damage by forming plaques over the damaged areas, which can build up over time and narrow blood vessels. Pieces of plaques can also break off and clog the blood vessels, cutting off blood flow completely.”

These changes in blood vessels can eventually lead to heart attack, stroke, changes in eyesight, lack of blood flow to the lower extremities and many other problems. “Another thing to consider is if your physician tells you you have low blood pressure. This can be concerning as well,” says Johnson. “Symptoms are dizziness upon standing, a light headedness for no reason, and fatigue. This condition is much more common in women, can be equally damaging and is easily treated.”

Beckwith notes new guidelines for blood pressure control and management will be published this year, so recommended blood pressure goals and treatments may be changing soon. But she continues to stress the importance of a healthy lifestyle and regular check-ups for women. “My main message to women is to fight for that healthy lifestyle and get your annual physicals to prevent disease before it happens.”

Kylie Blanchard is a local writer