TM
Physical Health
SPEM Health , LLC
TOPIC:
The Hypertension Dilemma:
A simple conversation
with a patient.
Joseph W. Lista, MS, PA-C
West Shore Family Practice
6375 Mercury Drive, Ste 200
Mechanicsburg, PA 17050
(717) 717-620-2500
The Hypertension Dilemma:
A simple conversation with a patient.
Patient Mrs. S:
So, Doctor, what is all this talk about high blood pressure? I feel fine. I work out every day.
I eat the right foods. So how could I have high blood pressure? I think there's something
wrong with your equipment.
Doctor:
Well, Mrs S, we have been taking your blood pressure several times this afternoon since you
have been sitting in our waiting room over the past 45 minutes. Plus, you brought in your home
blood pressure readings, and all the readings continue to be very high. The problem with high blood pressure is that they call it, "The Silent Killer". Most of the time, you do not have any symptoms.
You just go about your day, completing your daily chores, your job, cutting the grass, etc. Then, it
happens. Heart attack! Stroke! Kidney failure! Blindness!
Mrs S:
But, Doctor, what is blood pressure?
Doctor:
This occurs when the heart pumps blood through the arteries. The blood puts pressure on the
artery walls. Think of our arteries like a bunch of hoses. If you block the end of a hose, and you
keep adding more and more water pressure, what do you think is going to happen . . . POP!!
Mrs S:
But Doctor, shouldn't I have some kind of symptoms?
Doctor:
Yes. At times there are symptoms. Headache. Blurry vision. Dizziness. Chest pain. Tingling/Pins
and needles in your hands or feet, to name a few. But as I said, many times, there are no
symptoms.
Mrs S:
But, Doctor, are you telling me that I am the ONLY person in my family that has HIGH blood
pressure?
Doctor:
No. Actually. There's probably more people in your family with elevated or high blood pressure.
In fact, nearly half of all Americans have high blood pressure. Close to 120 million people.
Mrs S:
So, what do we do about this problem? And, what is HIGH blood pressure?
Doctor:
The first thing you should do is make an appointment with your family doctor to have your blood pressure checked like you are doing today. And, also make it a habit to have a routine, yearly
checkup. Even if you feel wonderful, it is best to find problems before they become problems.
Blood pressure consistently at, or above 130 over 80 is considered high blood pressure.
Mrs S:
So, Doctor, how do I educate the rest of my family to understand the causes of high blood
pressure?
Doctor:
You can review the medical literature, and you will find the following:
"Age - Blood vessels stiffen as you get older.
Diet - Eating too much salt. (sodium) and processed foods.
Weight - Being overweight or obese puts extra work on your heart.
Activity - Not getting enough regular physical exercise.
Habits - Smoking or drinking too much alcohol.
Stress - Long term stress, anxiety, or lack of sleep.
Other medical conditions:
Kidney disease - Damaged kidneys cannot filter fluid well.
Sleep apnea - Breathing stops and starts during sleep.
Adrenal gland issues - Tumors or hormone imbalances raise blood pressure.
Thyroid problems - An overactive or underactive thyroid gland.
Pregnancy - Conditions like pre-eclampsia can raise blood pressure.
Artery blockages - Narrowed arteries that carry blood to the kidneys.
Medication & Substances - Over the counter drugs, decongestants, cold medicines,
and pain relievers like ibuprofen.
Prescription drugs - Birth control pills, steroids, and some migraine treatments.
Substances like - Heavy caffeine or illegal drugs like cocaine and amphetamines."
Mrs S:
OK. So now we know what hypertension is. How can we defeat it and stay healthy?
Doctor:
Eat more fruits, vegetables, whole grains and low fat dairy. These foods are naturally rich in
potassium, calcium, and magnesium which helps relax your blood vessels.
Eat less red meat, saturated fats, sweets, and sugary drinks.
Cut back on ultra processed foods.
Cut back on salt. High sodium causes your body to hold on to fluid, this puts extra strain on your
blood vessels. Try to stay below 1500mg of sodium per day. Remember that, canned soups, broths, and mixed meals often contain large amounts of salt. Choose "sodium free" options. And, restaurant meals contain a lot of salt. These make up about 70 to 80% of daily salt intake.
Keep active - Regular exercise makes your heart stronger, allowing it to pump blood with much
less effort. Aim for at least 150 minutes of moderately intensive aerobic exercise every week.
About 30 minutes a day, 5 days a week. Incorporating activities like brisk walking, cycling or
swimming can lower your blood pressure. Isometric exercises are also effective.
Mrs S:
But doctor, if I have a number of disabilities, how can I do those exercises?
Doctor:
Then join a gym. They have trainers who can teach you other ways to keep your body active. If
you are elderly and on Medicare, gym membership is covered as it is on many commercial
insurance programs. If you are handicapped in any way, your doctor can prescribe Physical
Therapy.
Mrs S:
OK. So what else do I need to do?
Doctor:
Lose excess weight - Every 2.2 pounds of weight you lose reduces your blood pressure.
Limit alcohol and quit smoking. Drinking a lot of alcohol raises blood pressure. Smoking causes
blood pressure to go up and damages your artery walls.
Sleep better - Try to get 7-9 hours of quality sleep each night.
Chronic stress releases hormones that narrow your blood vessels. Keep your stress levels low.
Remember - See your family doctor. Get a home blood pressure cuff. Whenever you have a
number of these symptoms: (Headaches, Blurry vision, Dizziness, Chest pain. Tingling pins and
needles in your hands or your feet) The first thing you should do. . . Is check your blood
pressure, AND call your family doctor.
Mrs S:
Thank you for all your help!
Doctor:
You are certainly welcome. See you at your follow up appointment.