To Your Health: Blood Pressure a Silent Menace

According to the American Heart Association, nearly half of all adult Americans live with high blood pressure; many people don’t realize they are suffering from it at all. It is possible a person can experience high blood pressure for years without recognizing any symptoms. If left untreated, high blood pressure can cause damage to the heart and blood vessels and lead to an increased risk of heart attack and stroke.

Photo courtesy of J. Lavallée.

Jordan Porter, a doctor of nursing practice and family nurse practitioner at the Down East Community Hospital has strong family connections to the lobster fishery. “Historically, high blood pressure has been dubbed the ‘silent killer’ among the medical community because a large proportion of those living with high blood pressure do not exhibit any symptoms,” he explained. “Undetected, long-standing high blood pressure significantly increases the risk of heart failure, stroke, kidney disease, abnormal heart rhythms like atrial fibrillation, heart attack, and dementia.” The severity of these conditions is why it is so important for all adults to connect with a primary care provider (physician, nurse practitioner, or physician assistant) for blood pressure screening and an assessment of risk factors. The United States Preventive Services Task Force, the American College of Cardiology, and the American Heart Association recommend that all individuals 18 years or older should be screened at least yearly for high blood pressure, he noted.

There are many risk factors associated with high blood pressure. These include:

Age: Risk of high blood pressure increases as you grow older.
Family history: It is more likely for you to have high blood pressure if family members are also affected by it. If possible, talk to close relatives to find out if they have a history of high blood pressure.

Weight: Being overweight or obese can cause an increased demand of blood to supply tissues with oxygen and nutrients. This high blood volume may lead to increased pressure on blood vessels.

Tobacco: Smoking and chewing tobacco causes an immediate, temporary increase in blood pressure as well as long-term damage to the lining of artery walls. Over time, the arteries become narrower and increase the risk of heart disease.

Sodium: High levels of sodium in your diet can cause high blood pressure by retaining fluids.

Potassium: Sodium levels in our cells are balanced by potassium so if your diet is too low in potassium, it can lead to increased levels of sodium and thus increased blood pressure.

Alcohol: Long-term, heavy drinking can seriously damage heart health and lead to a variety of complications including high blood pressure.

If you are at risk for high blood pressure or other related cardiovascular conditions, your doctor may recommend that you monitor your blood pressure on a regular basis. This may be done by learning how to operate and read a blood pressure cuff at home, or by using automatic cuffs that can be found in some pharmacies and other health facilities such as gyms or wellness centers. Because high blood pressure is so common, it is important to monitor your blood pressure even if you do not visit a doctor on a regular basis.

Your blood pressure naturally varies throughout the day and may be affected by your daily activities. Therefore, it is important to look at long-term trends when diagnosing high blood pressure. If you are not visiting a doctor regularly, keep a written log of blood pressure measurements so that it is easier to identify a trend.

“Lifestyle changes to reduce the risk of high blood pressure include weight loss, a healthy diet rich in fruit, vegetables, whole grains, poultry, fish, and low-fat dairy products (the DASH diet), less than 1500 mg of dietary sodium intake daily, moderate-intensity aerobic exercise of 30 to 40 minutes at least 3 to 4 days a week, and limiting alcohol consumption in men to two or fewer drinks daily and in women to one or fewer drinks daily. Weight loss and dietary changes are considered to have the greatest positive effects on lowering blood pressure,” said Porter.

While lifestyle changes can be sufficient for some people, others will need to take medication to control high blood pressure. There is a wide range of medications that may be prescribed depending on an individual’s specific situation and conditions. You should never use someone else’s medication because of the side effects and complication risks.

“The decision to initiate medication for high blood pressure is individualized and involves shared decision-making between the patient and the primary care provider,” Porter said. “Medications for high blood pressure have been extensively researched over the past several decades with great outcomes for risk reduction.” He noted that in large studies, treatment with medications produced a nearly 50% relative risk reduction in the incidence of heart failure, a 30-40% relative risk reduction in stroke, and a 20-25% relative risk reduction in heart attack.”

“As a brother to a hard-working sternman in Downeast Maine, I greatly respect the labor-intensive work that lobster fishermen do to provide for their families. I want the lobster fisherman community to know that they do not need a major life overhaul to make a difference in their blood pressure,” Porter continued. Small steps, such as losing as little as 10 pounds, substituting water for high-calorie drinks, reading labels to help reduce sodium content, or going for a brisk walk a couple times a week can have a positive effect on blood pressure. “I encourage all fishermen to connect and partner with a primary care provider to discuss ways to reduce the risks and complications associated with high blood pressure, protect their overall health, and maintain their longevity in Maine’s lobster fishing industry,” Porter said.