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	James L. Holly, M.D.

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About SETMA - Special Services - Pre-hypertension and Hypertension Prevention Program

Special Services

Every patient who comes to SETMA has their risk of developing hypertension assessed. Remember, if you are 55 years of age and do not have hypertension, your life-time risk of developing hypertension is 90%. Without taking steps to avoid it, almost everyone who lives long enough will develop hypertension. SETMAs providers can give you the DASH Diet (Dietary Approach to Stop Hypertension) and education material on decreasing your salt intake. Both of these can have significant impact on preventing you from developing high blood pressure.

Pre-Hypertension

What is this condition? The Seventh Report of the Joint National Committee on Prevention, Detection and Treatment of High Blood Pressure, often referred to as JNC7, identified a new category of hypertension called pre-hypertension. This is defined as:

A systolic blood pressure (the top number in your blood pressure) between 121-139 and/or
A diastolic blood pressure (the bottom number in your blood pressure) between 80-89.

This category was added because research has demonstrated that patients with blood pressures in these ranges are at a much higher risk of going on to develop full blown hypertension with its risk for strokes and heart attacks than are people with completely normal blood pressure.

JNC7 recommends lifestyle modifications for those with pre-hypertension in order to prevent progress, but also recommends treatment of pre-hypertension in patients who have diabetes and/or kidney disease.

The significance of pre-hypertension is further demonstrated by the fact that if you are 55 years of age and do not have high blood pressure, your life-time risk of developing high blood pressure is 90%. The reality is that almost everyone who is eating a western diet will develop hypertension in their life time, if:

They live long enough.
They don't take steps to avoid it.

How can you prevent developing high blood pressure?

First, you can know the risk factors for developing high blood pressure. They are as follows.

Smoking -- within minutes of smoking a cigarette, pipe, cigar or using smokeless tobacco products, the heart rate goes up, which raises the blood pressure, which increases the work load on the heart. Each of these changes, experienced long enough, will contribute to high blood pressure and will dramatically increase the risk of heart disease and stroke. The inhaling of smoke produced by others will have the same effect. The solution is to stop smoking and/or to eliminate any form of tobacco smoke from your home, car, work place and life.

Stress -- stressful situations result in the production of a number of chemical responses in the body which if sustained over a long period of time can contribute to high blood pressure. It is impossible for anyone to remove all stressful situations from life, but it is possible to change how you deal with stressful situations. The reality is that stressful situations result in stress only by our response to them. Recognize what you can change and change it. Accept the things which you can't change. This will reduce your stress. Faith, family and friends can help with eliminating the stress from stressful situations.

Obesity -- fat cells around the abdomen produce many substances which are harmful to the body and which contribute to high blood pressure. Everyone who is overweight does not have high blood pressure, but everyone who is overweight is at a much higher risk of developing hypertension. The solution is to lose weight. A 10-15% reduction in weight, even if it does not produce your ideal body weight, greatly reduces your risk of hypertension.

High Salt Intake -- in societies where there is no added dietary salt, there is no high blood pressure regardless of the age of patients. Salt is used as the least expensive preservative in canned and boxed foods, as well as a device to enhance the taste of otherwise inferior food products. This salt greatly adds to the intake of sodium in the western diet, increasing the risk of high blood pressure. The solution is to retrain your taste buds to not want salt. It takes a while but you will get to the point that foods with dangerous amounts of salt are objectionable to your taste and your diet improves. The solution is to avoid salted nuts, potato chips, pretzels, canned foods and other prepared, prepackaged foods with high salt content.

Heavy Drinking of Alcohol -- alcohol is toxic to the heart muscle. Excessive drinking will contribute to the risk of high blood pressure for virtually anyone partially due to the high calories in alcohol without any nutritional benefits. Others, who are uniquely sensitive to alcohol will increase their risk of high blood pressure with very little alcohol consumption.

Heredity -- if you have an immediate family member with high blood pressure, it places you at a higher risk of developing high blood pressure yourself. Also, if you are African-American , you are at a higher risk. While there is nothing you can do to change this, you can increase your vigilance in other areas to prevent developing high blood pressure.

Pregnancy -- due to fluid volume changes and other hormonal changes associated with pregnancy, many women have elevated blood pressure during pregnancy. Also, oral contraceptives can cause high blood pressure. Careful monitoring of patients who are pregnant, or who are taking oral contraceptives will enable this problem to be identified and dealt with.

Other risk factors for the development of high blood pressure are:

Dyslipidemia -- elevated cholesterol, triglycerides, low-density lipoproteins and/or decreased high density lipoproteins, or other lipid abnormalities can contribute to the development of high blood pressure.

Diabetes -- patients with diabetes are at increased risk of developing high blood pressure but can often prevent hypertension by the aggressive treatment of their diabetes.

Age -- men over 55 and women over 65 with a family history of cardiovascular disease are at a higher risk of developing high blood pressure.

Your SETMA healthcare provider not only wants to help you treat your blood pressure if you have hypetension, but to help you avoid developing hypertension if you don't.

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