Debunking Myths about High Blood Pressure

High blood pressure is a common problem in our country.  Nearly half of all adults in the U.S. have high blood pressure, according to the American Heart Association (AHA).  Untreated high blood pressure significantly increases your risk for heart attack, stroke, kidney failure, and other serious health problems.  High blood pressure accounts for more deaths from cardiovascular disease than any other "modifiable" risk factor in the U.S.  It is second only to cigarette smoking as a preventable cause of death for any reason.  We all need to understand the dangers of high blood pressure.  Let's talk today about some common myths about high blood pressure and the dangers of believing them.

Myth - I feel fine, so my blood pressure must be normal.  

Truth - Research has shown that up to half of people with high blood pressure don't know they have it.  People who do know they have it usually know because they had their blood pressure checked, and not because they had symptoms.  High blood pressure often causes no symptoms at all.  It can sometimes cause symptoms when it is extremely high, but this is unusual.  Most of the time it is high enough to cause damage to your heart, arteries, kidneys, and other organs, without causing any symptoms at all.

Myth - No one in my family has high blood pressure, so I don't have to worry.
Truth - There are many factors that increase your risk of high blood pressure.  Your genetic make-up is only one of those factors.  Other factors that play a role in your risk for high blood pressure include smoking, being overweight, eating a poor diet, sedentary lifestyle/getting too little exercise, and drinking too much alcohol.

Myth - A blood pressure of 140/80 is considered normal.
Truth - New high blood pressure treatment guidelines were published in 2017.  A normal blood pressure is considered less than 120/80.  Elevated blood pressure, also called prehypertension, is 120-129 on top AND less than 80 on bottom.  Stage 1 high blood pressure is 130-139 on top OR 80-89 on bottom.  Stage 2 high blood pressure is at least 140 on top OR at least 90 on bottom.  Blood pressure in the Stage 1 range actually doubles your risk of cardiovascular complications, compared to people with blood pressure under 120/80.

Myth - All people with elevated blood pressure need medication.
Truth - People with "elevated" blood pressure, and most people with Stage 1 high blood pressure should be treated initially only with lifestyle changes, such as weight loss, increased exercise, and a heart-healthy, lower salt diet.  Medication is recommended, in addition to lifestyle changes, in people with Stage 1 high blood pressure who have already had a cardiovascular event, such as a heart attack, OR have a high risk of having a cardiovascular event based on other risk factors, or people with Stage 2 high blood pressure.  Some dietary changes have been shown to be as good as medication in treating the early stages of high blood pressure. 

Myth - I don't have to worry about salt because I don't add salt to my food at the table.
Truth - Most of the salt in the average U.S. diet is hidden in processed foods, such as sauces, salad dressings, soups, and prepared foods.  Be sure to look at food labels to see how many mg of sodium you are getting.  Although the recommended amount of sodium per day is 2300 mg, people over 50 and anyone who has high blood pressure should aim for less than 1500 mg per day.
   

What should you be doing to stay on top of high blood pressure and decrease your risk?

• Have your blood pressure checked once a year, or more often if you are at high risk.  If you are having it checked outside your doctor's office, be sure to see your doctor if it is elevated.
• Eat a heart-healthy diet, rich in fruits and vegetables, and low-fat dairy products, with reduced levels of saturated fat and cholesterol, and reduced salt intake.
• Maintain a routine exercise program with moderate exercise at least 150 minutes per week.
• If you are overweight, lose weight.  Research has shown that even just 9 pounds of weight loss can lower blood pressure by 5 points.  
• Don't smoke or use nicotine products.
• If you already have high blood pressure, follow your doctor's advice regarding treatment and routine follow up visits in order to keep it under good control and decrease your risk for complications.

If you have any questions about high blood pressure, please log into your account and send us your question. We are here to help.

Dr. Anita Bennett MD - Health Tip Content Editor

Do You Know Your Heart Age?

February is Heart Month, so I am trying to use this month to focus on topics that might help raise awareness about our heart health.  One way to understand your risk for a heart attack or stroke is to learn your "heart age."  This is an easy way for us to talk about your risk for cardiovascular disease.  Most US adults have a heart age older than their actual age, which puts them at higher risk for having a heart attack or stroke.  Let's talk about how to learn your heart age, and how that might help you improve your health.

What is your heart age?

Heart age is a way to express the relative age of your heart and blood vessels, based on your risk factors for heart attack and stroke.  There are some things that affect your risk for heart attack or stroke over which you have no control, such as your age or your family history.  There are a number of things that affect your heart age, which are within your control.
  

To calculate your heart age, click the link below.  Once at the site, scroll down to the Interactive Risk Score Calculators.  If you know your cholesterol numbers, you can do the one "using lipids".  The other uses your BMI (based on your height and weight).  Ideally, you would do both, and average them.  I'll put a link to a BMI calculator at the bottom of the page, in case you need it.

The Framingham Heart Study

What risk factors affect your heart age?

• Age – Obviously, this is something that you cannot control or change.  Ideally, you want your heart age to be the same as, or even younger than your actual age.
• Blood pressure – Having high blood pressure significantly increases your risk for heart attack and stroke.  If you have high blood pressure, managing your blood pressure by taking medications and making lifestyle changes can decrease your risk and make your heart "younger."
• Smoking – Smoking damages the blood vessels and can cause cardiovascular disease
• Cholesterol levels – High blood cholesterol can increase the risk for heart disease.  Sometimes high cholesterol levels are hereditary, but there are many things that contribute to unhealthy cholesterol levels, such as diabetes, obesity, eating unhealthy foods, and not getting enough physical activity.
• Diabetes – Diabetes can damage blood vessels and nerves that control the heart muscle.  
• Obesity – More than 1 in 3 Americans has obesity, including 1 in 6 children.  Carrying extra weight puts stress on the heart.  It also adversely affects your blood cholesterol levels.
• Physical activity – Being physically inactive increases your risk of heart disease and stroke.  The current guidelines recommend getting at least 150 minutes a week of moderate intensity exercise to lower your risk for heart disease and stroke.  Your heart needs a work out to stay strong, just like other muscles.  Your blood vessels also benefit from that physical activity.

What can you do to improve your heart age?

• Start by choosing a risk factor that you are ready to change.  That might be quitting smoking, or losing weight, or it might be getting your high blood pressure under better control.
• Work with your doctor to help improve that risk factor.  Your family doctor can help you to improve any of the risk factors that I listed above.
• As soon as you're ready, choose another one!   
• You can start at any age to lower your heart age.  The earlier the better!

To calculate your BMI, use this link: https://www.cdc.gov/healthyweight/assessing/bmi/...

If you have questions about your heart age, or how to improve your risk for heart disease or stroke, just login and send a question to one of our doctors. We are here to help.

Dr. Anita Bennett MD - Health Tip Content Editor

Is Sitting the New Smoking?

There has been quite a bit of talk recently about how bad sitting is for us.  Some people have even said that too much sitting is just as bad as smoking cigarettes.  I'm not sure if that is true, but it does seem pretty clear that being more active overall is associated with better health.  Just what are the risks of sitting too much?

What health conditions have been linked to sitting for long periods of time?

Research studies have linked prolonged periods of time sitting and too much sitting overall to the following health concerns:

• Obesity
• Increased blood pressure
• High blood sugar 
• Excess body fat around the waist
• Abnormal cholesterol levels
• Increased risk of chronic pain
• Increased risk of death from cardiovascular disease
• Increased risk of death from certain types of cancer

An analysis of 13 studies, which looked at sitting time and activity levels, did find that people who sat for more than eight hours a day with no physical activity had a risk of dying similar to the risks of dying associated with obesity and smoking.  However, this analysis of data, which included more than 1 million people, found that 60-75 minutes of moderately intense physical activity each day actually counteracted the effects of too much sitting.  Another study found that sitting time contributed little to mortality rates for people who were the most active overall in their day-to-day lives.  Another study indicates that the problem lies in the absence of movement, rather than the time spent sitting itself.  The study author states that "Any stationary posture where energy expenditure is low may be detrimental to health, be it sitting or standing."

We definitely need more study on this subject to really understand the effects of sitting on our overall health and risk of dying.  However, it does appear that less sitting and more moving overall can lead to better health.  Movement is the key.  Here are some things that you might do to try to decrease the amount of time you spend sitting every day. 

• Find small activities that you can do moving rather than sitting whenever you have the chance, such as pacing back and forth when talking on the phone.
• Take a break from sitting every 30 minutes, either with a short period of standing and stretching or a quick walk around the office.  Set a timer to remind yourself.  These short breaks can also help you be more focused on your work for the remainder of day.
• Try using a standing desk, or use a high table or counter to improvise if necessary, for at least a part of your work day.  Don't just stand there though, try to move a little while you're standing, even if it is just shifting from one leg to the other or moving back and forth.
• If you have a meeting with only a few colleagues at work, try having your meeting while walking, rather than sitting in a conference room or office.
• Instead of sending an email to a coworker, try walking over to talk to them.
• When at home, do something active while watching TV, such as walking on a treadmill, riding a stationary bike, standing while folding some clothes, or doing some stretching exercises.
• Rather than sitting in a chair, try sitting on a stability ball at your desk or while watching TV. This forces you use your muscles to stay upright.
• Don't forget to get at least 30 minutes of moderate intensity exercise on most days.

If you are generally sedentary, spending a good deal of your day sitting, you may be surprised at the impact that movement can have on your health and well-being.  Even leisurely movement uses more energy and burns more calories than sitting.  This might lead to some weight loss or a general feeling of increased energy.  Physical movement also helps maintain muscle tone, flexibility, and your ability to move and balance, which is more important as we get older.  It also decreases chronic pain from arthritis, fibromyalgia, back pain and other conditions.  It helps to improve blood sugar and blood pressure levels.  Physical activity can also have a big impact on your mental health by promoting a better chemical balance in your brain.  We should all get up and move more!

If you have any questions about improving your physical activity, please log into your account and send us your question. We are here to help.

Dr. Anita Bennett MD - Health Tip Content Editor

Radon - What You Need To Know

We all know that cigarette smoking is the leading cause of lung cancer.  You may not be aware that the second leading cause of lung cancer in the U.S. is exposure to radon.  Radon gas can become trapped in your home and build up to dangerous levels.  In 2005, the U.S. Surgeon General issued a Health Advisory warning about the health risks of radon and urged Americans to test their homes for its presence.  Most Americans still don't know much about this important public health issue, so I thought this might be a good topic for discussion.

What is radon?

Radon is a radioactive gas, which has no odor, no color, and no taste.  It is extremely toxic in concentrated amounts.  Radon comes from the decay of radium, which is present in almost all rock, soil, and water.  The amount of radon in the soil depends on many factors, as does the amount of radon that escapes from the soil into the air.  Radon can get into any type of building, but you and your family are most likely to get your greatest exposure at home, where you spend most of your time.

What are the adverse health effects of radon?
All major national and international organizations that have examined the health risks of radon agree that radon increases the risk of lung cancer in humans.

• Radon is the leading cause of lung cancer among nonsmokers.
• Radon is the second leading cause of lung cancer overall.
• It is estimated to cause between 15,000 and 22,000 lung cancer deaths per year in the U.S.  
• For smokers, the risk of lung cancer is further increased by exposure to radon because of the synergistic effects of radon and smoking.

How does radon get into your house?

Radon typically moves up through the ground to the air above.  It can enter your home through cracks and holes in the foundation.  Radon coming from soil is the main cause of radon problems.  Sometimes, radon can enter your home through well water.  In some rare cases, building materials can release radon as well.
   

Any home can have a radon problem, including new or old homes, drafty or well-sealed homes, and homes with or without basements.  Radon can be found all over the United States, although levels are higher in some areas than others. 

How do you test for radon?

Testing is the only way to know if there is a high level of radon in your home.  The EPA and the Surgeon General recommend testing all homes below the third floor for radon.  The EPA also recommends testing in schools.  Testing is very easy and inexpensive with kits that can be found online or in home improvement stores.  Follow the directions on the package for proper testing and where to send the device after the test to find out your home's radon level.  There are discounted, or sometimes even free, test kits available.  Use the link below for more information about that.

Can you fix a radon problem in your home?

If the radon level in your home is 4 picocuries per liter (pCi/L) or higher, the EPA considers that an unacceptable level, which requires action.  The EPA has also been recommending for years that homeowners should consider fixing their homes when the radon level is between 2 and 4 pCi/L.  The World Health Organization recommends the lowest acceptable level of radon be set at 2.7 pCI/L.

Although it is not feasible to totally eliminate radon from the air, there are radon reductions systems that can reduce radon levels in your home by as much as 99%.  Even very high levels can be reduced to acceptable levels.  For reference, the average indoor radon level is 1.3 pCi/L and the average outdoor level is about 0.4 pCi/L.

If you are building a new home, your builder can incorporate radon-resistant features with very little additional cost.  The house should still be tested for radon after occupancy. 

For more information about radon, please use this link:

https://www.epa.gov/sites/production/files/2016-12/documents/2016_a_citizens_guide_to_radon.pdf

Use this link for more information about radon testing and fixing radon problems:

https://www.epa.gov/radon/find-radon-test-kit-or-measurement-and-mitigation-professional

If you have any questions about Radon, please log into your account and send us your question. We are here to help.

Dr. Anita Bennett MD - Health Tip Content Editor