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Health > More Health StoriesSummer 2010 IS Magazine8/25/10 IS Online

Checked Your Blood Pressure Lately?

Unchecked hypertension could be deadly.

By Lucy Jokiel

Harold Oshiro has been an HMSA member for more than 50 of his 79 years. About four years ago, his doctor referred him to HMSA’s Care Connection to help him manage his cardiac, diabetes and kidney problems. At that time, Oshiro, who is 5 feet 6 inches tall, weighed 258 pounds and his systolic blood pressure was over 200. Today, he weighs 210 pounds and his systolic blood pressure is down to 140.

How did he do it? “Every day, I checked my blood pressure and weight and sent it by computer to the Kapolei clinic,” he explains. “If it was too high, they called me up. They sent me pamphlets and told me what to do. If it wasn’t for those nurses, I’d be dead by now.”

Oshiro is an excellent role model for others with hypertension (high blood pressure) who need to make significant lifestyle changes. Hypertension is called the “silent killer” because it usually has no noticeable warning signs or symptoms until serious medical problems arise. Anyone, including athletes and children, can develop hypertension; almost one-fifth of them don’t know that they have it.

The bad news is that one in every three American adults has hypertension, one of the most common and potentially serious health conditions in the nation. An estimated 197,400 people in Hawai‘i have high blood pressure, according to the 2008 Hawai‘i Health survey.

The direct and indirect costs of high blood pressure topped $73 billion nationally in 2009, according to the American Heart Association. “Hypertension is the most prevalent chronic condition in the adult population,” says John Berthiaume, M.D., HMSA’s vice president of Care Management. “Recognition of the importance of identifying, educating and adequately treating individuals with the disease is one of the highest priorities for HMSA’s Care Management department.”

The good news is that blood pressure can be controlled. Risks for hypertension include a lack of exercise, poor diet, obesity, older age, drinking too much alcohol, eating too much salt, and having a family history of hypertension. Researchers at the National Institutes of Health blame the nation’s current obesity epidemic as a major contributing cause for hypertension.

What is high blood pressure?

Blood pressure is measured by evaluating how hard the blood pushes against the walls of your arteries. It’s normal for blood pressure to go up and down throughout the day, but if it consistently stays high for too long, it is called hypertension.

The measurement for blood pressure is written as two numbers, for example, 120 over 80 or 120/80. The first, or top, number represents the pressure when your heart contracts. This is called systolic pressure. The second, or bottom, number represents the pressure when the heart rests between beats. This is called diastolic pressure.

Normal blood pressure is a systolic pressure of less than 120 and a diastolic pressure of less than 80. For adults, hypertension is defined as a systolic blood pressure of 140 or higher or a diastolic blood pressure of 90 or higher. Pre-hypertension is defined as a systolic blood pressure of 120 to 139 or a diastolic blood pressure of 80 to 89.

What are the dangers of uncontrolled hypertension?

When your blood pressure remains high, it begins to damage your blood vessels, heart and kidneys. It can lead to serious medical problems, such as cardiovascular disease, which is the leading cause of death in Hawai‘i and the nation. Key risk factors from hypertension include:

  • Atherosclerosis, a disease of the arteries caused by a buildup of plaque, or fatty material, on the inside walls of blood vessels.
  • Heart disease, including heart failure (the heart cannot adequately pump blood), ischemic heart disease (the heart tissue doesn’t get enough blood), and hypertrophic cardiomyopathy (an enlarged heart).
  • Kidney problems. Hypertension can damage the blood vessels and filters in the kidneys, so they cannot properly excrete body waste products.
  • Eye disease. Hypertension can damage the very small blood vessels in the retina; in some cases, it can cause blindness.

Strategies to control your blood pressure

Uncontrolled hypertension can lead to life-threatening outcomes. The solution to controlling it is lifestyle management, which includes:

Maintaining a healthy weight. Losing as little as 10 pounds can reduce your blood pressure significantly.

Staying active. Studies show that regular aerobic exercise lowers blood pressure. Adults should engage in moderate physical activities, such as brisk walking, for at least 30 minutes on most days of the week.

Following a healthy diet. An overall healthy diet can help maintain normal blood pressure levels. This requires eating lots of fresh fruits and vegetables, and lowering or cutting out salt.

Avoiding excessive use of alcohol. High alcohol consumption is related to an increase in blood pressure. People who drink alcohol should do so in moderation.

Not smoking. Smoking injures blood vessels, speeds up atherosclerosis, and is a major risk for heart disease and stroke. If you don’t smoke, don’t start. Quitting smoking lowers your risk of heart attack and stroke.

Taking your medications as prescribed. Regular doctor visits and continuing to take your medications as prescribed are critical to keeping your blood pressure in check.

Reducing stress. Researchers have shown that people who practice daily stress-reduction techniques, such as meditation, have significant reductions in their blood pressure.

How can HMSA help you manage your hypertension?

HMSA offers various programs for members with high blood pressure:

  • HMSA’s Care Connection. Our team of specially trained registered nurses, dietitians and health coaches can help you manage your hypertension by giving you the tools, information and support you need. Care Connection reaches over 90,000 HMSA members currently living with a chronic condition such as diabetes, heart disease, asthma, chronic obstructive pulmonary disease (COPD), or kidney disease. Care Connection is available to all HMSA members; call 1 (800) 499-5036 for more information.
  • HMSA’s HealthPass offers a variety of resources to help you set goals to manage your blood pressure, including health coaching services and wellness and health education programs. HealthPass has six convenient locations throughout the state. For more information or to schedule an appointment, call the HealthPass call center at 432-9220 on O‘ahu or 1 (800) 525-6548 toll-free on the Neighbor Islands.
  • Ready, Set, Quit! HMSA’s program is designed to help you quit smoking and stay smoke-free. To enroll, HMSA members can call 952-4400 on O‘ahu or 1 (888) 225-4122 toll-free on the Neighbor Islands.

HMSA’s workbook, Managing Your Blood Pressure with a Healthy Lifestyle, includes information, tools, resources and local recipes designed for HMSA members with high blood pressure. To receive a copy at no cost, eligible members can schedule a HealthPass visit by calling (808) 432-9220 on O‘ahu or 1 (800) 525-6548 on the Neighbor Islands. You can also download a copy of the brochure here.

Island Scene Online is not intended to replace the advice of health care professionals. Please consult your physician for your personal needs and before making any changes in your lifestyle.
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