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High blood pressure


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When we are having high blood pressure, it is time we are knowledgeable about it and follow the heart care requirements.

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High blood pressure

  1. 1. High Blood Pressure High blood pressure (or “hypertension”) produces no obvious symptoms until it reaches the advanced stage and damages organs, especially the kidneys, heart, brain, and blood vessels. It is one of the most common risk factors for heart attack, stroke, kidney failure, peripheral vascular disease, atherosclerosis, and heart failure, defined as an inability of the heart to pump enough blood to meet the body’s needs. Untreated, it can also lead to left ventricular hypertrophy (LVH), an enlargement and thickening of the walls of the heart’s main pumping chamber. LVH is an independent risk factor for heart failure. In general, high blood pressure is defined as consistent blood pressure readings above 140 / 90, although 120 / 80 is the goal. Stress Doctors have long debated the role of stress in promoting heart disease, but there’s a growing body of evidence that it is a risk factor. Exactly how stress harms the heart is not fully understood, but researchers do know that constant high levels of stress prompt hormonal changes that can send blood pressure and insulin levels soaring, and likely promote inflammation and other body changes that, over time, increase cardiovascular risk. Stress may also lead to depression, one of several psychological factors linked to an increased risk of a heart attack. Both short-term and prolonged stress appear to be risk factors. Many heart attack patients report undergoing unusual stress in the hours before they were stricken. It is well-known that sudden, severe stress can precipitate a heart attack in people who already have coronary disease. 1
  2. 2. Sustained stress has also been associated with an increased heart-attack risk. This connection was documented in a recent multinational study that surveyed more than eleven thousand people who had suffered heart attacks and compared them with about thirteen thousand healthy control subjects. The study found that the heart-attack patients had been under much more stress in the previous year than had been the healthy controls. The stress came from various sources — problems at work, financial difficulties, family troubles, depression, the death of a loved one, and other causes. The senior investigator of the study, Dr. Salim Yusuf of McMaster University, concluded that stress “was comparable to risk factors like hypertension and abdominal obesity,” and that its effect was “much greater than we thought before.” Of course, all of us are subjected to different types of stress every day, and most people can develop moderately effective ways of dealing with it. Yet the presence of other risk factors and a person’s personality make everyone’s experience of stress unique. A hard-driven executive may thrive on a stress level that would drive other people crazy. Conversely, even low levels of stress may tip the balance for a more high-strung person. In any event, persistent stress and poor coping mechanisms can harm health. Several studies published in the last few years have identified depression as an independent factor that increases the risk of a heart attack. Precisely how depression affects heart function is unknown, but diagnosing and treating depression is now considered an important aspect of reducing cardiovascular risk. 2
  3. 3. Sedentary Lifestyle Numerous studies have found that exercise is an important factor in preventing heart disease. People who exercise regularly are less likely to be overweight and develop other cardiovascular risk factors, including diabetes, high blood pressure, and elevated blood cholesterol. But even though most people know that regular exercise is beneficial, many have difficulty sticking to a regimen. Arthritis and other orthopedic problems, weight, weather, geographic locale, time constraints, and availability of exercise facilities are just some of the obstacles to a successful exercise program. Indeed, we all can probably come up with a long list of excuses to remain a sedentary “couch potato,” but in fact virtually everyone can develop an exercise program that fits his or her lifestyle. If you have arthritic knees, jogging or singles tennis is not going to be part of your long-term exercise regimen. But you may well consider swimming, tai chi, using an elliptical trainer, or any number of other enjoyable activities. 3
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  6. 6. The Three Variables of Every Exercise Program Three variables influence the beneficial or training effect of exercise: frequency, duration and intensity. Aerobic activities that require moderate exertion over an extended period are the most effective for improving cardiovascular function. To obtain maximum benefits, we recommend that you exercise for an average of thirty minutes three to five days a week. (You may exercise longer or more frequently provided that doing so does not provoke symptoms or complications.) The more intensive the exercise, the greater the cardiovascular conditioning. 6
  7. 7. Most healthy adults should strive for five weekly sessions, and those who need to lose weight should plan five or six low-impact workouts a week. (As a general rule, you should refrain from exercise one or two days a week to give the body a chance to recover.) The duration varies according to individual factors and the type of exercise. A sedentary person just starting a regimen may be well advised to start with one or two ten-minute sessions three times a week and to gradually increase the intensity and duration as endurance improves. The type of exercise also influences how long you should exercise. Walking or jogging a mile burns about a hundred calories, regardless of how fast or slow you go. For example, walking a mile in twenty minutes burns the same number of calories as running a mile in ten minutes. Thus, if the goal is to burn three hundred calories, you can achieve this in a half hour of running at a rate of six miles per hour, or an hour of walking at three miles per hour. As for intensity, the goal is to exercise at a certain percentage of your maximum safe heart rate, depending on your general health, age, and cardiovascular risk factors (see Box 3). In general, an obese or older person should exercise at a more moderate pace; for example, start at 50 or 55 percent of the maximum safe heart rate and gradually increase this over time. You’ll soon learn what is comfortable for you. As a rule of thumb, many experts recommend adopting a “talking pace,” which is intense enough to raise your heart rate and produce sweating but moderate enough that you can carry on a conversation without 7
  8. 8. gasping for breath. At first, you may be able to achieve this pace only while walking at a moderate pace, but as your fitness and endurance improve, you’ll be able to pick up the pace without feeling out of breath. Warming up before exercise and cooling down afterward will help avoid injury and discomfort. We recommend five to ten minutes of warm-up exercises— for example, walking at a moderate pace, swinging the arms, or slow jogging in place—at the beginning of each session. An older person may need an even longer warm-up. Some people do stretches during their warm-up, but do so with great caution, if at all, because stretching cold muscles increases the risk of injury. How you conclude an exercise session is also important because stopping abruptly can result in muscle cramps and/or a drop in blood pressure and dizziness, especially in older persons. So at the end of the session take five or ten minutes (or longer if you wish) to cool down by exercising gently—for example, walking at a slow pace—until your heart rate is again ten to fifteen beats a minute faster than your normal resting pulse. Gentle stretching exercises should also be part of the cool down period. 8