Hypertension means you have high blood pressure, a condition where the force of blood pushing against the walls of your arteries is consistently too high. High blood pressure puts you at a greater risk of a heart attack, stroke, and a number of other issues. As such, if you’re in that camp it’s urgent you make some lifestyle changes – or in more extreme cases take medication – to bring blood pressure levels down.
If you’re suffering from hypertension you’re not alone – it affects 1.4 billion people worldwide and one in four Canadians. As such, there’s extensive measures backed by clinical research on how to improve your levels.
The challenge with hypertension is catching the issue early, so you can make alterations before it does too much damage. Hypertension is commonly known as the ‘silent killer’, because its symptoms can be mild or non-existent. In Canada around 17% of those with hypertension are unaware they suffer from the condition.
Types of hypertension
- Primary/Essential Hypertension means you have been diagnosed with high blood pressure without knowing the cause. It accounts for 90-95% of cases.
- Secondary Hypertension is when there’s a known and identifiable cause for having high blood pressure, for example kidney disease, and it accounts for 5-10% of hypertensive cases.
- Malignant Hypertension is when blood pressure rapidly increases to dangerous levels, to the point where you generally need urgent medical care in the form of medication(s). It’s more common to have symptoms than other forms of hypertension, like headaches, blurred or double vision, as well as nausea or vomiting. It can be triggered by toxemia of pregnancy, also called preeclampsia.
- Resistant Hypertension means you don’t respond well to at least three treatments. Medication can fail to have positive effects due to factors like having a BMI above 25, diabetes, not doing enough exercise, eating too much salt, or drinking too much alcohol.
- Pulmonary hypertension is when there’s high blood pressure in the pulmonary arteries, between the heart and the lungs. Left untreated it can cause heart failure, while a primary symptom is a shortness of breath.
- Isolated systolic hypertension is when the systolic blood pressure (the force of blood against the artery walls) rises above 140 but diastolic pressure (when your heart rests and fills with blood between beats) stays at a normal range. This is more common for over-65s and is caused by a loss of elasticity in the arteries. Symptoms are similar to regular hypertension, but they can be more severe and/or happen more often.
The blood pressure categories, as defined by British Columbia’s Guidelines & Protocols Advisory Committee:
- Low Normal: Below 120/80 mmHg
- Normal: 120-129/80-84 mmHg
- High Normal: 130-139/85-89 mmHg
- Hypertension Stage 1: 140-159/90-99 mmHg
- Hypertension Stage 2: 160-179/100-109 mmHg
- Hypertension Stage 3: 180 and above/110 and above mmHg
Further up the severity scale doctors are urged to prescribe pharmacological treatments. At Stage 3 two separate medications are recommended, followed by a reassessment every one or two months until blood pressure levels are under control.
Making lifestyle changes
In less severe cases doctors may advise you to improve blood pressure levels by making lifestyle changes, rather than relying on medications, which themselves can carry side-effects.
Diet
The Heart and Stroke Foundation of Canada recommends sticking to the ‘DASH Diet’ to lower blood pressure.
To stick to the diet daily you need:
- 4-5 servings of vegetables
- 4-5 servings of fruit
- 7-8 servings of whole grains
- 2-3 servings of low or no fat dairy
- 2 servings of lean meats, poultry and fish
- 4-5 servings of nuts, seeds and dry beans
- 2-3 servings of fats and oils
Being disciplined with the DASH diet should reduce blood pressure within just two weeks.
Limiting other foods and drink
Cutting salt intake is a great way of improving blood pressure levels, so it’s recommended you remove the salt shaker from the table.
Too much salt is a major contributor to high blood pressure, while 60% of people with high blood pressure have a particularly negative response to sodium.
Drinking too much alcohol also increases risk, as well as consuming fatty meats, full-fat dairy, sweets, and sugary drinks.
Exercise
The Heart and Stroke Foundation of Canada recommends adults get at least 150 minutes of moderate- to vigorous-intensity aerobic physical activity per week, in sessions of 10 minutes minimum.
Ideally these should be split between endurance and strength. Endurance means activities like walking, cycling and tennis, while strength activities like carrying groceries or weight training.
Medications
Common blood pressure medications include diuretics, ACE inhibitors, beta-blockers and calcium channel blockers.
- ACE inhibitors work in the kidneys to decrease blood pressure. Possible side effects include dizziness, light-headiness and a dry cough, while you need to monitor potassium levels and kidney function.
- Calcium Channel Blockers decrease blood pressure in blood vessels, also causing a slowing of the heart rate. Side-effects include dizziness and swelling in the legs.
- Diuretics get rid of excess fluid in the kidneys. However they can make you need to pee more often, while you need to keep a close eye on potassium levels and kidney function.
- Beta Blockers slow down heart rate and decrease blood pressure, while complications can include dizziness, light-headedness and fatigue.
- Nitrates work by widening blood vessels. They shouldn’t be used in tandem with erectile dysfunction medications, as that can cause blood pressure to drop to dangerous levels. Side-effects include dizziness, light-headedness and headaches.
Given how medications can have unwanted effects, it’s easy to see why making lifestyle changes is often the preferred method of improving blood pressure.
The Hilo Band: Continuous monitoring
The Hilo Band comes in the form of a wristband that’s lighter and more comfortable than a traditional inflatable cuff. Currently you need to cross-reference your reading with a traditional cuff once per month, to ensure it’s all working appropriately, though it’s thought that process will eventually be done away with completely.
The Hilo Band uses optical sensors to take around 25 readings per day, providing an accurate ongoing reading of blood pressure levels, which are then accessible on the Hilo app (on iOS or Android). The band is an effective tool in tracking how and whether you are improving blood pressure levels, as well as giving you early warning signs before you suffer from hypertension.
The Hilo Band was granted Health Canada approval in November 2024, outlining its strong credibility within the scientific community.
Hypertension myth busting: Age, gender and symptoms
It’s important to get to the facts about this serious condition, so let’s clear the air around hypertension and examine four common misconceptions.
Myth 1: Hypertension only affects the old
Older people have higher blood pressure levels than the young, as acceptable levels shift up as we age. For 19-40 adults normal levels of blood pressure are 95-135/60-80, though from 41-60-year-olds that rises to 110-145/70-90. While older people are more susceptible to having a high blood pressure, all ages can suffer from hypertension. Even children can be affected, as research shows that 1-2% have high blood pressure in Canada.
Myth 2: Hypertension is more prevalent in men
This is half true, as adult males up to the age of 64 men are more likely than females to develop high blood pressure. This is due to the effects of testosterone on blood pressure, as well as environmental factors like smoking, alcohol and diet. A study found that men from ages 20 to 49 were up to 70% more likely to have uncontrolled hypertension compared to women.
After menopause however it flips, and women are more at risk, as the loss of estrogen causes arteries to stiffen. At this stage their risks are said to be 63% higher than men.
Myth 3: Hypertension is caused by stress
While stress can cause temporary spikes in blood pressure, long-standing hypertension isn’t caused by stress alone. Bigger factors are lifestyle, genetics and demographics. Rather than being the direct cause, stress can lead to unhealthy habits that worsen blood pressure, like a poor diet, lack of exercise or smoking.
Myth 4: There is a cure
There is no permanent cure for hypertension. Instead, it’s something that requires lifelong management, treatment and monitoring. That’s why the Hilo Band is designed to constantly monitor your blood pressure to ensure you’re not putting yourself at risk.
Hypertension can have symptoms
It may be known as the ‘silent killer’, but hypertension can sometimes come with symptoms. The challenge is they can also be symptoms of other ailments, so without getting your blood pressure checked it’s hard to get to the root of the problem.
Symptoms may include:
- Headaches: Frequent, unexplained headaches
- Shortness of breath: Difficulty breathing, especially during physical activity
- Dizziness: Feeling light-headed or unsteady
- Nausea: Sickness and sometimes vomiting
- Blurred vision: Changes in eyesight, indicating possible damage to blood vessels in the eyes
These symptoms commonly only appear when hypertension has reached a severe or life-threatening stage, which is why it’s far better to regularly monitor your blood pressure to identify the problems before you start having any symptoms.
Higher risk groups
Sex and Age
Men are more at risk of hypertension than women until the age of 65, when that flips.
Race and ethnicity
Canada’s First Nations populations are more likely to have high blood pressure than non-Indigenous people. The same also applies to those of African and South Asian heritage.
A 2015 US study found that a 45-year-old African-American man residing in the Southeast United States has the stroke risk of a 55-year-old white man in the Southeast, or a 65-year old white man in the Midwest.
Genes vs Environment
People of African and South Asian heritage are both more sensitive to eating salt than their European counterparts, while having a family history of high blood pressure suggests there’s a genetic correlation.
However, in most cases environmental factors are likely to be more important. For example smoking tobacco is far more prevalent in First Nations cultures, as 57% smoke daily or occasionally, compared to 20% of the general Canadian population.
Family history
If your parents or close blood relatives have high blood pressure, your chances of developing an issue increase. This is due to both genetic and environmental factors, as families may have unhealthy traits that affect the household, like cooking with too much salt.
Smokers
Smoking causes blood pressure to rise for around 20 minutes, while it causes a number of cardiovascular problems.
High BMI
Having a Body Mass Index above 25 puts more pressure on the heart. Excess weight gain, especially when there is fat around the organs, is the cause of 65-75% of hypertension, according to a 2015 study.
Kidney conditions
Kidney disease can be a symptom of, and cause, hypertension. On one side high blood pressure puts a strain on blood vessels, especially in the kidneys, inhibiting kidney function. In turn the kidneys regulate blood pressure, so if they are damaged blood pressure levels can worsen.
Diabetes
Diabetes can also cause hypertension, as high blood sugar levels can damage blood vessels and the kidneys. As such, a diabetic person is twice as likely to have high blood pressure than someone without.
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Conclusion
If you’ve been diagnosed with hypertension, your first port of call is making lifestyle changes, like increasing levels of exercise and living a healthy, balanced diet. In more extreme cases you can turn to medications, either singularly or multiple at once. Whatever is decided, it’s important you keep the lines of communication open with your health professional when taking medication or making significant changes.
Whether you suffer from hypertension or not it’s important to understand and monitor your blood pressure levels. That’s why the Hilo Band is a helpful tool, given that it enables you to easily keep track of your progress. Improving blood pressure levels can be a slow process, but it’s a fantastic motivator to see how conditions are improving over the weeks and months.
Disclaimer: If you have hypertension, we encourage you to speak to your healthcare professional if you plan to start monitoring your blood pressure at home.
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