Transcript Harmony Health and Wellness, LLC

BLOOD PRESSURE CONTROL WITH
DIET AND EXERCISE
KIMBERLY HARM, PHD, APRN-NP
KIM HARM, PHD, APRN-NP
• Columbus Community Hospital’s Humphrey Medical Clinic
•
Primary care
• Harmony Health and Wellness
•
Functional medicine
•
Personalized, lifestyle medicine
OBJECTIVES
• To understand the underlying causes of high blood pressure
• To become familiar with lifestyle changes to prevent or
reverse high blood pressure
• To develop confidence in your ability to make changes to
optimize your control of high blood pressure
HIGH BLOOD PRESSURE
• 29% of Americans (around 70 million) have high blood pressure
• 1 in 3 adults
• Another 1 in 3 have prehypertension
• High blood pressure costs the US $46 billion each year
• High blood pressure as a primary or contributing cause of death
• 1000 deaths per day
• Key risk factor for heart disease and stroke
• Heart disease is the leading cause of death for both men and women
• 610,000 people die of heart disease in the US yearly; 1 in 4 deaths
Cardiovascular disease (CVD) deaths versus cancer deaths by age (United States: 2011).
Dariush Mozaffarian et al. Circulation. 2015;131:e29-e322
Copyright © American Heart Association, Inc. All rights reserved.
Prevalence of high blood pressure in adults ≥20 years of age by age and sex (National Health
and Nutrition Examination Survey: 2007–2012).
Dariush Mozaffarian et al. Circulation. 2015;131:e29-e322
Copyright © American Heart Association, Inc. All rights reserved.
BLOOD PRESSURE
• The force of blood against the walls of the arteries.
• Normal
•
Systolic: <120 mmHg
•
Diastolic: < 80 mmHg
• At Risk (Prehypertension)
•
Systolic: 120-139 mmHg
•
Diastolic: 80-89 mmHg
• High
•
Systolic: > 140 mmHg
•
Diastolic: > 90 mmHg
CONSEQUENCES
• Damage to the heart and coronary arteries—heart attack, heart disease, congestive
heart failure, aortic dissection, atherosclerosis
• Stroke
• Kidney disease
• Loss of eye sight
• Erectile dysfunction
• Memory loss
• Angina
• Peripheral artery disease
•
http://www.heart.org/HEARTORG/Conditions/HighBloodPressure/WhyBloodPressureMatters/Why-Blood-Pressure-Matters_UCM_002051_Article.jsp
RISK FACTORS
• Age
• Heredity, but your genes are not your destiny
• Overweight or obesity
• Smoking and second hand smoke
• High cholesterol
• Diabetes, metabolic syndrome
• Physical inactivity
• Poor diet, too much salt, not enough potassium
• Drinking too much alcohol
• Stress
• Sleep and sleep apnea
•
http://www.heart.org/HEARTORG/Conditions/HighBloodPressure/WhyBloodPressureMatters/Why-Blood-PressureMatters_UCM_002051_Article.jsp
CAUSES OF HIGH BLOOD PRESSURE
• Unhealthy relationship between your genes and your environment
• Includes your lifestyle
• How you move
• How you rest and sleep
• How you stress
• How you eat
CAUSES OF HIGH BLOOD PRESSURE
• High fat
• High sugar
• High alcohol
• High stress
• No exercise
• Depression
• Hostility
• Weight gain, especially in the middle
LIFESTYLE CHANGES TO LOWER BLOOD PRESSURE
• Get moving
• Focus on nutrition
• Cut the salt
• Take your medications
• Check your blood pressure
• Lose weight
• Cut back on alcohol
• Don’t smoke
• De-stress
• Sleep well
GET MOVING!
• Keep it simple if you are not doing anything already
• Walk each day
• Stand instead of sitting
• Park further away
• Optimally:
• 5 days per week, moderate intensity for 30 or more minutes
FOCUS ON NUTRITION
•
•
•
•
You gotta eat your veggies!!!!
Mind your portion sizes
Keep proportion of vegetables half or more of your meals
Whole grains, not processed!
• Can you eat anything else besides cereal and toast for breakfast?
• Does it always have to be a sandwich for lunch?
• Homemade is best
• Avoid processed foods and packaged, semi-made items
CUT THE SALT
• At the table
• See what food tastes like without it
• Biggest source is from processed foods and dining out
• Homemade is better
MEDICATIONS
• If on medication for blood pressure
• Take your medications as instructed
• Keep a card of the medications you take with you
• Keep the card up-to-date
• Keep your regular follow-up appointments and blood draws with your
primary care provider
• If not on medications, let’s keep it that way! Prevention is best
CHECK YOUR BLOOD PRESSURE
• Make sure you do not have high blood pressure
• It does not have symptoms, “The Silent Killer”
• Remember, the incidence increases with age
• Getting away with poor choices earlier in life does not mean that will last!
• Seek the care if the numbers are creeping up
LOSE WEIGHT
• See numbers 1, 2, 7, and 8
• Get moving
• Nutrition
• Eat your veggies
• Whole fruits and vegetables
• No processed foods
• Cut back on alcohol
• Get a handle on stress
• Get good sleep
• Ask for local resources if you need help
ALCOHOL
• Drinking too much alcohol can cause heart failure, lead to stroke, cause
irregular heart beats, contribute to high triglycerides, cancer, obesity,
alcoholism, suicide and accidents
• 2 per day for men
• 1 per day for women
• Caution, there are those who cannot handle this much
• May need to reduce to 3-4 per week
• Optimally, alcohol only on holidays or special occasions
SMOKING
• There is no amount of smoking consistent with optimal health goals
• Please stop smoking tobacco
• Seek special counseling
• Nebraska Tobacco quit line
• 1 (800) QUIT NOW
• Nebraska Department of Health and Human Services has online
resources
• Stop smoking all substances
DE-STRESS
• “Stress is not a product of the world, it is
the lens through which you view the
world.”
•
Shilpa Saxena, MD
DE-STRESS
• Find a sense of purpose
• Participate in your community
• Find a community
• Deep breathing exercises twice daily
• Real versus perceived threats
• Yoga
• Walking or moving
• Smile
SLEEP WELL
• Devote 8 hours per day to sleep
• Prepare for sleep with a bedtime ritual
• Have regular bed and wake times
• No work in the bedroom
• Do not check email or search on the web
• No TV
• Make the bedroom comfortable
• Do not stay in bed if you toss and turn
• No clock in the bedroom
SLEEP APNEA
• People who snore or stop breathing at night
• This needs to be evaluated
• Your primary care provide can get you set up for a sleep apnea test
THANK YOU!
QUESTIONS?