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Health & Exercise Forum

Hypertension Awareness

Nov 3, 2014

Dr. Mackarey's Health & Exercise ForumThe Commonwealth Medical College presents: Keystone Symposium 2014 “Hypertension: Guide to the Guidelines”

In an effort to address the nation’s growing problem with hypertension, The Commonwealth Medical College with host “Keystone Symposium 2014 - Hypertension: Guide to the Guidelines” on Saturday, November 8, 2014 from 8 am to 12:30 pm. If you are a health care professional and would like to attend the symposium, at TCMC 525 Pine St. Scranton, PA, please contact the medical school at: 570-207-3686.



According to the Centers of Disease Control (CDC), Hypertension (HTN), also known as high blood pressure (HBP), affects one in three adults (67 million people) in the USA. Unfortunately, only one-half of those with high blood pressure control the problem and, as a result, are at great risk for heart disease and stroke. Emergency rooms in the United States have experienced a 25% increase in emergency room visits for HBP between 2006 and 2011.

Blood pressure numbers represent the force against the walls of your arteries. Normal blood pressure (BP) is defined as a systolic pressure (the top number) of 120 mm Hg and a diastolic pressure (the bottom number) of 80 mm Hg (120/80). The Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure has classified blood pressure as follows:

  • Normal: lower than 120/80 mm Hg
  • Prehypertension: 120-139/ 80-89 mm Hg
  • Stage 1 Hypertension: 140-159/90-99 mm Hg
  • Stage 2 Hypertension: 160+/100+ mm Hg

 Risk Factors for HBP*

  1. African American
  2. Obesity
  3. Stress and anxiety
  4. Excessive alcohol use – more than 1 drink/day for women, 2/day for men
  5. Excessive salt intake
  6. Family history of HBP
  7. Diabetes
  8. Smoker

Medical Conditions or Medications Contributing to HBP*

  1. Chronic kidney disease
  2. Adrenal gland disease
  3. Hyperactive Thyroid
  4. Pregnancy
  5. Renal artery stenosis
  6. Medications: birth control pills, diet pills, cold and migraine meds 

*(National Institutes of Health, Medline Plus)


Symptoms of HBP

For most people with HBP, there are no obvious symptoms. HBP is usually detected at a health fair or a routine visit with a physician. However, over time, HBP can cause problems with the heart and kidneys. Sometimes, a more serious condition can develop from very high blood pressure called malignant hypertension. Symptoms include; severe headache, nausea and vomiting, confusion, vision changes and nosebleeds. Notify your physician immediately if you develop these symptoms.


Diagnosing HBP

Almost everyone has had their blood pressure checked with a standard or automatic blood pressure cuff. Sometimes, when a problem is detected, a home blood pressure unit is recommended to track BP throughout the day.

Treating HBP

  1. Eat Healthy – low salt, low fat, include: fish, fiber, grains, fruits and vegetables
  2. Drink Plenty of Water
  3. Do Not Smoke
  4. Limit Alcohol to 1/day for women and 2/day for men
  5. Maintain a Healthy Body Weight
  6. Medication – not usually used for pre hypertension
  7. Limit Salt - less than 1,500 mg/day
  8. Limit Stress – consider meditation, tai chi, yoga
  9. Exercise – 30 – 45 minutes of aerobic exercise daily

Manage Stress

According to a recent long-term study, both men and women without a history of coronary artery disease or high blood pressure suffered from both diseases when they did not manage stress well. Those who allowed stress to upset them, (short fused and easily frustrated) had significant increases in cholesterol and blood pressure when compared with those who were more even-tempered and easygoing under stress.

Commit to Exercise

Exercise combats HBP and maintains a healthy body weight. The key to success when it comes to improving your life with exercise is to develop a regular, consistent program.

10 Tips to Stick to an Exercise Program

  • Add variety to your program – stick to your basic program to meet your goals, but add variety to help you stick to your program. On off-days, walk in the woods, play tennis, ride a bike, or swim. One day, do upper body and the next do lower body.
  • Find an exercise buddy – no one wants to let a buddy down, so the likelihood of compliance is much greater when you have someone depending on you. Make sure it is a good match.
  • Make exercise a priority – friends and family must understand that exercise is important to you. It is a non-negotiable element of your day, like taking a vitamin or brushing your teeth.
  • Exercise first thing in the morning – before all of the demands of the day come into play.
  • Exercise on the way home from work – after you fulfill other obligations but before you get home.
  • Exercise even when you are tired – keep in mind that you will be energized after you exercise.
  • Keep a log of your exercise – writing down the dates, times, speed, distance, reps and sets can help you monitor your progress.
  • Look for signs of progress – the scale is only one sign of progress. Make note of how your clothes fit, how much energy you have, the pep in your step.
  • Walk – incorporate walking into your daily routine. Walk to the store, walk the dog, walk when you play golf, and choose to take the stairs.
  • Reward yourself – try to avoid a food overdose as a reward. For example, when you lose 10 pounds, buy yourself an outfit. For the next 10 pounds, go away for the weekend.

In conclusion, while HBP is a potentially serious medical condition, for most it is a controllable and preventable problem. Lifestyle changes such as diet, exercise and stress reduction have been found to be most effective.

SOURCES: Centers For Disease Control (CDC); American Heart Association (AHA), University of Pittsburgh Medical Center (UPMC), National Institutes of Health (NIH), Medline Plus

Visit your doctor regularly and listen to your body.

NEXT MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum” in the Scranton Times-Tribune.

This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email:

Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at The Commonwealth Medical College.