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Health & Exercise Forum

Hypertension: Part 2 of 2

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Jan 15, 2018

Dr. Mackarey's Health & Exercise ForumHypertension: Part 2

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.

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 (narrowing)
  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.


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.


  1. Eat Healthy – low salt, low fat diet which includes: 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 4-5 days per week

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. A good program must include aerobic exercise (walking, jogging, biking) for 30 minutes (or 15 minutes twice a day) 4-5 days per week and mild/moderated weight training 2- 3 times per week.


  • A low salt, low fat diet which includes: fish, fiber, grains, fruits and vegetables is essential. Moreover, take care to avoid the “Seven Deadly Sins for High Blood Pressure” (Zee News):
  • Table Salt- Don’t add salt to your food because most foods have enough. Limit total salt consumption to 1,500 mg per day.
  • Deli Meat – These foods are loaded with salt as an additional preservative.
  • Red Meat – In excess, the trans and saturated fats in red meat can also damage the blood vessels of the heart over time. Limit consumption to 1 -2 times per week.
  • Alcohol – It causes the blood pressure to rise and in excess, can damage the blood vessel walls. Limit intake to 12 oz of beer, 8 oz of red wine daily.
  • Whole Milk – similar to red meat, the high concentration of saturated fats can damage blood vessels over time. A low fat substitute is a better option.
  • Pickles – Just 3 of these tasty cucumbers have more than the 2,300 mg of recommended sodium for an entire day.
  • Coffee – Caffeine can cause a temporary spike in blood pressure and should be consumed in moderation, especially for those at risk or with high blood pressure.

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, Zee News

Visit your doctor regularly and listen to your body.

NEXT MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!”

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 Geisinger Commonwealth School of Medicine.