High Blood Pressure: A Vital Understanding for Health Management and Dispelling Myths-by Harold Gunatillake
Even if you are healthy and active, high blood pressure is shared among the ageing population and is an inevitable observation. This is a significant health problem that many healthy people are unaware of and do not routinely check their blood pressure for. When you visit your family doctor for an ailment unrelated to high blood pressure, your doctor will check your BP while listening to your ailment. This shows the importance of regularly checking your blood pressure and empowers you to take control of your health by making informed choices.
Blood pressure is the force exerted by blood on the walls of the arteries as it flows through them. This pressure is essential for pushing the blood throughout the body and ensuring that vital organs receive an adequate supply of oxygenated blood.
The ideal blood pressure range is a systolic pressure below 120 mmHg (millimetres of mercury) and a diastolic pressure below 80 mmHg. This range is considered healthy and reduces the risk of cardiovascular problems such as heart disease, stroke, and kidney damage. Blood pressure consistently above this range is considered elevated or high and requires medical attention and appropriate treatment.
The above readings are taken at rest (5 minutes after resting). Why check your BP at rest, which does not reflect your BP during regular daily working hours?
I have noticed that when I check my blood pressure at rest, it often shows a high reading, such as 140/80, with a pulse rate of 70-80, and I am not taking any medication to control hypertension. However, walking for half an hour and checking my blood pressure seems to lower it to 120/70, and my pulse rate drops to about 60 beats per minute.
This observation is relevant for people like me who walk daily, taking over 24,000 steps (about 3 hours), and may not be observed among sedentary individuals.
How can this be possible?
The American Heart Association defines “alternative approaches” as non-pharmacological treatments that can lower blood pressure. It classifies them into behavioural therapies, non-invasive procedures, and exercise-based regimens.
In recent decades, several studies have revealed that exercise and fitness produce beneficial effects in the general population, reducing the relative risk of death by 20%-35%, particularly death caused by cardiovascular disease.
The literature provides strong evidence supporting the effectiveness of physical fitness in treating hypertension. Physical
activity helps to lower blood pressure, thus reducing the risk of developing and worsening hypertension.
Wellman and colleagues conducted a study of adolescents and found that physical activity is associated with a lower risk of high blood pressure. The exact molecular mechanisms underlying the positive effects of physical activity on blood pressure are not fully understood, likely due to the complexity of blood pressure regulation, which involves neurohormonal, hemodynamic, and metabolic processes. Exercise training can impact blood pressure by influencing various processes (see Figure 1), although our understanding of these processes is incomplete.
As I mentioned in an earlier article, physical activities like regular daily walking affect BP by regulating endothelial (inner-layer) blood vessel function. Nitric oxide (NO) synthesis dilates blood vessels, improving oxygen and nutrient delivery during exercise.
People with type 2 diabetes have difficulty producing nitric oxide, leading to claims that taking supplements can increase nitric oxide levels. However, it is essential to emphasise that walking improves insulin sensitivity, making nitric oxide supplements unnecessary.
Nitric oxide is a gas your body naturally produces. Certain enzymes called nitric oxide synthase break down an amino acid called arginine and produce nitric oxide.
This chemical reaction happens in almost every cell and tissue in your body, producing a small-molecule gas that quickly enters your cells. It’s vital for your blood vessels and helps keep them flexible.
(The author was a person with type 2 diabetes taking 30 units of Novomix injections twice a day and subsequently walking daily for 3 to 4 hours intermittently reversed my insulin resistance, and there was no necessity to take insulin injections anymore, or as it now)
In addition to leading a sedentary life with no exercise, smoking, excessive alcohol consumption, a diet high in salt, being overweight, and having a family history of stress and ageing are other factors causing high blood pressure.
So, without antihypertensive medication, one can sustain normal blood pressure with effort.
Exercising daily benefits your body and helps lower your BP. It can reduce the risk of developing heart disease, diabetes, and metabolic syndrome, prevent kidney failure, strengthen your heart, lungs, and skeletal muscles, help you manage stress, and improve your mood.
Exercise is not only walking; it also includes gardening, housework, dancing, and other physical activities.
When you have high blood pressure, avoid intense, heavy weightlifting; usually breathe, try to avoid holding your breath, and stay hydrated.
If exercise is Medicine, why take pharmaceutical chemicals? There are side effects to taking drugs like Angiotensin 11 Receptor Blockers (ARBs) or Angiotensin-converting enzyme inhibitors (ACE inhibitors), the commonly prescribed antihypertensive drugs for the elderly.
ARBs are generally well-tolerated, but, as with any drug, they can cause unwanted effects, including dizziness, headache and fatigue. These may improve after a few days. After you start the drug, you’ll need another blood test to check your kidney function.
ACE inhibitors, too, have nasty side effects, which may include dry cough, needing a change of drug, and too much potassium accumulation in the blood.
Having too much potassium in your blood can be dangerous. Hyperkalemia can even cause a heart attack or death!
Unfortunately, many people do not feel symptoms of
hyperkalemia until it is too late, and their heart health worsens. If you have kidney disease, you are at risk of high potassium levels.
ACE inhibitors can cause extreme tiredness or dizziness from blood pressure dropping too low, headaches, loss of taste, and, rarely, a short-term worsening of kidney function.
With such dangerous side effects from drugs taken to control blood pressure, it gives the very same conditions as having high blood pressure, maybe without kidney disease and more; as mentioned, why take these drugs when simpler non-drug taking efforts can control high blood pressure?
These drugs don’t come cheap unless there is a government subsidy.
In Sri Lanka, any of these antihypertensive drugs, a 30-day supply costs over Rs. 5,000.00, and the average wage owner cannot afford it.
The cost of walking there is only the wear and tear on your shoes.
So, take my advice—start walking daily, taking as many steps as possible within your time constraints, sticking to a low-calorie, plant-based diet, and limiting your alcohol intake. With weight loss, your blood pressure will reduce to within the normal range. I bet that.
Image Source:Onlinelibrary
