Vim & Vigor - Summer 2021 - 26

26

Eating healthfully and
exercising regularly have
proved difficult for our
society. How do you help
people succeed?

If high blood pressure
doesn't cause noticeable
symptoms, how should
people monitor for it?
Yang: While research shows mixed

results for whether yearly checkups

Are checks at regular
doctor visits enough to
catch a problem before it
causes damage?
Eugene Yang, MD,
chair of the
American College
of Cardiology's
Hypertension
Work Group

Blood
Pressure
and Stroke
Risk
High blood pressure
is a leading cause of
stroke, which is on
the rise in young and
middle-aged people.
The good news is
high blood pressure
and other stroke
risk factors are preventable. Learn how
at uvahealth.com/
stroke-prevention.

Yang: Most of the time, yes. Let's
say you developed elevated blood
pressure from one annual visit to
the next. There is a relatively low
probability that you've suffered
long-term damage, and we can
take steps to lower your blood pressure. That's why an annual visit is
a reasonable approach.

When someone
first gets high blood
pressure, what's the
treatment plan beyond
behavioral changes?

Yang: It depends on how high
the blood pressure is. Initiation of
medication is based on your risk
of having a heart attack or dying
in the next 10 years. We use a risk
calculator that considers whether
you smoke, have diabetes and
have a history of heart disease,
among other factors. If your blood
pressure is consistently elevated
and your risk is high, we would
initiate treatment.

What are the major
treatment options?

Yang: There are various classes
of medications. Diuretics, or
water pills, reduce sodium in the
bloodstream, which helps lower
blood pressure. There are drugs

ILLUSTRATION BY MONICA HELLSTRÖM

Yang: Typically, I'll give you something to focus on: Your job in the
next three months is to reduce
your sodium intake by eating less
processed foods and to try to lose
5 pounds. At your next visit, we will
see if you've been able to accomplish
this modest goal. The reality is it's
very hard. Holding people accountable and giving them small tasks is
much more digestible.

OUR EXPERT

lower the risk of heart problems,
I think it's important to have an
annual visit at a minimum to
measure what your numbers look
like-your weight, your blood
pressure. The blood pressure test
is quick, using a cuff that squeezes
your arm. Your doctor will notice
increases in blood pressure from
year to year.

SUMMER 2021 VIM & VIGOR

V1_VVSU2100_24-27_QA_BloodPressure.indd 26

4/28/21 10:36 AM

PHOTO BY GETTY IMAGES

almost 90 percent developed high
blood pressure by their 80s and 90s.
Conversely, people in an isolated
South American tribe, followed by
researchers for many years, have not
developed high blood pressure. This
argues that blood pressure is influenced by our environment.
Systolic blood pressure-the top
number-could go down with some
changes. I describe this as the " rule
of fives " : For every 10 pounds you
lose, you may be able to reduce your
blood pressure 5 points (millimeters
of mercury). Reducing your sodium
intake (by 1,000 milligrams per day)
and exercising regularly (150 minutes a week of moderate-intensity
activities, such as walking briskly)
can also help by 5 points. You're not
going to get 5 plus 5 plus 5, because
they're all related. But these interventions contribute in a way that
you may be able to prevent high
blood pressure or lower it to where
you don't need medication.
http://uvahealth.com/stroke-prevention http://uvahealth.com/stroke-prevention
Vim & Vigor - Summer 2021

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