High Blood Pressure & Heart Health: How to Measure and Manage

Welcome and Event Introduction 0:00

Welcome to Calgary's 13th Walk with a Doc and our one year anniversary. Thank you guys so much for making this happen. Genuinely cannot believe that we're here and 100% could not have done this without each and every one of you. So I really appreciate all of your coming consistently, even in weather like today. We'll do our usual thing, a little about me, little bit about Walk With A Doc. Our health topic for today is hypertension or high blood pressure, so we'll talk about that and then we will take our group photo and get on our way.

Does that sound good? Myself, as you know, I'm Dr. Hussein Kimji. I am on a mission to help you with three things. Become your happiest and healthiest self, manage, prevent and reverse chronic disease, and optimize your mental and emotional well-being.

Hypertension Overview and Cardiovascular Risk 0:39

More importantly, i'm also a human in progress, so i am here to get my steps in with you, build this healthy community together, And as know it's my privilege to host Calgary's Walk with the Doc. Now for a year here, And Walk with a Doc as an organization is now 21 years old this month in April 2026 and some of you are doing that walking challenge with me as well which we'll talk about at the end today. Our health topic is high blood pressure or hypertension which I think all of are familiar with whether you have the diagnosis or not.

It is something that affects one in four Canadians, so very, very common. It's one of the silent killers or silent chronic diseases, and it really pushes our risk up for things like heart attack, stroke, kidney disease, lots of other consequences. So it's really important that we learn about it, learn how to navigate it and learn to manage it. Backing up a little bit, cardiovascular disease. Is everyone familiar with what that is?

Blood Pressure Screening and Office Targets 1:35

Kind of, sort of. Mostly, yeah. Cardio just means heart, vascular means vessels. So these are the diseases that affect your heart as an organ and the vessels that carry blood in your body, your blood flow, you bloodstream. Again, these leads to those bad outcomes that none of us want. 80% of cardiovascular disease is preventable, including things like managing blood pressure, cholesterol, diabetes, through your lifestyle, though your choices, habits and behaviors, and also through early screening and detection.

Makes sense so far? Okay, let's talk a little bit about early screening and detection. Rachel's going to be handing out a handout that I've prepared this time, which I'll walk you through, but screening is very important. This is why it's important that you see your family doctor, you participate in primary care, get your annual physical done. When we come to the clinic, we're going to check your blood pressure as many of you have experienced. If we are looking for a target in clinic of 130 over 80, less than or equal to that.

Thank you. if you end up at a number below those numbers, you're okay. If you end up at a number higher, we tend not to make a diagnosis just off a one-off assessment, but then we move on to something called an out-of- office measurement. The reason we do that is some people can get what we call white coat hypertension where the doctor stresses you out or the healthcare provider.

How Blood Pressure Readings Work 2:51

So instead of, you know, there's lots of things that influence your blood pressure. We want to be sure we have accurate diagnosis and accurate readings. One thing about the readings, as you've seen a blood pressure reading, there's a number on the top and a Number on The bottom. The top number is called your systolic blood Pressure. That's when your heart squeezes or contracts and it pumps and pushes blood around your body. Why does it even do that? It needs to get oxygen and nutrients to your cells, your organs, the things your Body needs To function.

Once it's delivered those nutrients and oxygen, The blood comes back to Your lungs and your Heart, and then your Heart relaxes so that the blood can fill. and that relaxation phase is the bottom number on your blood pressure called your diastolic. Does that make sense? Okay, so we're looking for that target under 130 over 80. If let's say it's high, we are going to send you for an out of office measurement. That can be done in one of two ways. Number one is called a 24 hour ambulatory walking blood-pressure monitor.

So that's where you wear a wearable blood pressur cuff for 24 hours. It's going go off and take measurements every so often throughout the day.

Home and Ambulatory Blood Pressure Monitoring 3:51

while you live your normal life. I think this is really helpful because it shows us how our pressure changes throughout the day, different activities, when we're stressed, sleeping, etc. That data then comes, you bring it to the physician and they're going to review that with you to see is it accurate that you have high blood pressure or was it a false positive in the office, et cetera. The other option is to do what we call a One of the reasons I made the handouts today is A to leave you with the information that you can actually do, but B is because I see a lot of patients who tell me Well, I took my blood pressure at the pharmacy and it was really high or I take my pressure out home and I was high and even then I'm skeptical to make a diagnosis on a one-off reading.

So if you want to follow along on the handout, there's this I've borrowed this and adapted a little. The image on bottom right is from Hypertension Canada, which is a fantastic resource. They have public education resources, they produce the clinical practice guidelines for Canadian healthcare professionals. But I wanted to go over this because a lot of people don't measure their blood pressure this way and I think it's important to give you accuracy.

Lifestyle Tips for Better Blood Pressure 5:00

So you'll see in the image, stay in a seated position. Make sure your back is well supported. Don't be on a stool or on the edge of something. Keep your arm bare and supported, ideally maybe like a dining table or a table where you can have your arms at the level of your heart. Use the appropriate size cuff. We have cuffs for kids, cuff for people who have extra weight, cuff for who are in a more normal BMI range, make sure you've got the right one because that'll affect your reading. Again, keep it at the level of the heart, the lower edge of cuff, three centimeters above the crease of your elbow.

And then when you're sitting, keeping your legs uncrossed and your feet flat on the floor. There's some other notes on this side there, you can review those at home. Where I now want you to look is the top of this sheet because these are, as I always leave you with, actionable, tangible things that you could do to improve your heart health, improve you blood pressure, and improve overall health. So there's four there, nutrition, movement, stress, and substances. You guys, most of you have been here before, you've heard me talk about these a lot.

I think it's pretty cool that the pillars of lifestyle medicine are the same things required to manage your blood pressure or even prevent or reverse it. A little note about each one, nutrition. In blood pressure world, we talk about the DASH diet, dietary approaches to stop hypertension. So this is very similar to the Mediterranean diet for your heart health. It's very similiar to whole food plant-based eating pattern from the American College of Lifestyle Medicine. You're seeing the repeating themes.

Eat plenty of fruits and vegetables. healthy whole grains, legumes like beans, nuts are great but in moderation if you're trying to manage your weight as well. And then other products too, low fat milk products in moderates, lean meats, fish, all of that is going to be helpful. The second kind of bonus tip about nutrition for blood pressure, one of the most important things, limit your sodium and salt intake. So the sodium target is 1500 to 2300 milligrams per day. Next we have movement. Get active and stay active so you're all here to be active.

The more regular and consistent you can be with that activity and for blood pressure especially walking. Bonus if it's outdoors bonus if you are in nature around a forest or with trees and plants. Each of those factors individually and in combination help you to regulate and reduce your blood pressures. Number three is stress. Ideally eliminate all your stress Practically and reasonably not possible.

Sleep, Social Connection, and Closing Remarks 7:18

So if it's not Possible think about ways that you can cope with stress in a healthy way or think About continuously focusing on what is in your control in any stressful situation as opposed to what isn't out of your Control and that'll at least reduce your stress and number four is substances substances Stop smoking. That is the single best thing you can do for your health if you are a smoker. If not, and you've already stopped or you don't smoke, fantastic. Also try to reduce or eliminate alcohol.

It is bad for you health. The old guidelines said less than two drinks a day was the maximum, so 14 drinks per week. New guidelines are now less then two drink a week! I know it's very different. I feel it is unreasonable. You still want to participate socially, that's fine. But just be aware of what the risks and benefits of your decisions are. There's two bonus things that are not on the sheet, which are the other two pillars of lifestyle medicine. Of course, prioritizing high quality restorative rest or seven to nine hours of good quality sleep is going to help regulate your blood pressure, especially reduce early morning rises in your pressure and positive social connection.

You know, saying hi to people, making friends, smiling at others, being in this community together with you guys. This is all going help to regulate pressure as well. I'll leave it there for now because I'm starting to get cold. I sure you guys are too.