Full Transcript Podcast Introduction and Blood Pressure Overview 0:00 While I was growing up, 140 over 90 was considered the place where we got nervous about blood pressure and started to do treatment. 0:10 Recently, what's been shown is that that number should be quite a bit lower than that. 0:16 In other words, the normal blood pressure is really 120 over 70. Have you made it past menopause, or are you going through it now? 0:25 I'm Dr. 0:25 Pat McShane, and on the Women's Health Span Voices podcast, I'll guide you through the health challenges of the menopausal years and beyond, 0:35 guiding the way to thriving in this powerful era of your womanhood. 0:39 Hello and welcome. 0:40 Our topic for this episode is blood pressure, especially high blood pressure. 0:45 We're going to have another episode on low blood pressure, which does affect a certain number of people. 0:51 But high blood pressure is hugely important, and it is estimated that it impacts about 50% of women over age 40, and that goes up to about two-thirds of
Why High Blood Pressure Matters 1:04 American women, that is, over age 60. So what's so important about blood pressure? 1:10 Well, it's the most modifiable factor that we have for cardiovascular disease, which is the major cause of mortality in the developed world for women and men, 1:21 as well as dementia. 1:24 And for a while, we weren't so sure about dementia, but there have been several studies now showing in populations of people that those who had high blood 1:33 pressure were as much as 40% more likely to develop dementia. 1:37 So this is really important. 1:39 Starting out with some definitions, what is measured when you get your blood pressure measured at a doctor's office or at home for that matter? 1:49 Well, the top number is the systolic number, and that's the pressure that the blood exerts on your blood vessels, your arteries, 1:58 when the heart is pumping. 2:01 And the diastolic number, the lower number, is the pressure on those same arteries in between the different heartbeats.
Understanding Blood Pressure Numbers 2:10 So a typical blood pressure would be 120 over 70, and the units are millimeters of mercury. 2:18 While I was growing up, 140 over 90 was considered the place where we got nervous about blood pressure and started to do treatment. 2:29 Recently, what's been shown is that that number should be quite a bit lower than that. 2:34 In other words, the normal blood pressure is really 120 over 70. When it gets up to 130 over 80, the incidence of those conditions that we just described, 2:48 heart disease, kidney disease, and so on, tends to rise. 2:53 And the other thing that has been noted is that treatment, if your blood pressure is in that range of 130 and to above that, 3:06 will lead to lower risk of those outcomes. 3:11 So again, if your blood pressure is consistently over 130, you and your clinical care team, your doctors, your nurse practitioner, 3:21 may decide that you should be treated for your high blood pressure to reduce these risks.
Causes and Lifestyle Risk Factors 3:28 What causes high blood pressure? 3:30 Well, there certainly is a genetic cause. 3:32 Some people just have it in their family and we know some of those genes, but there's nothing much we can do about that at this point. 3:40 The kind of blood pressure that we're concerned about here for this series is the elements that we can actually control. 3:49 And those actually are quite a long list. 3:54 So such things as high salt intake, being overweight, not getting adequate exercise, other kinds of dietary choices. 4:05 These are what we consider modifiable factors for blood pressure control. 4:10 Things that are within our control that are important for blood pressure, the major risk factors that are manageable in our lives that do lead to high 4:21 blood pressure are too much salt intake in our diet, otherwise poor dietary quality, lack of exercise, being overweight, 4:31 smoking, and chronic stress. 4:35 Poor sleep may also be another one that fits on that list. 4:39 So right away we can see some of the things that we might be able to try to get our blood pressure down into a good range without the need for medications. 4:48 And this would be avoidance of smoking, having the best diet that you can without a lot of salt, and we're going to come back in a second and talk about 4:58 what diet that is. 4:59 Lack of excessive alcohol intake, reducing stress as much as possible, perhaps with something like yoga or meditation. 5:07 Lifestyle factors that are within our control that may help to reduce blood pressure without need for any medications is maintaining a normal weight,
DASH Diet and Healthy Habits 5:17 which of course can be very, very difficult. 5:21 having the best possible diet, and I'm going to come back and talk about that in a second, avoiding smoking, avoiding excessive alcohol intake, 5:31 reducing stress with something such as yoga or meditation perhaps, getting good sleep, and getting adequate exercise, which is somewhere between 75 and 150 5:45 minutes per week of cardiovascular exercise, which includes walking, dancing, such things as whatever raises your blood pressure. 5:54 Cardiovascular exercise includes things that elevate your heart rate slightly, such as walking or dancing. 6:03 For many years we've known of a diet that is called the DASH diet, and that stands for Dietary Approach to Stop Hypertension, 6:13 which is the other name for high blood pressure. 6:16 And on that diet, like the Mediterranean diet, are the following items, and I'm going to read these off so I don't miss any. 6:23 Pie and vegetables, fruits, whole grains, legumes, which is beans and lentils and so on, nuts and seeds, and low-fat or non-fat dairy. 6:36 And it can include lean meats and poultry, fish, and non-tropical oils. 6:42 So this is pretty similar to a good diet overall, not a big stretch from a Mediterranean diet, and certainly could include vegetarian diets as well. 6:54 When you've been diagnosed with high blood pressure and some of these lifestyle considerations have been taken into account and modified if possible,
Testing, Screening, and Takeaways 7:04 your care providers, your docs and nurse practitioners may want to do some additional testing. 7:12 And there's some testing that has been recommended with the current guidelines from the American Heart Association and the American Cardiology Association 7:22 that have not been typically ordered in the past. 7:26 And these include some blood tests and some urine tests. 7:31 And this whole list of things is often used in accord with the PREVENT screening. 7:39 And PREVENT stands for This list of testing may be part of a screening protocol that is called the PREVENT protocol. 7:52 And this is something that is used with people without current risk factors for heart disease to try to predict whether they are likely to develop heart 8:03 disease and take into account adequate steps to try to prevent it as best as possible. 8:10 So this is kind of an overall approach to preventing the most frequent causes of death and morbidity, or that is limitations of your lifestyle that affect 8:22 people in the developed world. 8:23 So the take-home message here is to be mindful of your blood pressure, which is usually not symptomatic if it's elevated. 8:32 People expect that they're going to have some symptoms, but they usually don't. 8:36 But if it's consistently elevated, to basically go along with the recommendations of your care provider team and follow up on it. 8:46 And this will in turn lead to a reduction in your risk of these critical diseases that we mentioned, including dementia. 8:55 So that's some new information. 8:58 Take care. 8:58 Great to have you on board and hope to have you again soon with me. 9:03 Thanks. 9:04 Thanks for listening to the women's health span voices podcast. 9:08 If today's episode spoke to you, follow the show and share it with a friend ready to take charge of her health and please leave a review. 9:17 It helps more women find us.
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