The New Blood Pressure Numbers Every Woman Should Know

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. Recently, what's been shown is that that number should be quite a bit lower than that. 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? I'm Dr. 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, guiding the way to thriving in this powerful era of your womanhood.

Hello and welcome. Our topic for this episode is blood pressure, especially high blood pressure. We're going to have another episode on low blood pressure, which does affect a certain number of people. 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 0:58

American women, that is, over age 60. So what's so important about blood pressure? 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, as well as dementia. 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 pressure were as much as 40% more likely to develop dementia. So this is really important.

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? Well, the top number is the systolic number, and that's the pressure that the blood exerts on your blood vessels, your arteries, when the heart is pumping. And the diastolic number, the lower number, is the pressure on those same arteries in between the different heartbeats.

Understanding Blood Pressure Numbers 2:06

So a typical blood pressure would be 120 over 70, and the units are millimeters of mercury. While I was growing up, 140 over 90 was considered the place where we got nervous about blood pressure and started to do treatment. Recently, what's been shown is that that number should be quite a bit lower than that. 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, heart disease, kidney disease, and so on, tends to rise.

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, will lead to lower risk of those outcomes. So again, if your blood pressure is consistently over 130, you and your clinical care team, your doctors, your nurse practitioner, may decide that you should be treated for your high blood pressure to reduce these risks.

Causes and Lifestyle Risk Factors 3:25

What causes high blood pressure? Well, there certainly is a genetic cause. 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. The kind of blood pressure that we're concerned about here for this series is the elements that we can actually control. And those actually are quite a long list. So such things as high salt intake, being overweight, not getting adequate exercise, other kinds of dietary choices. These are what we consider modifiable factors for blood pressure control.

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 blood pressure are too much salt intake in our diet, otherwise poor dietary quality, lack of exercise, being overweight, smoking, and chronic stress. Poor sleep may also be another one that fits on that list. 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.

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 what diet that is. Lack of excessive alcohol intake, reducing stress as much as possible, perhaps with something like yoga or meditation. 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 5:15

which of course can be very, very difficult. 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, reducing stress with something such as yoga or meditation perhaps, getting good sleep, and getting adequate exercise, which is somewhere between 75 and 150 minutes per week of cardiovascular exercise, which includes walking, dancing, such things as whatever raises your blood pressure. Cardiovascular exercise includes things that elevate your heart rate slightly, such as walking or dancing.

For many years we've known of a diet that is called the DASH diet, and that stands for Dietary Approach to Stop Hypertension, which is the other name for high blood pressure. 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. 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. And it can include lean meats and poultry, fish, and non-tropical oils.

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. 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 7:00

your care providers, your docs and nurse practitioners may want to do some additional testing. And there's some testing that has been recommended with the current guidelines from the American Heart Association and the American Cardiology Association that have not been typically ordered in the past. And these include some blood tests and some urine tests. And this whole list of things is often used in accord with the PREVENT screening. And PREVENT stands for This list of testing may be part of a screening protocol that is called the PREVENT protocol.

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 disease and take into account adequate steps to try to prevent it as best as possible. 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 people in the developed world. So the take-home message here is to be mindful of your blood pressure, which is usually not symptomatic if it's elevated.

People expect that they're going to have some symptoms, but they usually don't. But if it's consistently elevated, to basically go along with the recommendations of your care provider team and follow up on it. And this will in turn lead to a reduction in your risk of these critical diseases that we mentioned, including dementia. So that's some new information. Take care. Great to have you on board and hope to have you again soon with me. Thanks. Thanks for listening to the women's health span voices podcast.

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