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Health

Understanding How to Prevent and Handle High Blood Pressure

By Janet Rivera Mednik

Educators know a little something about pressure. From creating daily lesson plans and dealing with unruly or uncooperative students, to burning the midnight oil grading tests and papers, teachers and ESPs constantly deal with pressure in their jobs. However, there is one type of pressure with which some educators might not be familiar, although it can be more problematic than any other they encounter: high blood pressure (HBP). Fortunately, as retired teachers Diane Dettmann and Joy Renfrew know, there are ways to prevent and treat the disease.

WHAT IS HIGH BLOOD PRESSURE?
According to the American Heart Association (AHA), “blood pressure measures the force pushing outwards on your arterial walls.” It is measured in two ways: the systolic pressure and the diastolic pressure. The former is the pressure on the arterial walls when the heart beats while the latter is the pressure when the heart is at rest. When blood pressure (BP) is often high, it stretches the tissues of the arteries further and further, which can thin out the arterial walls and cause damage throughout the body. Some of the negative effects of high blood pressure—and damaged arteries—are vascular scarring, an increased risk of blood clots, tissue and organ damage, and a greater workload on the circulatory system. These damages can in turn lead to serious health issues, including heart attack, heart failure, stroke, and kidney failure.

For most of his life, Max Bochmann, a retired school bus driver, didn’t pay much attention to his diet, level of exercise, or tobacco consumption. Still, he was able to maintain a healthy blood pressure throughout his 69 years. Chalk it up to good genes, country air, or a positive outlook, Bochmann, of DuPage County in Chicago, is fortunate. The AHA reports that about “80 million U.S. adults have been diagnosed with high blood pressure,” or hypertension. This means that approximately one in three adults in the U.S. suffer from this disease. Despite its dire consequences, there are usually no symptoms associated with high blood pressure, which is why it has been dubbed, “the silent killer.”

Normal blood pressure, as defined by the AHA, is when the systolic pressure is less than 120 mm Hg (or millimeters of mercury) and the diastolic is less than 80 mm Hg. They then categorize high blood pressure in three phases: prehypertension, BP between 120-139/80-89 mm Hg; stage 1 hypertension, BP between 140-159/90-99 mm Hg; and stage 2 hypertension, BP 160 or higher/100 or higher mm Hg. If blood pressure readings are 180 or higher/110 mm Hg after more than one reading over the course of a few minutes, then a person “should seek immediate emergency medical treatment for a hypertensive crisis.”

ONE ROAD TO RECOVERY: LIFESTYLE SOLUTIONS

 

When Diane Dettmann, an elementary school teacher in the St. Paul, Minn., area for 31 years, first became aware that her blood pressure was escalated in 1998, she was still in the prehypertension zone. Twelve years later, her first husband passed away and the tragedy not only broke her heart, but it also added more stress to it. While she was grieving, Dettmann went on an anti-depressant and gained weight. Furthermore, she changed careers, leaving the classroom after decades and taking a job as a literacy expert. The job had her traveling a lot, sitting at a desk more often, and exercising less, all of which affected her heart health. She held the job as part of the literacy team for six years before retiring in 2006.

In 2009, Dettmann’s blood pressure had officially crossed over into the stage 1 hypertension zone, with her systolic blood pressure at 145 mm Hg. Her doctor was worried and suggested Dettmann see a dietary coach when she expressed her desire to avoid medicine if she could. Her coach helped her to learn portion control, how to read food package labels, and how to eat more wisely.

“It was a lifestyle change,” says Dettmann. “I try to make good health and exercise wise choices at least 90 percent of the time.” Those choices include eating a diet that is heavy on fruits and vegetables, whole grains, fish and chicken, nuts, and no or low-fat dairy.

She also learned how to be a smart consumer when it came to sodium. The AHA recommends “consuming less than 1,500 mg of sodium a day.” An excessive amount of sodium is problematic for those with high blood pressure because it causes fluid build up which in turn puts extra, unnecessary pressure on the heart, increasing blood pressure. The AHA says that “up to 75 percent of the sodium we consume is hidden in processed foods like tomato sauce, soups, condiments, canned foods, and prepared meals.” The AHA also warns that kosher salt and sea salt are not better than regular table salt as they ultimately are the same chemically. Now, Dettmann trades her canned food for fresh or frozen and makes more of her food from scratch, including whole-wheat pizza dough.

The AHA also recommends limiting alcohol consumption to no more than two drinks a day for men and no more than one drink a day for women. Additionally, people with high blood pressure should avoid tobacco and hot tubs or saunas, and exercise regularly.

Dettmann did just that, increasing her physical activity to help lower her blood pressure. As a former inline skater and roller skater, Dettmann was no stranger to being active. However, her life had become more and more sedentary after her job change. Now, she walks one to two miles daily and is enjoying more outdoor activities in her countryside town on the border of Wisconsin and Minnesota.

Through these lifestyle changes, and the support of her dietary coach and her husband (Dettmann remarried in 2007), Dettmann was able to lose 20 pounds and, importantly, return her blood pressure to the normal range.
“I would urge people to take weight loss in small steps,” advises Dettmann, who weighs in regularly, but doesn’t deny herself if she wants to eat something.

Dettmann was able to avoid feeling overwhelmed through other lifestyle changes, which keep her mentally and physically fit. She has reconnected to her faith and just as important as her daily walks are her daily meditations in prayer. She also finds solace in writing, and recently wrote “Courageous Footsteps,” a book about the internment of Japanese Americans during World War II.

Although stress is often believed to contribute to high blood pressure, the AHA says, “it is not a confirmed risk factor” nor does it cause high blood pressure or heart disease. There is proof that stress affects overall health so reducing it can only be a positive goal, but a person who is calm and relaxed can just as easily suffer from hypertension as a person who is nervous and tense. It is for this reason that it is important for everyone to regularly have his or her blood pressure checked by a doctor.

MEDICATION IS IMPORTANT

 

Unlike Detmann, Joy Renfrew (pictured left) from Coatsville, Pa., has never had trouble staying active, as evidenced by her 25 years as a public school health and physical education teacher for ninth and tenth graders.

“I’ve been active since I was born,” says Renfrew, who retired in 1990 and was a former member of the Pennsylvania State Employee Association (NEA).

And it’s true. While the 80-year old may not be running half marathons like other women her age (see sidebar story), Renfrew skied until she was 74 and still regularly plays tennis twice a week and lifts weights at the YMCA. The former softball coach is also considering taking yoga with a couple of friends who have started the activity, although she manages to do a lot of stretching on her own.

Renfrew also considers herself to be very aware of nutrition, avoiding heavily salted foods and consuming lots of fruits.

Despite her healthy lifestyle, Renfrew still discovered at one of her annual doctor’s visits in her 60s that she too had an elevated blood pressure. While changes in diet and exercise were good options for Dettmann, they weren’t enough for Renfrew.

The solution for Renfrew, like many others, was medication. There are lots of medications available to help maintain a healthy blood pressure, from diuretics (which help get rid of excess sodium) to beta-blockers (which reduce the heart rate and reduce stress on the heart) to calcium channel blockers (which prevent calcium from getting into the heart and arteries’ cells, which makes the heart’s contractions less forceful), just to name a few. Your doctor will work with you to find exactly the right prescription for you.

While some may be reluctant to take the medication route, sometimes it will be a necessary part of managing blood pressure for a person’s lifetime, as diet and exercise are not the only contributing factor to high blood pressure. Hypertension can also be caused by family history, advanced age, gender-related risk patterns, or drinking too much alcohol. Stress, smoking, and sleep apnea have also been connected to high blood pressure, although none have been shown to be direct causes. Additionally, some groups are at a higher risk of high blood pressure, including African Americans, women, and children.

WHAT CAN YOU DO?
High blood pressure is not something to be taken lightly. No matter the circumstances, you should have a doctor regularly check your blood pressure, as high blood pressure has no symptoms.

If your blood pressure is normal, you should still take steps to prevent hypertension including eating healthily, exercising regularly, reducing stress, avoiding excessive alcohol consumption, and complying with medication if
it is deemed necessary.

Even Bochmann, the retired school bus driver who has never been on medication in his life, is making lifestyle changes to help ensure a healthy blood pressure. “I think I’m eating better. I ride my bike, and six years ago, I stopped smoking,” he says.

To find out more about high blood pressure, including how to prevent it and treat it, visit the American Heart Association’s website.

 

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