Blood Pressure Classification for Healthy Adults
When systolic and diastolic pressure fall into different categories, the higher category should be used to classify blood pressure status.
The risk of death from heart attack and stroke begins to rise when blood pressure is above 115/75.
Based on the average of two or more readings taken at different physician visits. In persons over 50, systolic blood pressure greater than 140 is a much more significant CVD risk factor than diastolic blood pressure.
The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. 2003. Bethesda, MD: National Heart, Lung, and Blood Institute. National Institutes of Health (NIH Publication No. 03-5233). These guidelines are under development according to the NIH National Heart, Lung, and Blood Institute (www.nhlbi.nih.gov/guidelines/current.htm, May 2011, accessed May 9, 2013). both the heart and the arteries. Eventually, the strained heart weakens and tends to enlarge, which weakens it even more.
High blood pressure is often called a silent killer, because it usually has no symptoms. A person may have high blood pressure for years without realizing it. But during that time, it damages vital organs and increases the risk of heart attack, congestive heart failure, stroke, kidney failure, and blindness.
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Recent research has shed new light on the importance of lowering blood pressure to improve cardiovascular health. The risk of death from heart attack or stroke begins to rise when blood pressure is above 115 over 75, well below the traditional 140 over 90 cutoff for hypertension. People with blood pressures in the prehypertension range are at increased risk of heart attack and stroke as well as at significant risk of developing full-blown hypertension.
Hypertension is common. About 33% of adults have hypertension and 37% have prehypertension (defined as systolic pressure of 120-139 and diastolic pressure of 80-89). The incidence of high blood pressure rises dramatically with increasing age, but it can occur among children and young adults. In most cases, hypertension cannot be cured, but it can be controlled. The key to avoiding complications is to have your blood pressure tested at least once every two years (more often if you have other CVD risk factors).
Lifestyle changes are recommended for everyone with prehypertension and hypertension. These changes include weight reduction, regular physical activity, a healthy diet, and moderation of alcohol use. The DASH diet (see Post 8), is recommended specifically for people with high blood pressure; it emphasizes fruits, vegetables, and whole grains foods that are rich in potassium and fiber, both of which may reduce blood pressure. Sodium restriction is also helpful. The 2010 Dietary Guidelines for Americans recommend restricting sodium consumption to less than 1500 mg per day. This recommendation applies to all Americans but is particularly important for people with hypertension, African Americans, and middle-aged and older adults. Adequate potassium intake is also important. For people whose blood pressure isn’t controlled adequately with lifestyle changes, medication is prescribed.
Unhealthy Cholesterol Levels Cholesterol is a fatty, waxlike substance that circulates through the bloodstream and is an important component of cell membranes, sex hormones, vitamin D, the fluid that coats the lungs, and the protective sheaths around nerves. Adequate cholesterol is essential for the proper functioning of the body. Excess cholesterol, however, can clog arteries and increase the risk of CVD (Figure 11.1). Your liver manufactures cholesterol; you also get cholesterol from foods.
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