Resistant Hypertension

What happens when you hit a high blood pressure plateau?
You’ve made lifestyle changes. You’re taking a diuretic and at least two other blood pressure medicines. But your blood pressure still isn’t budging. This is called resistant hypertension. Simply put, it means that your high blood pressure (HBP or hypertension) is hard to treat and may also have an underlying (secondary) cause.

Possible causes of resistant hypertension
Resistant hypertension may have one or more other underlying medical conditions. In addition to treating resistant hypertension with medications, doctors typically investigate secondary causes (contributing factors), such as:

  • Abnormalities in the hormones that control blood pressure.
  • The accumulation of artery-clogging plaque in blood vessels that nourish the kidneys, a condition called renal artery stenosis.
  • Sleep problems, such as the breath-holding type of snoring known as obstructive sleep apnea.
  • Obesity or heavy intake of alcohol or other substances that can interfere with blood pressure.

Monitoring and treatment of resistant hypertension
Reining in blood pressure levels begins with the basics, such as understanding your pressure patterns. Sometimes that means wearing a pager-sized automatic blood pressure recorder for 24 hours or checking pressure with an at-home monitor several times a day. Treatment also usually involves a change or addition of medications and investigation of secondary causes – along with key lifestyle changes, including:

  • Eating a well-balanced, low-salt diet
  • Limiting alcohol
  • Enjoying regular physical activity  
  • Maintaining a healthy weight
  • Managing stress
  • Taking your medications properly
    People with resistant hypertension should take the right medications, in the right doses, at the right time. DO NOT take medications or supplements that can boost blood pressure, such as diet pills and stimulants, cyclosporine, natural licorice, ephedra and painkillers and non-steroidal anti-inflammatory agents (NSAIDs), such as ibuprofen and celecoxib.

Exercising with High Blood Pressure

Original Post by David Berkson, M.D.

High blood pressure, or hypertension, is one of the most common medical problems—affecting about one quarter of all Americans. It is also the most common cardiovascular condition in competitive athletes.

Blood pressure can be thought of as looking at the stress on the heart. The top number is known as the systolic pressure and measures the stress when the heart is actively beating. The bottom number is called the diastolic pressure which measures the stress when the heart is at rest, between beats. The greater the stress on the heart, the greater the risk of strokes, heart attacks, and heart failure.

In adults, normal blood pressure is less than 120/80. Blood pressure between 120-139/80-89 is considered pre-hypertension, which puts someone at an increased risk of developing hypertension in their future. Stage 1 hypertension is when the blood pressure is between 140-159/90-99. Stage 2 is over 160/100, which puts you at a 150-300% increased risk of having a stroke, heart attack, or heart failure.

So if you have high blood pressure, what can you do to get it down? Eating a healthy diet and exercising are a great start. But, depending on the height of your blood pressure, there may be certain exercises you should avoid until your blood pressure is under better control. In particular, anyone with stage 2 hypertension needs to have their blood pressure controlled before they start an exercise program. Your doctor can discuss these issues with you in detail.

Cutting out foods and drugs that can raise blood pressure will help also. Caffeine, alcohol, and tobacco are common agents that elevate the blood pressure, as are certain over-the-counter medications like decongestants and appetite suppressants.

While lifestyle modifications are great for your overall health, they may only help to lower the blood pressure by about 10 points, which may not be enough. Often time medication is needed to fully control the blood pressure. Many options for medications exist, but some of them are better than others for athletes.

Medications preferred by many athletes are those that do not affect exercise tolerance and heart rate response to exercise. ACE inhibitors and Angiotensin II Receptor Blockers (ARBs) both are very well tolerated and are the least likely to cause any problems with exercise.

Medications like Beta blockers and Calcium Channel blockers, while excellent medications to help control blood pressure, can decrease the heart rate and also possibly affect exercise tolerance and are typically not used as first line agents for treatment of blood pressure in athletes.

Elite athletes who participate in events sanctioned by national or international governing bodies need to make sure any medication they take is not part of the banned substances list for their sport.


Original Post by David Berkson, M.D.

How to Lower Your High Blood Pressure Risk

Original Post by Withings

High blood pressure is the number one killer in the world according to the World Health Organization (WHO). As the risks of encountering a heart attack or stroke are infinitely higher for people who have high blood pressure, it is imperative that we get these levels under control. Seventy percent of people who have their first heart attack suffer from high blood pressure and 80% of people who encounter their first stroke suffer from high blood pressure. Not only is high blood pressure dangerous, it is also incredibly costly. In fact, high blood pressure costs the nation $46 billion each year.

The eye-opening statistics don’t stop there.

Did you know that 35.8 million people in the U.S. suffer from hypertension (or high blood pressure)? Of this 35.8 million, 14.1 million people are unaware of their conditions, but 5.7 million people are aware that they have high blood pressure, but their condition goes untreated. The remaining 16 million people are aware of their hypertension and are currently seeking treatment to reach normal blood pressure levels.

Luckily, adopting new lifestyle practices could prevent a large portion of these deaths and diseases.

As medical technologies become more readily available outside of doctors’ offices, tracking blood pressure levels at home is becoming more common. In fact, individuals with hypertension are shown to be more in control of their disease when they practice self-measurement of blood pressure (SMBP) than with medication alone.

According to Jerry Penso, MD, president of the American Medical Group Foundation, engaging patients in their own care—both in and out of the office—makes a big difference when it comes to blood pressure management. Remote patient monitoring can be an integral part of helping patients manage their blood pressure levels. For some patients, blood pressure readings may appear higher when they are in a doctor’s office (sometimes called “white coat syndrome”). This may provide inaccurate results and could potentially lead to dangerous outcomes for patients. Remote patient monitoring can help to combat this syndrome by providing doctors with a larger and more representative set of blood pressure measurements.

Withings conducted a study to test the effects of enrolling people in a blood pressure monitoring program. From the study, we derived that: the program had the effect of reducing participants’ systolic pressure (the pressure in the arteries when the heart beats) by 6 mmHg and diastolic pressure (the pressure in the arteries between heart beats) by 2 mmHg. We also saw that a decrease of 5 mmHg reduces the heart attack mortality rate by 14% and the heart disease mortality rate by 9%.

In addition to regularly measuring blood pressure, tracking and improving physical activity levels can help combat hypertension. WHO estimates that 27% of diabetes cases and 30% of all coronary diseases related to hypertension could be avoided by regular physical activity. Controlled trials have shown a reduction of 5 mmHG systolic pressure in hypertensive individuals who exercised regularly for at least eight weeks.

There’s also a high correlation between weight loss and lowering blood pressure. Users in the Withings study who lost 22 pounds or more over the period of a year also lowered their systolic and diastolic blood pressure by 3 mmHg.

The first step in preventing or lowering high blood pressure: understanding the issue. Nearly half of patients with hypertension are unaware that they suffer from this condition. Thus, it is imperative to monitor your vital signs regularly, and take control of your own health metrics. The second, and more complicated, step is inciting behavior change. Here are some quick ways to incorporate heart-healthy habits into your everyday life:

  1. Aim for 10,000 steps a day. Start small with a walk during your lunch hour or after dinner. For extra motivation, find a walking partner, as you’re more likely to make exercise a habit with someone by your side. Finding the extra time in your day may seem challenging, especially if you are frequently tied up at work. The first few days of forming a new habit are the hardest, but the second and third weeks will begin to feel more natural. You may even inspire others around you to get active.
  2. Set a goal, and monitor your progress. Whether it’s a weight-loss goal or training for yourfirst 5K, we are often motivated by specific goals rather than lofty aspirations. Sign up for that 10K you’ve always been talking about, and set up a weekly walking routine to whip yourself into shape. Studies have indicated that people who monitor their daily activity levels with a pedometer walk an average of 2,000 additional steps a day, and record a drop in their blood pressure of 3.8 mmHg.
  3. Set reminders in your smartphone or daily planner to take your blood pressure regularly. The numbers you record may surprise you, and it’s best to catch high blood pressure at its onset. Sixty-two percent of Withings users changed their daily habits once they started monitoring health metrics.
  4. The mid-day slump has a way of making us crave a third cup of coffee or a temporarily feel-good snack. We don’t expect you to forgo once-in-a-while treats, but we hope to help you indulge smarter.
  5. Sleep for 7-8 hours a night, every night. When you’re asleep, your heart rate drops allowing your body to rest up from working hard all day long. If you’re not getting enough sleep, your heart will be overworked which could lead to high blood pressure or other heart diseases.
  6. Limit your stress levels. We’ve all had bad days, but it’s important to find time to unwind. Try meditating for five minutes a day, squeezing in a yoga class, or journaling positive thoughts.

High blood pressure can be cured once identified. Start measuring your vital signs today and take control of your health.

Original Post by Withings

Personal Stories: Christina

Q: Please tell us why you are involved in the Hypertension community? Do you have Hypertension?

A: I am involved in hypertension because it affects my immediate and extended family. I am the first one in my family who does not have hypertension. I made serious changes 11 years ago. I lost 60 pounds over 8 years and completely changed my lifestyle. I first became educated about what hypertension is, and how it happens. I also tapped into resources such as Dr. Ted Broer, Dr. Eric Braverman and Life Extension All of these sites along with my holistic GYN, and General Practitioner, aided in my transformation.

Q: Why are you involved in spreading information about Hypertension on social media platforms?

A: In 2014 and early 2015, I lost 2 family members and 1 close friend in a 6 month period. All were under the age of 55, and 2 died from heart disease, specifically hypertension. One was an athlete, and physically active, he was 44, and his heart stopped in his sleep. His pressure was so high, the medications were not very successful in the genesis of his diagnosis in bringing it down. Once he died, many of my friends and co-workers encouraged me to start the site since I am always asked about health information, what to eat, how to supplement etc.

Q: What interesting research, tips, recipes, or story can you share with our Hypertension Community?

A: Hypertension is a hardening (loss of flexibility) of the arteries. Your blood flow through your arteries is like a garden hose. As the flexibility ceases, the ability of free flowing blood is compromised causing the heart to work harder to pump blood, thus the pressure is raised. Chronic inflammation damages blood vessel walls with plaque formation causing the hardening. Chronic inflammation comes from excessive insulin levels in the body , which derives from the food you eat. Processed foods high in sugar and salt cause this condition. If you eat like this regularly, you are constantly inflamed. All disease originates from inflammation.The great thing is heart disease is totally reversible and preventable. A diet low in sodium, high in vegetables, fiber, healthy fats (olive oil, coconut oil, avocado, walnuts, sunflower seeds), and proteins (organic eggs, grass-fed meats, wild fish (not farm raised), will prevent this. I recommend the book The Amazing Way to Reverse Heart Disease by Dr. Eric Braverman. I took his book to the supermarket and followed The Rainbow Diet, purchasing what he suggested. I bought a blood pressure machine to monitor my pressure, exercise and supplement with herbs in what I eat (ginger, garlic, tumeric, rosemary, thyme etc. ) A great spice rack goes a long way!


image1 image2 image4 image5 image6 image7 image8 image9 image10 image11 image12