Hypertension and Healthy Aging: What You Can Do to Stay Ahead

How Lifestyle and Smart Choices Can Help You Stay Ahead of High Blood Pressure

Maybe you have someone in your family with high blood pressure or have heart stories about what hypertension can do to your heart, brain, and kidneys. This article will close the knowledge gap between you and your doctor for a better conversation.

Questions to consider in order of priority:

1. How can you prevent hypertension?

2. How can you manage it yourself?

3. If it remains elevated, what are your actual risks?

4. What are the best clinical treatments?

How to Diagnose Hypertension

Often convenient, automatic blood pressure devices cost just $30, but they tend to overdiagnose. We can do a little better than a cheap automated cuff. 

Using the same cuff or a higher-quality automated blood pressure cuff for the upper arm, take 12 random blood pressure readings throughout the day. Set an alarm every 90 minutes, sit down, place the blood pressure cuff, and take a reading. You also want some nighttime readings. If you wake up to a tinkle, place the cuff, and take a reading, you can stay lying in bed. Don’t worry; the device stores all readings.

1. 144/98

2. 122/67

3. 155/69

4. 115/88

5. ….

Average of total: 134/80

The average of all these readings is your ambulatory blood pressure numbers. More expensive units, called Ambulatory Blood Pressure Monitors (ABPMs), do this all automatically. The data is sent to your doctor, who comes up with an average number for you.

Common Mistakes: Most of my patients tell me that they measure their blood pressure when they feel off, falsely assuming that the high blood pressure is causing their symptoms. In fact, it’s their off symptoms that are causing the high blood pressure or their anxiety about it. Blood pressure should be measured randomly.

What I do: I ship a cuff to my patient and have them set the alarm for 90 minutes. When the alarm goes off, they sit down and take a few deep breaths as they put on the cuff. I have them give me two measurements, and we use the second. If they wake up at night, we have them check it as well while sitting or lying in bed. 

Treating High Blood Pressure With Lifestyle Changes

Some patients drastically lower their blood pressure readings through cardio, others through stress management, weight loss, resistance training, reducing salt, drinking less alcohol, and getting better sleep.

What I do: This is how I approach most patients unless something obvious stands out.

1. Improve aerobic capacity through training

2. Meditation and stress management

3. Improve muscle mass

4. Cut out ultraprocessed foods like unnecessary sugars and alcohol.

5. Correct any fatty liver or visceral fat problems.

Common mistakes: Don’t force yourself to commit to a particular lifestyle or dietary regimen that seems impossible. It’ll just fail, and you’ll feel defeated. The small actions that you can stick with are often the most meaningful.

Solid results often take a year, but for some, they may arrive sooner. For those at high risk, I might recommend a pharmaceutical or herbal option until we see some positive results.

I prefer lifestyle treatment options because it puts the individual at the helm. You learn a lot about your body when experimenting with your lifestyle.

Pharmacologic Treatment for Hypertension

There are reversible causes that must be ruled out before assuming it’s essential hypertension, aka idiopathic hypertension. Some may have had kidney or liver disease, sleep apnea, or endocrine problems.

Treatments for hypertension decrease the pressure exerted on the heart and vascular system. Some medications work by removing water from the vascular system (diuretics), while others decrease the tightness of the vessels (vascular dilators). Some medications also reduce the output from the heart (beta blockers).

Medications always have side effects, but fortunately, many more options are available.

Diseases Associated with Hypertension

We forget that continued high blood pressure can lead to various diseases, from heart failure to heart attacks and strokes. It can cause erectile dysfunction and kidney disease. And it can hasten dementia or other neurocognitive conditions. Remember, it significantly contributes to plaque development more than high cholesterol.

It is also among the leading causes of eye problems and circulation issues, such as peripheral vascular disease.

I mention all of these because treating a condition such as hypertension can significantly improve one's health, resulting in a significant return on investment.

What is Your Overall Risk?

If you have a strong family history of heart disease and you don’t have the ideal lifestyle, even slight blood pressure elevations will increase your risk of organ damage over time.

If you are healthy, exercise, eat well, manage your stress, and don’t have other major risk factors, even a slightly high blood pressure likely won’t affect your overall health too much.

Personally, my blood pressure sometimes runs high. It was routinely in the 160s during medical school, and it was cured with my graduation from the high-stress world of education. These days, a night of restless sleep or stress or alcohol can drive it up, but otherwise, it’s low. Is it low enough to satisfy the current JNC8 guidelines? Probably not. But healthy aging isn’t about specific guidelines.

Healthy Aging and Your Blood Pressure

Stressing over your blood pressure is against the tenets of healthy aging. I view healthy aging as a way to exist in harmony and peace with the world around us. That includes the sometimes less-healthy food, inactivity, stress, loud noises, and poor sleep we experience.

Healthy aging is about making small, meaningful choices to age with purpose. Knowing your blood pressure and what raises and lowers it is the empowerment necessary to know how you can manage your health.

Own your aging journey by investing in your body & mind.