There are many stresses that interrupt us daily, but the pressure put upon your heart is particularly important to consider.
By knowing your numbers and understanding the new blood pressure and hypertension guidelines, you can reduce your risk of other serious diseases.
Todd Tessendorf, MD, Bryan Heart cardiologist, joins the show to share what those numbers mean and how to change them.
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New Blood Pressure Guidelines: What You Need to Know
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Learn more about Todd Tessendorf, MD
Todd Tessendorf, MD, Bryan Heart
Dr. Todd Tessendorf is a cardiologist with Bryan Heart.Learn more about Todd Tessendorf, MD
Transcription:
New Blood Pressure Guidelines: What You Need to Know
Melanie Cole (Host): The American Heart Association and the American College of Cardiology have put out the first update to comprehensive US guidelines on blood pressure detection and treatment since 2003. My guest today is Dr. Todd Tessendorf. He’s a cardiologist with Bryan Heart. Welcome to the show, Dr. Tessendorf. So, let’s start by giving the listeners a little physiology lesson. What is blood pressure and why is it so important that we know what it is?
Dr. Todd Tessendorf, MD (Guest): So, your heart pumps blood forward and whatever the pressure is inside of your arteries, that’s the amount of force your heart has to generate to maintain the flow going to your body. The higher the blood pressure is, the more force your heart has to generate and the harder it has to work, and that is hard on the heart, and the arteries themselves actually can break down the higher the blood pressure is. So, it’s very important to know your blood pressure, and if it is elevated, to work on strategies to reduce it.
Melanie: So, what are those numbers that people see mean, and what did we used to consider high blood pressure and normal blood pressure?
Dr. Tessendorf: So, the newest guidelines changed what we thought was normal to a different number. We used to think 130/80 was the correct blood pressure or normal blood pressure. Now the guidelines have lowered that to less than 120 over less than 80 millimeters of mercury. The change came about because a few studies that were done, most recent one called the SPRINT trial, that looked at blood pressure in females and showed dramatic reductions in blood pressure had dramatic effects of reducing heart attacks and strokes and the guideline committee decided that it was an important enough trial to make these changes.
Melanie: So, why is it so important and how often should people get their blood pressure checked? And sometimes Dr. Tessendorf, when people get their blood pressure checked it could be high because they’re stressed out or nervous to see the doctor, so, how often should they get it checked to really diagnose hypertension?
Dr. Tessendorf: So, every time you go to the doctor, you’ll get your blood pressure checked and most people see the doctor at a minimum once a year. People with elevated blood pressures at the doctor’s office will need repeated evaluation. We really want to check the blood pressure at a minimum of two times before you diagnose hypertension in two different settings. I actually recommend getting it multiple times so that we can get a more accurate diagnosis, but when you see your physician, they’ll check it at least once a year, but we want to check it more frequently than that if you do have high blood pressure.
Melanie: So what are the treatments if you diagnose someone with hypertension? What is the first line of defense, what do you tell them?
Dr. Tessendorf: The first line of defense is lifestyle changes. If you’re not exercising, we recommend exercise therapy. If you are overweight, we recommend losing weight. Obviously want to reduce sodium. Sodium has been linked to high blood pressure, and so, we use a low-salt diet. Potassium supplementation is also something that we use in the diet—foods rich in potassium: [Inaudible 03:17] avocados, spinach, salmon. We also recommend limiting alcohol intake. In men, no more than two drinks per day and in women, no more than one drink per day.
Melanie: So, if you try these lifestyle modifications and you change some of your behaviors, if you exercise and maybe reduce your alcohol or salt intake and none of those seem to work and you’re still running on the high side, then what?
Dr. Tessendorf: Then, that’s where medications come in and in some people with elevated blood pressures, what we call Stage 1 and Stage 2, we actually recommend both lifestyle changes and medication therapy. There are very standard medications that we use. The guidelines go through some of those approaches, but this is where your doctor’s expertise comes in. There are certain medications that are used for certain diagnoses. In my patients, I see a lot of patients with heart disease, and we use classes of medications called beta blockers for their heart disease as well as to lower the blood pressure. There are other classes that you would use if you didn’t have any of those disease processes. So, that’s where your doctor’s expertise really comes in handy to help drive the blood pressure lower with medication therapy.
Melanie: So, we’ve heard about exercise, and you mentioned it earlier. How much exercise is necessary to create that blood pressure-lowering effect?
Dr. Tessendorf: So, what’s recommended is 30 minutes a day, at a minimum of five days a week. We know more Is better, but even lower levels of exercise have been shown to reduce blood pressure. If you exercise on average, 30 minutes, five days a week, you’ll actually lower your blood pressure about five points, and so it is a dramatic effect. The guidelines talk about other things besides walking or running. It really doesn’t matter what exercise you do as long as you’re doing it regularly and consistently.
Melanie: And then what about blood pressure as a risk for other diseases so that when we’re looking at medicational intervention or exercise and lifestyle; these other diseases—heart disease, diabetes, things that kind of tie in with blood pressure?
Dr. Tessendorf: Yes. We really want to work on lowering the blood pressure because they have such profound effect on other organ systems. Obviously, heart attacks and strokes are the main things that are affected by blood pressure, but if you get really high blood pressure, you can get renal disease or kidney dysfunction. You can have damage to your eyes. So, high blood pressure control is really important, particularly for people with other disease processes. It really worsens the effect on these other disease processes.
Melanie: And now food. People hear about salt, Dr. Tessendorf, and so is that a myth? Is that a real thing if somebody does suffer from high blood pressure, should they be steering clear of sodium and salty products?
Dr. Tessendorf: Absolutely. That’s one of the first things we recommend with blood pressure elevation is to get on a low-salt diet. There are some people who are not salt-sensitive, but almost all of my patients are, and so sometimes we don’t see dramatic effects with salt restrictions, and those patients we’re a little more liberal with their use, but the vast majority of patients are salt-sensitive with their blood pressure, so we do recommend a low-salt diet.
Melanie: So, wrap it up for us, Dr. Tessendorf, with your best advice about blood pressure, the new guidelines, and what you really want people to know about, you know, keeping within these guidelines and keeping a normal blood pressure and living a healthy lifestyle.
Dr. Tessendorf: So, to summarize, I would say the first thing is, you need to get your blood pressure checked regularly and frequently. If it is elevated, you need to discuss your doctor with treatment options. There are many different things we can do to improve your blood pressure. Some of them are medications, but a lot of them are just lifestyle changes. Simple changes with exercise, with diet, with reducing alcohol intake can be very effective in lowering the blood pressure and really helping you live longer. The goal of all this is to impact your lives in such a positive way and so some simple changes that you do on a daily basis can really make you live longer and avoid lots of problems down the road.
Melanie: Thank you so much for being with us today. It’s really such important information for listeners to hear. If you’re concerned about your heart health, take our free, quick, and confidential HeartAware online screening at bryanhealth.org/heartaware. That’s bryanhealth.org/heartaware. This is Bryan Health Podcast. I’m Melanie Cole. Thanks so much for listening.
New Blood Pressure Guidelines: What You Need to Know
Melanie Cole (Host): The American Heart Association and the American College of Cardiology have put out the first update to comprehensive US guidelines on blood pressure detection and treatment since 2003. My guest today is Dr. Todd Tessendorf. He’s a cardiologist with Bryan Heart. Welcome to the show, Dr. Tessendorf. So, let’s start by giving the listeners a little physiology lesson. What is blood pressure and why is it so important that we know what it is?
Dr. Todd Tessendorf, MD (Guest): So, your heart pumps blood forward and whatever the pressure is inside of your arteries, that’s the amount of force your heart has to generate to maintain the flow going to your body. The higher the blood pressure is, the more force your heart has to generate and the harder it has to work, and that is hard on the heart, and the arteries themselves actually can break down the higher the blood pressure is. So, it’s very important to know your blood pressure, and if it is elevated, to work on strategies to reduce it.
Melanie: So, what are those numbers that people see mean, and what did we used to consider high blood pressure and normal blood pressure?
Dr. Tessendorf: So, the newest guidelines changed what we thought was normal to a different number. We used to think 130/80 was the correct blood pressure or normal blood pressure. Now the guidelines have lowered that to less than 120 over less than 80 millimeters of mercury. The change came about because a few studies that were done, most recent one called the SPRINT trial, that looked at blood pressure in females and showed dramatic reductions in blood pressure had dramatic effects of reducing heart attacks and strokes and the guideline committee decided that it was an important enough trial to make these changes.
Melanie: So, why is it so important and how often should people get their blood pressure checked? And sometimes Dr. Tessendorf, when people get their blood pressure checked it could be high because they’re stressed out or nervous to see the doctor, so, how often should they get it checked to really diagnose hypertension?
Dr. Tessendorf: So, every time you go to the doctor, you’ll get your blood pressure checked and most people see the doctor at a minimum once a year. People with elevated blood pressures at the doctor’s office will need repeated evaluation. We really want to check the blood pressure at a minimum of two times before you diagnose hypertension in two different settings. I actually recommend getting it multiple times so that we can get a more accurate diagnosis, but when you see your physician, they’ll check it at least once a year, but we want to check it more frequently than that if you do have high blood pressure.
Melanie: So what are the treatments if you diagnose someone with hypertension? What is the first line of defense, what do you tell them?
Dr. Tessendorf: The first line of defense is lifestyle changes. If you’re not exercising, we recommend exercise therapy. If you are overweight, we recommend losing weight. Obviously want to reduce sodium. Sodium has been linked to high blood pressure, and so, we use a low-salt diet. Potassium supplementation is also something that we use in the diet—foods rich in potassium: [Inaudible 03:17] avocados, spinach, salmon. We also recommend limiting alcohol intake. In men, no more than two drinks per day and in women, no more than one drink per day.
Melanie: So, if you try these lifestyle modifications and you change some of your behaviors, if you exercise and maybe reduce your alcohol or salt intake and none of those seem to work and you’re still running on the high side, then what?
Dr. Tessendorf: Then, that’s where medications come in and in some people with elevated blood pressures, what we call Stage 1 and Stage 2, we actually recommend both lifestyle changes and medication therapy. There are very standard medications that we use. The guidelines go through some of those approaches, but this is where your doctor’s expertise comes in. There are certain medications that are used for certain diagnoses. In my patients, I see a lot of patients with heart disease, and we use classes of medications called beta blockers for their heart disease as well as to lower the blood pressure. There are other classes that you would use if you didn’t have any of those disease processes. So, that’s where your doctor’s expertise really comes in handy to help drive the blood pressure lower with medication therapy.
Melanie: So, we’ve heard about exercise, and you mentioned it earlier. How much exercise is necessary to create that blood pressure-lowering effect?
Dr. Tessendorf: So, what’s recommended is 30 minutes a day, at a minimum of five days a week. We know more Is better, but even lower levels of exercise have been shown to reduce blood pressure. If you exercise on average, 30 minutes, five days a week, you’ll actually lower your blood pressure about five points, and so it is a dramatic effect. The guidelines talk about other things besides walking or running. It really doesn’t matter what exercise you do as long as you’re doing it regularly and consistently.
Melanie: And then what about blood pressure as a risk for other diseases so that when we’re looking at medicational intervention or exercise and lifestyle; these other diseases—heart disease, diabetes, things that kind of tie in with blood pressure?
Dr. Tessendorf: Yes. We really want to work on lowering the blood pressure because they have such profound effect on other organ systems. Obviously, heart attacks and strokes are the main things that are affected by blood pressure, but if you get really high blood pressure, you can get renal disease or kidney dysfunction. You can have damage to your eyes. So, high blood pressure control is really important, particularly for people with other disease processes. It really worsens the effect on these other disease processes.
Melanie: And now food. People hear about salt, Dr. Tessendorf, and so is that a myth? Is that a real thing if somebody does suffer from high blood pressure, should they be steering clear of sodium and salty products?
Dr. Tessendorf: Absolutely. That’s one of the first things we recommend with blood pressure elevation is to get on a low-salt diet. There are some people who are not salt-sensitive, but almost all of my patients are, and so sometimes we don’t see dramatic effects with salt restrictions, and those patients we’re a little more liberal with their use, but the vast majority of patients are salt-sensitive with their blood pressure, so we do recommend a low-salt diet.
Melanie: So, wrap it up for us, Dr. Tessendorf, with your best advice about blood pressure, the new guidelines, and what you really want people to know about, you know, keeping within these guidelines and keeping a normal blood pressure and living a healthy lifestyle.
Dr. Tessendorf: So, to summarize, I would say the first thing is, you need to get your blood pressure checked regularly and frequently. If it is elevated, you need to discuss your doctor with treatment options. There are many different things we can do to improve your blood pressure. Some of them are medications, but a lot of them are just lifestyle changes. Simple changes with exercise, with diet, with reducing alcohol intake can be very effective in lowering the blood pressure and really helping you live longer. The goal of all this is to impact your lives in such a positive way and so some simple changes that you do on a daily basis can really make you live longer and avoid lots of problems down the road.
Melanie: Thank you so much for being with us today. It’s really such important information for listeners to hear. If you’re concerned about your heart health, take our free, quick, and confidential HeartAware online screening at bryanhealth.org/heartaware. That’s bryanhealth.org/heartaware. This is Bryan Health Podcast. I’m Melanie Cole. Thanks so much for listening.