Transcription:
Lifestyle Habits to Take Care of Your Heart

Disclaimer: The medical health information provided during this program is for general information and educational purposes only, and is not a substitute for professional advice. None of the given information is for the purpose of diagnosis or treatment. Neither does this program serve as approval for any health product or brand.

This program aims to enhance your personal health and wellness through the adoption of healthy lifestyles and your prompt presentation to the health professional whenever you suspect that you are ill. For treatment and professional advice ensure you consult your physician.

Melanie Cole (Host): Welcome to Say Yes to Good Health with Memorial Hospital. I'm Melanie Cole. And today we're talking about high blood pressure with Dr. Douglas Heighton. He's a Physician at Memorial Medical Clinic. Dr. Heighton, it's a pleasure to have you join us again. And we're talking about blood pressure.

So as we get into this topic and I love this topic, I told you that off the air, I'd like you to give the listeners a little physiology lesson because they don't know what blood pressure is and why it's important. Can you tell us what it is?

Douglas Heighton, MD (Guest): Blood pressure is the pressure that is made by the heart every time it pumps blood. Every heartbeat, it pumps blood out of the heart. There has to be some kind of pressure to make the blood flow through the arteries, down to the body parts, and then back up the veins. So there always has to be some blood pressure. The problem is sometimes it just gets too high.

Host: So, what are those numbers that we see when people get their blood pressure taken from even little kids at the pediatrics office, all the way to our senior citizens, they get the arm squeeze. Can you tell us what that systolic and diastolic, the high and low numbers really are?

Dr. Heighton: Yes. We measure blood pressure with a blood pressure cuff or a band that goes around the arm that has a little balloon in there. And we pump up the balloon until we can't hear the blood squirting through, and then we slowly open it up and listen for the sounds. The first sound we hear is the highest pressure and that's the top number or called the systolic. It's just the top number. It's the highest pressure that is coming out of the heart. Then the second sound we hear is the bottom number or diastolic, and it is the blood that is now going through kind of reverse or just at a lower volume.

Host: So that's the blood heading back?

Dr. Heighton: Well, it yes, you can say that. Okay. What we typically say is the top number is the end of the heartbeat, the maximum pressure, the bottom number is when we're not squeezing the arm anymore with the cuff, that it is the sound that is between the heartbeats. So the top number is the max and the bottom number is the average or what's there when it's just going through normally.

Host: So what's considered normal blood pressure and what's considered high blood pressure because recently those guidelines changed. Tell us a little bit about what those numbers are, what we're supposed to be having.

Dr. Heighton: For years, we're talking decades, we have had ongoing tests or trials to find out what are perfect blood pressures. So we have developed blood pressure ranges for people of every age. We have blood pressures for a newborn baby, literally a minute old. We have blood pressures for five-year-olds. We have blood pressures for ten-year-olds. We have pressures for 20, 30, 40, 50, 60, and 90 year old people, and each of those blood pressures are different. We find the ones that are the average. We find the ones that are normal and anything outside of those ranges, whether they're high or low, and blood pressure would be the high ones. Okay. Then we have to do something about it.

Host: Okay. So, so when we hear those numbers, 120 over 80 or 140 over, where do you want the average adult individual? So, so that when we're told that we have hypertension, or high blood pressure. Some people even have low blood pressure. My mother had low blood pressure. So what does that mean when we have high blood pressure? What is that number you determine and say, okay, now your blood pressure's high. So now we need to look at doing some things.

Dr. Heighton: Yeah. So again, blood pressure goes by the name, hypertension. High blood pressure is hypertension. It's hyper, it's up and tension means something is tense within the body system. Okay. And that ends up how we go about treating it also, but normal blood pressure for an adult, a person over the age of 21, and maybe up to the age of 75 would be considered 110 to 130 would be safe. And on the bottom, anywhere from 60 up to 80 would be for the diastolic, the bottom. So 110 to 130.

Host: So that's good. And the lower number, that one doesn't move around a lot, but we don't want that one high at all. Cause that one's -

Dr. Heighton: Well, it can depending on the situation and the cause, and there are many causes of high blood pressure. It can vary too. It definitely can go up. I see many people with the diastolic, the bottom number being above the 80. I mentioned we never want the bottom number to go over 90 and we never like the top number to go over 140.

There's a few exceptions, but you know, of elderly people that might be slightly different but typically we never like the systolic on the top, over 140 and the diastolic on the bottom over 90.

Host: Yeah. And I think what I meant was that it's not as dynamic. So if somebody exercises their blood pressure goes up, or if they're, you know, and that lower number, doesn't tend to jump as much. Right? But tell us a little bit about the causes of high blood pressure, whether it's sodium or disease or cardiovascular issues.

Dr. Heighton: Well, the exercise issue. Exercise is good for blood pressure. Yes. When you exercise your blood pressure will almost always go up. And I would say always, okay, because exercising speeds up the heartbeat and when the heart beats faster, more blood's coming out and more blood is being pushed through the system, the arteries, and then back up the veins.

But what happens when you are exercising, you get warm, you get hot from exercise. Plus there's chemicals that are made, which makes the little teeny blood vessels called capillaries that are at the ends of the arteries; it dilates those. So yes, your heart's going fast. Yes, your blood pressure goes up, but it's going around faster. It's going around easier because they open up, the capillaries.

Host: Sure. So exercise is a really good way, even if it raises your blood pressure, but there are other things that raise your blood pressure that are not as good for us. Can you speak about those modifiable now? I'd like you to speak about hypertension in general, and there are some controllable and some non-controllable or non-modifiable risk factors for having high blood pressure, which can contribute to a myriad of diseases. So can you tell us a little bit about those risk factors? The ones we can control and the ones we cannot.

Dr. Heighton: Again, hypertension means high blood pressure. That's all, it means. It's two words that mean the same thing, high blood pressure and hypertension, but there are many causes for high blood pressure. First of all, it can be inherited. You could have got it from your mother or your father and that at some age, maybe it's when you turn 30 it starts to go up. Maybe it was perfect before that, but it just goes up because of age. Okay. And that might say that, well, there was a heart issue. There was a blood vessel issue, something like that. It's inherited. Second of all, stress, any kind of stress, stress at work, stress at home, any kind of stress can raise your blood pressure.

So in those cases, you try to reduce your stress. We also know that as you get older, everyone, their blood pressure goes up. It may never become high blood pressure, but it's not the same as when you were 10 years old. It's not the same as when you were 20 years old. It's not the same as when you were 30 years old, age raises blood pressure.

I'm sorry, but blood pressure because the arteries change as you get older. Second of all pain, any kind of pain, knee pain, shoulder pain, muscle pain, working pain. Okay. Can any kind of pain can raise your blood pressure. So we tried to reduce pain in whatever way we can. Sometimes medicines can raise blood pressure, like the ibuprofen you use for any kind of injury, well those raise blood pressure. Also your diet. You can raise your blood pressure, particularly due to salt which is one of the things we watch really close in anybody with high blood pressure is their salt level in their blood. Sickness, any kind of sickness can raise your blood pressure. When you're sick, particularly if you've got a fever of any kind, even low grade, your heart will speed up.

And so when your heart speeds up, it's pumping more blood out and therefore your blood pressure goes up. There are of course other diseases of the heart that can cause high blood pressure. Yes. There are some that can lower blood pressure, but there are heart diseases. Also obesity or being overweight. It doesn't take much overweight to cause your blood pressure to go up. Those are the major causes of high blood pressure.

Host: And including smoking in there. Yes.

Dr. Heighton: Oh, yeah. Nicotine definitely smoking. All it takes is like one cigarette and your blood pressure will go up some yes. And definitely it raises your blood pressure. Yes, absolutely.

Host: So how often should we have our blood pressure checked?

Dr. Heighton: Well, typically in a family practice offices, we check the blood pressure every time. Unless it's checked, there are no, usually there are no symptoms of high blood pressure. So it is recommended that at every office visit that we check your blood pressure to see if it's up that day, or if it's continuing to stay up. Again, there are usually no symptoms of high blood pressure.

If it gets extremely high, you can get chest pain, you can get headaches, you can get a red face or skin color changes, other kinds of little issues that people come in with.

Host: In the last minute here, Dr. Heighton, what do you think of the home blood pressure cuffs, do you want us, if somebody is diagnosed with high blood pressure and you want them to keep track of their blood pressure, do you prefer they go to their local pharmacy and get it once a week? Or do you like them to keep a track of it at home?

Dr. Heighton: If a person has the diagnosis of high blood pressure, I would like them to purchase a home blood pressure monitor or cuff and do their readings once, maybe twice a day. Most of the new machines record those pressures so they can bring that machine to me in the office and show me what their blood pressures are at home.

Host: That's a really important point that you just made. And I'm so glad that you told the listeners this, because that's important for you doctors to keep track so that we know we keep our journal. We keep track, you can bring the machine in. So this is a really great topic because it is truly an epidemic in this country, whether we're talking about obesity, diabetes, heart disease, which really is such a killer and high blood pressure seems to be this little cog in all of those wheels. Right? It's always mentioned when someone suffers from one of those other diseases. So if somebody comes to you and you've determined that's what they have, and maybe it's the first time that you've determined it. What is the first line of defense? Do you look to lifestyle? Do you head right for the medications? What do you tell people to do right off the bat if you determine that they are hypertensive?

Dr. Heighton: We always like to recheck their blood pressure at several visits, at least two, three would be better depending on how high it is. If it's extremely high, then we want to get it under control, even if it's for the short term, right away. But in most cases, if it's above normal we'll say, okay, come back in a week, come back in a couple of weeks and we'll recheck it again here to see, because again, it might be one of those other issues of being sick, being stressed out. Something happened at work that day. There are many causes. Okay. So we do it usually a week apart if it's not super, super high. All right. And the important thing is why do we even care about blood pressure overall is because it's a silent killer just as you mentioned. It, and most people think, oh, it's going to hurt my heart, or it's just the pressure in my arm, but that's not the case.

What we worry about is what we call end-organ damage that the blood pressure will damage other things. We know that over a short period of time, it can damage your kidneys can stop. We know that it can damage your liver. Your liver can have serious problems. Again, pressure-related. We know that it can damage your eyes, that, and we know that it can cause strokes.

Pop a blood vessel in the brain and that's called a stroke. Can't move an arm. Can't move a leg. Can't move. Can't think. Those are the reasons we do this whole thing. All right. But we always recommend changing your daily activities of first a mild exercise. If it's not too high a blood pressure, second of all, reducing the salt. There's way too much salt in the American diet.

It's in the bread, it's in the cheese, it's in all the Ketchup and things that we put on our foods. And even in lots of prepared foods that you might buy at the store have added salt to make it taste better, make it preserve, and pickles, they use it as a preservative in pickles. So there's way too much. They say that most people in the United States get twice too much salt of what they need. All right. You need a little bit, but most of the American diet is double the amount of salt, they really need. So we try, we try those things first.

Host: So you always try the sort of lifestyle changes. And I'm one of those people that after menopause, my low blood pressure went to more normal levels, but even a little higher. And I didn't change much but age related. My goodness. So okay. You've mentioned exercise, you've mentioned salt and sodium in our diet. You mentioned stress relief before. Now, if none of those things work; there's a million medications on the market that we see now. Calcium channel blockers, beta blockers, diuretics, ACE inhibitors. Gosh, Dr. Heighton, can you tell us what they're intended to do? Just why these medications lower our blood pressure.

Dr. Heighton: Those medications are designed to lower your blood pressure. There've been many, many medical studies with really millions of people over the last 50 years to find which blood pressures do what and how well they work to find a better blood pressure medicine. We have many, many new medicines. Today, most of them are generic because we've used them for 10 years, 20 years, 30 years, some of them for 50 years.

All right. And we try to pick when we get, when the diet and lifestyle do not help or losing weight can help, but when it doesn't work, then we try to add one of those medications which we believe would work the best. All right. As you said earlier in the podcast that blood pressure is a serious problem, many people, a huge number of people in the United States have blood pressure problems.

Okay. The average person is on two medicines at the same time, two to three. Because blood pressure is so hard to control and that it is just getting worse because of, like I said, the diet, the exercise and the obesity and the stress in our lives. So we try to pick the medicine that, or medicines that will work the best. We start with one usually. All right. But we do that by first doing a blood check to check how well the person's kidneys are working, how well their liver is working and what level of salt, sodium is in their blood. Because that's what we're trying to do is fix each of those things at the same time.

Host: I'm so glad that you mentioned that sometimes people are on multiple medications because I myself have heard over the years, people say, well, I had to be on two because one wasn't working. So that, that was great that you pointed that out. If you're on medications for hypertension, Dr. Heighton, why is it so important to take those medications as prescribed?

And I told you a little story off the air about my husband, who didn't take his medications as prescribed and his blood pressure shot up so much they wouldn't do a colonoscopy on him. Tell people about the importance and really what you want them to know about some of the things that they can do along with the medications to try and get that blood pressure under control, because it's so important.

Dr. Heighton: Yes, it is very important to take your medication as your prescriber tells you to. Most of the medications we have, work for 24 hours one day or a slightly less than a day, maybe 20 hours, maybe 12 hours. And so a lot of times we have to take medicines twice a day or three times a day because that's how long they last. Okay. Other medications, will last 24 hours or just a little bit longer. So it's important that you take the medication at exactly the same time, meaning plus, or minus 30 minutes or so if you take them in the evening, always take them in the evening. If you take them in the mornings, always take them in the mornings, whatever your doctor prescriber recommends you do to take them.

Host: That's great advice. And now back to exercise for a minute. Cause you know, I love to talk about exercise, but it really does help. And up to like four hours past your exercise session, how much do you want people to exercise if they can start an exercise program? And as you mentioned, even light walking helps at the beginning. What would you ideally like them to do to really keep that blood pressure under control? And it can also help them lose some weight.

Dr. Heighton: Well, the recommendations are, first of all, ask your doctor or provider, what kind of exercise would be right for you and safe for you? All right. Typically if it's mild, I have my patients start out with a mild 15 minute, 30 minute walk, you know, on level ground, not up hill, not up steps or anything like that, that they start slowly and increase slowly over many months. All right. Second of all, again, we would like them to reduce their salt because that can help. Also we know that it is recommended that at least five days a week, that people get that exercise. So however many minutes your doctor recommends you, you start with, then you would keep up with pace or that amount, minutes of exercise for at least five days a week, if you can do seven, fine. We don't want you to have other kinds of problems, like getting thirsty or getting dehydrated, but whatever your provider recommends at least five days a week.

Host: And you mentioned to reduce our salt, because again, that's one of those things that help sort of harden up the arteries in there and contributes to that pressure inside that artery. And people hear about these different diets, Mediterranean and DASH diet and all of these things. When you would advise somebody about changing their diet, what do you tell them Dr. Heighton? Do you tell them to look at labels? Do you tell them to Google what is the DASH diet? What do you tell them?

Dr. Heighton: Well, first of all, I do tell them to read the labels on the food packages. Foods are required to have that label to tell how much sodium is in the average portion that people eat. Now, the problem sometimes is people eat two pieces of cake or, instead of two cookies, they ate 10 cookies and now they've just doubled their salt if they don't follow what it says at top.

But again, I try to keep the salt or sodium level below 2000 milligrams a day. All right. So you have to add up everything you ate in the day and see how much sodium you got. Less than 2000 milligrams a day is the recommended in the American diet though, again, most people get four or five, 6,000 milligrams a day, which is not safe.

Also the exercise, every time you exercise, not only does it stretch your blood vessels, make them work better, make you warm for the four hours you mentioned. But every time the heart pumps, a small percentage of your blood about one third goes to your kidneys. And when the extra blood from exercising goes to your kidney, it also helps to make urine, but when it does that, it pumps out salt at exactly the same time.

Host: Wow. You are just a wealth of great doctor information Dr. Heighton. As we get ready to wrap up, I would love to hear your best advice, what you tell your patients every single day about controlling their blood pressure, the importance of knowing their numbers. And I'm so glad that you mentioned how much sodium is really needed that 2000 a day, because really, as you said, people are getting so much -

Dr. Heighton: Or less. Or less.

Host: Less.

Dr. Heighton: thousand is the max.

Host: That's the max and people didn't know that. So you really cleared up a lot of these things and give us your best advice now, what you tell people every single day about controlling their blood pressure.

Dr. Heighton: Again, diet, watching the salt levels, secondary getting daily exercise, whatever's recommended by their physician and trying to minimize their stress, minimize their pain and continue to take their medications, whatever choices they've been put on at the proper times and not missing any days of medication because your blood pressure will pop up within hours or half a day after you stop taking your medications.

Host: Wow. So informative. Dr. Heighton, what a great guest you are. I hope you'll come and join us again and talk about more medical things because we learn so much. And thank you again for joining us today. For more health tips, like you heard here, please visit our website at mhtlc.org, or you can call 217-357-2173 to schedule an appointment with Dr. Heighton. That concludes this episode of Say Yes to Good Health with Memorial Hospital. We'd like to thank our audience and invite you to download and subscribe, rate and review ,these podcasts on Apple podcast, Spotify and Google podcasts, and be sure to share this information with your friends and your family on your social channels, because we are learning from the experts like Dr. Doug Heighton at Memorial Hospital together. I'm Melanie Cole.

Disclaimer: The medical health information provided during this program is for general information and educational purposes only, and is not a substitute for professional advice. None of the given information is for the purpose of diagnosis or treatment. Neither does this program serve as approval for any health product or brand.

This program aims to enhance your personal health and wellness through the adoption of healthy lifestyles and your prompt presentation to the health professional whenever you suspect that you are ill. For treatment and professional advice ensure you consult your physician.