Ask a Health Care Professional – Heart Disease & Stroke

By Latha Raja Shankar, M.D., Chief Medical Officer, Blue Cross and Blue Shield of New Mexico

Heart disease and stroke are the No. 1 and No. 5 killers respectively of all Americans, according to the American Heart Association (AHA). Since high blood pressure is a primary contributor to both, prevention and control strategies are critical. This is especially important for men and adults age 65 and older as these demographics are at greater risk for developing high blood pressure. However, all people should take steps to protect their heart and cardiovascular system.

What is blood pressure?
When the heart pumps blood, the blood exerts pressure against the walls of blood vessels. This is blood pressure. Normal blood pressure is less than 120 systolic (the top number) and less than 80 diastolic (bottom number), read as less than 120/80 millimeters mercury. Elevated blood pressure is 120-129/80 or less. Hypertension Stage 1 is 130-139/80-89 and Hypertension Stage 2 is 140/90 or higher.

What are the dangers of uncontrolled high blood pressure?
High blood pressure threatens your health and quality of life. In most cases, damage from high blood pressure (HBP or hypertension) occurs over time. Left undetected or uncontrolled, high blood pressure can lead to heart attack, stroke, heart failure, kidney disease or kidney failure, vision loss, sexual dysfunction, and angina/chest pain. High blood pressure also narrows the arteries to the legs, arms and stomach, causing pain and fatigue (called peripheral arterial disease).

What can you do about it?
Know your numbers, educate yourself, discuss your blood pressure with your provider, and make changes that matter.

  • Eat nutritious foods: Eat a variety of foods rich in potassium, fiber, and protein, and low in salt. The DASH (Dietary Approaches to Stop Hypertension) eating planis a healthful diet plan with a proven record of helping people lower their blood pressure. The recommended amount of dietary fiber is 20-35 grams per day. Fruits, vegetables and beans are some of the food groups with high fiber content. Wheat bran is another good source of fiber. Fiber supplements such as psyllium and methylcellulose are other options. Please discuss your options with your health care provider. For a low-sodium diet, the recommendation is to consume less than 2,400 milligrams of sodium per day. The ideal goal is less than 1,500 milligrams of sodium per day. Watch for hidden salt in processed food and canned food.
  • Maintain a healthy weight: Being overweight or obese increases your risk for high blood pressure. To determine whether your weight is in a healthy range, doctors often calculate your body mass index (BMI). If you know your weight and height, you can calculate your BMI at the Centers for Disease Control’s Assessing Your Weight website. Doctors sometimes also use waist and hip measurements to assess body fat. Talk with your health care team about ways to reach a healthy weight, including choosing nutritious foods and getting regular physical activity.
  • Exercise: Even if you don’t lose weight, regular exercise can lower your blood pressure. Please remember that any amount of physical activity is better than none. However, to see substantial benefits, the American Heart Association recommends that adults get at least two hours and 30 minutes of moderate-intensity exercise, such as brisk walking or bicycling, every week. That’s about 30 minutes a day, five days a week.
  • Do not smoke: Smoking raises your blood pressure and puts you at higher risk for heart attack and stroke. If you do not smoke, do not start. If you do smoke, quitting will lower your risk for heart disease. Your doctor can suggest ways to help you quit.
  • Limit alcohol intake: Do not drink too much alcohol, which can raise your blood pressure. Men should have no more than two alcoholic drinks per day, and women should have no more than one alcoholic drink per day.
  • Be mindful of caffeine consumption: Caffeine can temporarily increase blood pressure, especially in people who are not regular coffee consumers. If you are a regular user of caffeine, drinking less than two cups of coffee per day typically does not affect blood pressure.
  • Get adequate sleep: Getting enough sleep is important to overall health and is part of keeping your heart and blood vessels healthy. Not getting enough sleep on a regular basis is linked to an increased risk of heart disease, high blood pressure and stroke.
  • Avoid medications that increase blood pressure: In some people, non-steroidal inflammatory drugs, such as ibuprofen or oral contraceptives and other stimulants, can increase blood pressure. Over-the- counter medicines, such as some decongestants and some herbal supplements, as well as illegal drugs can increase blood pressure for those who are susceptible. Therefore, if you consume medications regularly, including supplements and over-the-counter medications, discuss the details with your provider.

Keep in mind that high blood pressure often occurs without symptoms, so annual wellness exams are essential to understanding and mitigating your risk. For more information, visit the AHA website at

If you have a health question that you would like to be considered in Ask a Health Care Professional, please email [email protected]. BCBSNM will select questions that may appear. Questions will not be personally answered. The opinions expressed in this column are solely those of the author and not necessarily those of BCBSNM. This column is not intended to be a substitute for professional medical care.




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