Hypertension, also known as high blood pressure, is often called “the silent killer,” because it is a deadly disease that shows no early symptoms. It is the single most significant risk factor for heart disease, congestive heart failure, stroke and kidney disease.

According to the Centers for Disease Control and Prevention (CDC), almost a third of adults in the United States suffer from various degrees of hypertension. The latest survey lists high blood pressure as the primary or contributing cause of death for 326,000 Americans in 2006 – making it one of today’s most widespread life-threatening diseases.

Hypertension affects both genders equally, although men seem to face it at an earlier age than women. Apparently, race and ethnicity also play a role. Proportionately, high blood pressure is more prevalent among African Americans than Caucasians and Hispanics.

Epidemic proportions

In a more recently conducted study, the CDC reports that nine out of ten Americans now consume around 3,500 milligrams (mg) of sodium every day, which is almost double the recommended limit.

This does not mean that Americans are too heavy-handed with the salt shaker. Most sodium comes from commonly eaten foods, like processed grains in breads, cookies, pizza, poultry and luncheon meats. Many of these items don’t even taste salty. Experts say that sodium has become so pervasive in our diet that it is difficult to stay within the recommended limits, even for those who try to cut back on their intake.

What is hypertension?

Hypertension is elevated blood pressure that can develop into a chronic condition over time. Blood pressure is the force the heart must exert to circulate blood throughout the body. The more force the heart must apply to fulfill its task, the greater the risk of damage.

There are two types of hypertension – “primary” (also called “essential”) hypertension and “secondary” hypertension. There are no known specific causes for “primary” hypertension. Natural factors, like age, gender, race and heredity pre-conditions may all play a role in its occurrence. Secondary hypertension, on the other hand, is caused by certain diseases and deficiencies, including kidney problems and blocked arteries.

The latter are often lifestyle-induced. Stress, anxiety, poor diets and eating habits, weight problems, lack of physical exercise, smoking and excessive alcohol and caffeine intake are all well-known culprits. While there is not much we can do about our age, gender, race and heredity health conditions, we all can make better dietary and lifestyle choices.

How is hypertension measured?

An instrument, called a sphygmomanometer, also known as a blood pressure cuff, measures blood pressure when the heart muscle contracts to push blood out into the arteries, called “systolic” pressure, and again when the heart is at rest between beats, which is called “diastolic” pressure. The test results are measured in millimeters of mercury (mm Hg). An optimal reading for adults is a systolic pressure of 120 or less and a diastolic pressure of 80 or less – or 120/80 mm Hg (systolic/diastolic mm Hg).

Managing the risks of hypertension through…

Keeping a healthy weight range

Managing a healthy weight range is essential for controlling blood pressure. What constitutes a healthy weight range depends on age, gender, frame size and physical activity level. There are easy ways to determine your body mass index (BMI), waist size and daily calorie needs, all of which you can do by yourself in the privacy of your home. (For guidelines, go to http://www.timigustafson.com @ Succeeding at Weight Loss and Just 12-Weeks to Total Health and Fitness.)

Limiting sodium intake

When in good health, the body usually adjusts to a temporarily higher intake of dietary salt (sodium chloride). The kidneys are able to excrete the extra sodium without raising blood pressure. However, with age and/or diminishing kidney functions, the natural regulation of the sodium excretion may become impaired, which can lead to the increase of blood-water volume. When this happens, blood pressure becomes elevated and there is a higher risk for heart disease and blood vessel damage.

To decrease your sodium intake, you should follow a diet plan that is dominated by fresh food items, like fruits and vegetables as well as whole grains, beans, legumes, low-fat dairy products and only lean poultry, fish and meat.

Otherwise healthy adults should limit their daily sodium intake to 1,500 to 2,300 milligrams (mg) or less. (One level teaspoon of table salt equals 2,300 mg sodium.)
Those diagnosed with hypertension should aim for an upper limit of 1,500 mg sodium per day.

A health-conscious diet

Healthy eating starts at the grocery store. Your diet is only as healthful as the ingredients you use and the cooking techniques you apply. A little knowledge about food in general and how to prepare it can help you make better choices.

To limit sodium content, it is important to read and understand food labels. The amount of sodium in packaged food items is listed on the “Nutrition Facts” labels. Observe the “Serving Sizes,” since the amount is measured per serving.

As mentioned in the CDC report, sodium can be excessively high in baked goods, frozen dinners, luncheon meats, soups and many other packaged and canned food items. Watch out for salty snacks, like potato chips and pretzels.

When cooking food at home, you can use herbs and spices, in place of salt, to enhance the flavors. For home-made soups, you can make chicken-, fish- or vegetable stock from scratch, instead of bouillon cubes or broths from cans. Go easy on certain condiments, like ketchup, mustard, soy sauce, monosodium glutamate (MSG), BBQ sauce, salad dressings, salsa and gravies.

Cutting back on alcohol and caffeine

Moderate drinking of alcoholic beverages, especially red wine, may have some health benefits, including lowering blood pressure. But these positive effects are quickly lost if you overindulge.

It is common knowledge that excessive alcohol consumption can lead to addiction and may contribute to serious diseases, including cancer. The presence of alcohol in the body can interfere with its nutrient absorption and metabolism. Moreover, alcoholic beverages are all high in calories (7 calories per gram) and can cause weight gain.

Consumed in moderation (up to 300 mg per day or two 8-oz cups of coffee), caffeine has not been shown to carry any significant health risks for adults. However, caffeine acts as a stimulant, which affects the cardiac muscle and central nervous system. That is why it has the “wake-up” effect.

Excessive use of caffeinated beverages can lead to increase of blood pressure and heart beat irregularity. Another potential problem is dehydration. Caffeine is a diuretic, enhancing the loss of fluids.

Stress reduction

Chronic stress is a widespread cause of high blood pressure. Unlike acute stressors, which allow eventually for relief once a particular threat has passed, chronically stressful situations produce a permanently elevated state of alertness and tension.

There are many ways to manage stress. Relaxation techniques, such as meditation, yoga, massage or simply a warm bath, along with healthy eating habits and sufficient sleep, can do wonders. If your own efforts don’t work, seek professional counseling.

Regular exercise

Physical activity is a must-have for every healthy lifestyle. How much and how often you are able to exercise may depend on your lifestyle and personal situation. If you don’t have access or are too busy to visit a gym or other sports facilities, look for alternative opportunities to put your muscles to work, e.g. by taking walks during lunch hour, or by using stairs instead of elevators. (For a whole range of ideas for “in-between exercises,” go to http://www.timigustafson.com @ Basic Information About Exercise.)

Make sure you consult with your physician before starting a new health and fitness program. If you have had little or no exercise for some time, begin slowly and cautiously test your limits.

Not smoking

Nicotine causes blood vessels to constrict and make the heart beat faster – thereby raising blood pressure. The Surgeon General has named smoking as the most serious risk factor for coronary heart disease. Smoking is to blame for almost half a million preventable deaths in America every year. Additionally, secondhand smoke is estimated to kill as many as 40,000 non-smokers.

Countermeasures are simple and commonly known: If you don’t smoke, don’t start. If you do smoke, quit now or ask your physician how you can overcome your smoking habit.

Taking action

It is easy to feel discouraged in the face of all these statistics and negative reports. But instead of giving up and letting things slide even further, we all can take steps in the right direction. The world we live in may not always afford us the opportunity for radical changes, independent from circumstances and structures. But we can consciously and deliberately make small improvements, find alternative solutions and take responsibility for our actions. And that can be a very freeing and empowering experience.

Timi Gustafson R.D. is a clinical dietitian and author of “The Healthy Diner – How to Eat Right and Still Have Fun™,” is available on her blog http://www.timigustafson.com and at Amazon. Her latest book, “Kids Love Healthy Foods™” is now available in e-book format at http://www.amazon.com