Healthy Conversation with cardiologist Tamara Aipass
You don’t feel it, you don’t see it, but it’s called a silent killer: high blood pressure. As many as 4 million Dutch people have high blood pressure, also known as hypertension. Cardiologist Tamara Aipassa of the Zuyderland Medical Center in Heerlen explains in a very clear conversation what high blood pressure is, why it is so dangerous, the best way to measure blood pressure and of course: what the best treatment is for high blood pressure. The good news is: improving your lifestyle often has a greater effect than medication!
What is high blood pressure?
Your heart pumps blood through your arteries, creating continuous pressure in the arteries. Each contraction of the heart muscle propels the blood forward and at that time the pressure on the blood vessels is greatest. We call this the upper pressure. With each relaxation of the heart muscle, the pressure decreases slightly and that is called the negative pressure. A normal, healthy blood pressure is around 120/80. There is high blood pressure or hypertension when the top pressure is above 140 and/or the negative pressure is above 90. High blood pressure literally puts a lot of pressure on the blood vessels and they can be damaged as a result. Ultimately, this leads to an increased risk of cardiovascular disease. Aipass: “I always think it’s such a general term, ‘cardiovascular disease’. But you must not forget that these are extremely annoying conditions. You can think of, for example, a heart attack, heart failure, a brain haemorrhage, shop windows or damage to the blood vessels in the eyes.”
Measuring at home is recommended
Cardiologist Aipasa emphasizes that many people are not aware that they have high blood pressure: “You don’t notice it and it is often discovered by accident. Once a high blood pressure measurement at a doctor or practice nurse does not say much. There are factors that temporarily raise blood pressure. You may be nervous in a doctor’s office, you may have personal stress, accidentally ate extra salt or you have just exercised. Therefore, a few more measurements are always needed to confirm the diagnosis to provide security.” Aipass is an advocate of measuring blood pressure at home. “With your own meter you can measure at a quiet moment, you can measure at different times of the day and you do not have the blood pressure-raising effect of the white coat from the doctor’s office. Those values are very valuable to me as a doctor.”
How does high blood pressure develop?
In the vast majority of people, high blood pressure is caused by a combination of genetic susceptibility, plus lifestyle. High blood pressure can run in families, but lifestyle also plays a major role. The risk of high blood pressure is increased by, for example, being overweight, not exercising much, smoking, eating unhealthy foods and drinking a lot of alcohol. And therein lies the key to recovery: if you improve your lifestyle, your blood pressure will usually drop quickly. Aipass: “That effect can be very direct: after a good workout or brisk walk, the blood pressure is already lower for the rest of the day. But a healthy lifestyle also helps to lower blood pressure in the long term. That effect can be greater. than that of medicines. Therefore, the treatment of high blood pressure should always be a combination of first and foremost lifestyle, plus possibly medicines.” Aipass therefore finds it a pity that many doctors have little time to guide their patients through a lifestyle change. “Lifestyle change is behavioral change and that by definition takes time and effort. That cannot be done in 10 minutes during the consultation.”
Weaning off medications?
There are many different medicines for high blood pressure, each with its own mechanism of action. According to Aipass, a working medicine can be found for everyone with a little searching: “But then ‘adherence to therapy’ is important: are you taking the medicines every day and in the right way? Some patients find it annoying to tell them that they are taking their medicines. don’t take it, for whatever reason, but I’d like to hear that. Then I know what’s going on and we can look for another solution.” And if you start living a healthy life, can you taper off the pills? Aipass: “That is certainly possible. It helps if you keep a good record of your own blood pressure values, so that the doctor can reduce the pills. But: never stop taking medicines for high blood pressure on your own!”
Bomb for your blood pressure
And what about salt, can it raise blood pressure? “Yes, you can,” says Aipass. “But some people are sensitive to salt and others are not. We don’t really know why that is, nor how to find out. It is also important to know that sugar, especially fructose , also has an increasing effect on blood pressure, especially in combination with salt. For example, if you eat a fast food meal with a lot of salt, and you drink soft drinks with a lot of fructose, then that is a kind of ‘bomb’ for you blood pressure. Healthy, Mediterranean food with lots of vegetables, fruits and fish is probably the best food for healthy blood vessels.”
You can listen to the high blood pressure podcast below.
