Prevention of Hypertension

Lifestyle changes can help lower blood pressure and prevent hypertension, including if you are on anti-hypertensive medications. Lark can help you turn healthy lifestyle choices, such as losing weight and getting active, into long-term habits that are sustainable and effective.

Hypertension affects 45% of Americans and is a risk factor for stroke, heart attack, and kidney failure, according to the Centers for Disease Control and Prevention (CDC)[1]. While it affects about 100 million adults, and millions more are at risk, prevention is often possible with lifestyle changes. 

What is Hypertension?

Blood pressure is the force of blood against the walls of blood vessels. Systolic blood pressure is the force when your heart contracts. Diastolic blood pressure, which is lower than systolic blood pressure, is the force measured when your heart relaxes between beats. Hypertension occurs when systolic, diastolic, or both blood pressures are higher than normal.

These are the cut-offs for normal, pre-hypertension, and hypertension [2].

Most people have no symptoms of high blood pressure. The only way to tell if you have it is to get it measured. Your doctor may do it each time you have an appointment, or you can ask a pharmacist to do it.

Causes of Hypertension

For most people, there is no specific cause of hypertension. However, there are many risk factors. Some are non-modifiable, and there is nothing you can do about them besides be aware.

• Family history
• Older age
• Being African-American

Other risk factors are modifiable and you can do something about them.

• Being overweight or obese
• Being physically inactive
• Having a high-sodium diet
• Having a low-potassium diet
• Using tobacco
• Not managing stress
• Overusing alcohol

Lark can help with small changes in daily choices to lower risk for hypertension.

Effects of Hypertension

Hypertension tends not to cause symptoms, and patients may not know they have it until it causes other problems. For that reason, hypertension is called the "silent killer." Left untreated, high blood pressure can lead to:

• Stroke
• Heart failure. 
• Heart attack.
• Kidney failure.
• Cognitive decline.

Close to half a million deaths each year in the US are attributable to high blood pressure, according to the CDC. That is equivalent to nearly 1 death each minute because of hypertension, and accounts for almost 1 in 5 deaths.

Still, prevention of hypertension is often possible, and treatment if you have high blood pressure can lower your risk of developing complications.

Weight Loss and Preventing Hypertension

Losing extra weight if you are overweight or obese can reduce your risk of developing high blood pressure. In one study, for example, obese women with a body mass index (BMI) of 29 were up to 6 times more likely to develop hypertension than normal-weight women with BMI 22. Other studies have found similar results[3]. Losing extra pounds can also prevent diabetes or help manage high blood sugar, which in turn lowers risk for hypertension.

Small changes are typically most sustainable, and that leads to more sustainable weight loss. Lark can be there to help you set weight loss goals, track your progress, and offer tips. These are a few simple choices to make that can lead to weight loss.

• Reducing hunger by making choices that are lower in calories and higher in fiber or protein. Foods to include are vegetables, whole grains, beans, eggs, tofu, fish, nuts, and fruit.
• Choosing foods in their lower-calorie, more filling forms. For example, a cup of grapes has 100 calories, while a cup of grape juice has 170 calories.
• Eating from a smaller plate or bowl, and filling it half full with vegetables before serving yourself other foods.
• Eating slowly and stopping when you are just barely starting to get full.

Nutrition and More Lifestyle Choices to Prevent Hypertension

Weight loss is not the only food-related choice you can make to lower risk for hypertension. Certain foods are associated with increased or decreased risk. For example, consuming more whole grains, fruit, nuts, and dairy products may lower risk for high blood pressure, and fish and legumes may also be beneficial. On the other hand, red and processed meats, as well as sugar-sweetened beverages and a high-sodium diet, may raise risk[4].

Many other lifestyle behaviors can be effective in the prevention of hypertension. They include the following.,[5, 6]

• Being physically active.
• Getting enough sleep.
• Not abusing alcohol.
• Avoiding tobacco use.

Managing Hypertension

Strategies for managing hypertension include the same lifestyle choices for the prevention of hypertension. It can be motivational to see the approximate decreases in blood pressure that results of research studies have found [7]. The values given here are for systolic blood pressure.

• 1 mm Hg per kilogram (2.2 lb.) weight loss.
• 5 to 20 mm Hg for achieving a normal BMI body weight.
• 8 to 14 mm Hg for consuming plenty of vegetables, fruit, and reduced-fat dairy products, and limiting saturated fat.
• 4 to 9 mm Hg for achieving at least 30 minutes of physical activity most days.
• 2 to 4 mm Hg for limiting alcohol consumption to 1 (women) or 2 (men) drinks per day.

Medication adherence or compliance, or taking medications as prescribed, can help achieve target levels of blood pressure, but few patients are completely adherent. In addition, home monitoring may help. 

Lark is a fully digital health coach that supports patients in making these and other healthy choices to lower blood pressure. Hypertension patients in the Lark hypertension study had lower hypertension after six months of using Lark and a home blood pressure machine. The average decrease among Lark users was more than 8 mm Hg systolic and 6 mm Hg diastolic. Areas of emphasis with the Lark coach were weight management, physical activity, nutritious eating, sleep, and stress management, along with medication adherence and home monitoring of blood pressure.

While hypertension is an expensive, widespread, and serious chronic condition, it is also one that is responsive to self-management. Diet, exercise, and medication adherence are just a few of the strategies that can help lower blood pressure, and Lark is a personalized health coach that is always available through your smartphone to guide you.

References

1. https://www.ahajournals.org/doi/10.1161/CIR.0000000000000757
2. https://www.cdc.gov/bloodpressure/facts.htm
3. https://www.ahajournals.org/doi/full/10.1161/HYPERTENSIONAHA.107.094011
4. Schwingshackl L, Schwedhelm C, Hoffmann G, et al. Food Groups and Risk of Hypertension: A Systematic Review and Dose-Response Meta-Analysis of Prospective Studies [published correction appears in Adv Nutr. 2018 Mar 1;9(2):163-164]. Adv Nutr. 2017;8(6):793–803. Published 2017 Nov 15. doi:10.3945/an.117.017178
5. Diaz KM, Shimbo D. Physical activity and the prevention of hypertension. Curr Hypertens Rep. 2013;15(6):659–668. doi:10.1007/s11906-013-0386-8
6. Lu Y, Lu M, Dai H, et al. Lifestyle and Risk of Hypertension: Follow-Up of a Young Pre-Hypertensive Cohort. Int J Med Sci. 2015;12(7):605–612. Published 2015 Jul 16. doi:10.7150/ijms.12446
7. Chobanian et al. Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Hypertension. 2003;42:1206–1252