High Blood Pressure
>> Tuesday, September 29, 2009
High Blood Pressure
High blood pressure (hypertension) is a common problem for up to 90% of transplant recipients.
Blood is carried from the heart to all parts of the body in vessels called arteries. Blood pressure is the force of blood pushing against the walls of the arteries as it is being pumped through them. Hypertension occurs when the force of blood against the artery walls is greater than normal, causing the heart to pump harder. High blood pressure can damage the arteries and the heart, increasing the risk of a stroke, a heart attack, kidney problems, or heart failure.
Blood pressure is always reported as 2 numbers: the systolic and diastolic pressures. Both numbers are important. Systolic pressure is the highest pressure when the heart beats, pumping blood into the arteries. Diastolic pressure is the value when the heart is at rest, in between beats. Systolic pressure is reported first, followed by diastolic (for example, 120/80 mm Hg — 120 is the systolic pressure and 80 is the diastolic pressure, and mm Hg refers to millimeters of mercury, which is the standard measurement for blood pressure).
High blood pressure (hypertension) is a common problem for up to 90% of transplant recipients.
Blood is carried from the heart to all parts of the body in vessels called arteries. Blood pressure is the force of blood pushing against the walls of the arteries as it is being pumped through them. Hypertension occurs when the force of blood against the artery walls is greater than normal, causing the heart to pump harder. High blood pressure can damage the arteries and the heart, increasing the risk of a stroke, a heart attack, kidney problems, or heart failure.
Blood pressure is always reported as 2 numbers: the systolic and diastolic pressures. Both numbers are important. Systolic pressure is the highest pressure when the heart beats, pumping blood into the arteries. Diastolic pressure is the value when the heart is at rest, in between beats. Systolic pressure is reported first, followed by diastolic (for example, 120/80 mm Hg — 120 is the systolic pressure and 80 is the diastolic pressure, and mm Hg refers to millimeters of mercury, which is the standard measurement for blood pressure).
What Causes High Blood Pressure?
For many patients, the cause of hypertension is not known. However, people with kidney disease, diabetes, or high blood pressure before the transplant are at higher risk of high blood pressure after the transplant. Other factors that contribute to high blood pressure after a transplant include a diet high in salt, clogged arteries, high blood fats, smoking, obesity, and some anti-rejection medications such as cyclosporine, tacrolimus, and steroids (prednisone).
Diagnosing High Blood Pressure
People with a blood pressure of 140/90 mm Hg or higher are considered hypertensive. While most transplant recipients should have a blood pressure of 130/80 mm Hg, the ideal blood pressure can vary from person to person. Be sure to ask your transplant team what your ideal blood pressure should be and what is considered too high and too low.Classification Systolic Pressure (mm Hg) Diastolic Pressure (mm Hg)
Normal Less than 120 Less than 80
Prehypertension 120-139 80-89
Stage 1 hypertension 140-159 90-99
Stage 2 hypertension 160 or higher 100 or higher
High blood pressure usually does not cause any symptoms, which is why it is important to have yours checked by your transplant team at regular follow-up exams. Your transplant team may also want you to monitor your blood pressure closely while at home. Getting your own blood pressure cuff may be recommended. Your local pharmacist can help you select a blood pressure cuff that is easy to use and relatively inexpensive. Some insurance plans will pay for a cuff.
It is a good idea to take your blood pressure cuff with you to your follow-up exams so you can get a good reading. Many digital cuffs tend to run about 10 points higher than traditional blood pressure cuffs used in doctors' offices.
Risk Factors for Hypertension That You Can Change
Making some lifestyle changes can lower your blood pressure and prevent hypertension. The table below lists recommended changes for healthier living.
Managing Hypertension
Too much salt (sodium) in your diet may increase your chances of developing high blood pressure. It is recommended that you eat no more than 2,000 milligrams (mg) of sodium a day, which equals about 1 teaspoon of table salt. Recent studies have shown that a diet with less than 1,500 mg of sodium (less than 1/2 teaspoon of table salt) can lower your blood pressure even further. It is important to read food labels to see how much sodium there is in each serving of food. It can be very surprising to learn that some foods have higher amounts of sodium than you would expect.
To reduce the amount of salt that you eat, make these dietary changes:
Do not add salt to your food — this can reduce your sodium intake by 50%
Cook with as little salt, onion salt, or garlic salt as possible
Use herbs and spices to add flavor instead of salt
Avoid salty foods such as crackers, pretzels, potato chips, salted nuts, salted popcorn, and salted french fries
Avoid canned, processed, or preserved foods that contain high amounts of salt (sodium) such as processed meats, canned soups, vegetable juices, frozen dinners, and pickles
Avoid instant dinners or side dish mixes that include seasoning packets (eg, Hamburger Helper®, Rice-A-Roni®, Top Ramen® noodles)
Avoid the use of soy sauce, canned spaghetti sauce, packaged gravy, and seasoning mixes
Do not use salt substitutes (Lite Salt®, No Salt®, Salt Sense®) unless your transplant team says it is okay because they can be high in potassium
Drinking too much alcohol can also raise your blood pressure. If you drink alcoholic beverages, limit them to only a moderate amount, which is 1 drink a day for women and 2 drinks a day for men. A drink consists of 12 ounces of beer (150 calories), 5 ounces of wine (100 calories), or 1 ounce of 80-proof liquor (100 calories).
Treating High Blood Pressure With Medication
Sometimes hypertension can be controlled with lifestyle changes such as diet and exercise, but most patients also require medication. There are a variety of medications for treating and controlling hypertension. The most commonly prescribed medications include ACE inhibitors, ARBs, calcium channel blockers, beta-blockers, and diuretics. Some of these medications may have interactions with certain anti-rejection medications. Listed in the table below are some of the anti-hypertensive medications that are currently available. You can go to the American Heart Association Web site at www.americanheart.org for more information.
Too much salt (sodium) in your diet may increase your chances of developing high blood pressure. It is recommended that you eat no more than 2,000 milligrams (mg) of sodium a day, which equals about 1 teaspoon of table salt. Recent studies have shown that a diet with less than 1,500 mg of sodium (less than 1/2 teaspoon of table salt) can lower your blood pressure even further. It is important to read food labels to see how much sodium there is in each serving of food. It can be very surprising to learn that some foods have higher amounts of sodium than you would expect.
To reduce the amount of salt that you eat, make these dietary changes:
Do not add salt to your food — this can reduce your sodium intake by 50%
Cook with as little salt, onion salt, or garlic salt as possible
Use herbs and spices to add flavor instead of salt
Avoid salty foods such as crackers, pretzels, potato chips, salted nuts, salted popcorn, and salted french fries
Avoid canned, processed, or preserved foods that contain high amounts of salt (sodium) such as processed meats, canned soups, vegetable juices, frozen dinners, and pickles
Avoid instant dinners or side dish mixes that include seasoning packets (eg, Hamburger Helper®, Rice-A-Roni®, Top Ramen® noodles)
Avoid the use of soy sauce, canned spaghetti sauce, packaged gravy, and seasoning mixes
Do not use salt substitutes (Lite Salt®, No Salt®, Salt Sense®) unless your transplant team says it is okay because they can be high in potassium
Drinking too much alcohol can also raise your blood pressure. If you drink alcoholic beverages, limit them to only a moderate amount, which is 1 drink a day for women and 2 drinks a day for men. A drink consists of 12 ounces of beer (150 calories), 5 ounces of wine (100 calories), or 1 ounce of 80-proof liquor (100 calories).
Treating High Blood Pressure With Medication
Sometimes hypertension can be controlled with lifestyle changes such as diet and exercise, but most patients also require medication. There are a variety of medications for treating and controlling hypertension. The most commonly prescribed medications include ACE inhibitors, ARBs, calcium channel blockers, beta-blockers, and diuretics. Some of these medications may have interactions with certain anti-rejection medications. Listed in the table below are some of the anti-hypertensive medications that are currently available. You can go to the American Heart Association Web site at www.americanheart.org for more information.
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