Dietary, lifestyle factors affect hypertension levels

Dietary, lifestyle factors affect hypertension levels

By Grace Segran

DENPASAR, Bali (JP): Did you know that what you eat and what
you do play a major role in determining whether you get
hypertension or not?

Speaking at the first meeting of the Asian-Pacific Society of
Hypertension in Bali recently, Professor Lawrie Beilin from the
University Department of Medicine and the West Australian Heart
Research Institute at the Royal Perth Hospital in Western
Australia said, "There is now abundant evidence that dietary and
lifestyle factors critically determine an individual's blood
pressure level and the prevalence of hypertension in
populations."

He added that it was estimated that some 80 percent of
patients currently diagnosed with hypertension had a preventable
disorder.

Dr. Ashikin Hanafiah, the professor of cardiology at the
University of Indonesia and chairman of the medical board of the
Harapan Kita Cardiac Center in Jakarta, said it was estimated 15
percent of adults in Indonesia aged 25 years and above suffer
from hypertension.

Normal blood pressure is 130/80mmHg and any reading higher
than the borderline of 140/90mmHg constitutes hypertension, said
Ashikin.

Ashikin warned that hypertension could affect other organs as
well. The areas that we need to keep a careful eye on if we
suffer from hypertension are the eyes, brain, heart, kidney and
peripheral arteries.

Hypertension is one of the major risk factors for coronary
heart disease and the biggest single factor influencing stroke.
"Given the burden of heart disease and stroke, it is vital to
increase awareness of current evidence offering opportunities for
better prevention and management of hypertension," said Beilin.

Beilin said excess body fat remains the biggest single factor
related to blood pressure elevation and hypertension. Weight
reduction trials have shown clear reductions of blood pressure
with weight loss as little as five kilograms.

The effects on weight loss can be enhanced by simultaneously
increasing physical fitness, reducing alcohol consumption,
reducing salt intake and by regular dietary consumption of fish.

"Randomized trials combining these various measures have been
shown to reduce blood pressure by 10-15mmHg systoles in treated
or untreated hypertensives, with effects as great as those seen
with antihypertensive drug therapy," said Beilin.

The benefits of weight control extend beyond those with just
blood pressure reduction. It also results in a general reduction
in your risk of getting heart disease due to improvements in
lipid profile, glucose tolerance, a reduced cardiac load and
heart rate.

The effects of alcohol on hypertension are well-documented but
are still generally underestimated by the medical profession.
From a study of 20 44-year-old working men, it was estimated that
some 70 percent of hypertension cases could be prevented by
moderating alcohol to below 2 standard drinks per day and
controlling weight and obesity.

Doctors tend to be ambivalent over alcohol because of the
bivalent effect of alcoholic beverages on cardiovascular disease.
However, it is important to note that the lowest mortality rates
occur in people drinking one standard drink per day or none at
all.

"Vegetarian diets characterized by a relatively low-saturated
fat intake and a high consumption of fruit, vegetables and fiber
have been shown to be associated with low blood pressure," said
Beilin.

The recently published DASH study from the United States
involved 459 mildly hypertensive subjects who either continued
their normal diet, increased fruit and vegetable consumption or
combined the latter with a reduction in total and saturated fat
intake and increased low fat milk consumption.

Consumption of lean meat and fish were encouraged.

The largest blood pressure reduction of 5.5 to 3mmHg was seen
in those on the combined diet, while those increasing only fruit
and vegetables showed a fall in blood pressure of 2.8 to 1.1mmHg.
The study demonstrates how dietary changes which could be
acceptable to the general population are likely to achieve
significant blood pressure control.

"High salt intake remains a major contributor to hypertension,
especially when potassium is low," said Beilin. He also added
that smoking has a dominant effect in increasing the
cardiovascular risk in hypertensives.

In practice, many lifestyle factors operate in concert and
have additive or interactive effects. "Moreover, people tend to
demonstrate a clustering of unhealthy habits," said Beilin. For
example, heavy smokers are more prone to drinking heavily, eating
more saturated fat, adding salt to their food and being
physically inactive. Risk factors are also more common among the
lower socioeconomic group.

What can we do then to ensure our blood pressure remains at an
acceptable level? Ashikin advocates that we follow the Indonesian
Heart Foundation's slogan S.E.H.A.T. (health). The acronym stands
for: seimbang gizi (balanced nutrition), enyahkan rokok (kick the
smoking habit), hindari stress (avoid stress), awasi hipertensi
(beware of hypertension and to have blood pressure checked
regularly) and Teratur olahraga (exercise regularly).

Hence, it seems that our best bet against hypertension is also
the cornerstone for staying healthy: eat a balanced diet with
lots of fruit and vegetables; go easy on the fat, salt and
alcohol; stop smoking; avoid stress; exercise regularly and
reduce excess body fat.