Hypertension (high blood pressure)
We all need a certain amount of pressure in our blood vessels to make sure that delivery of blood is happening in an efficient manner. When the pressure becomes too high as noted in the chart below the heart and vessels have to work harder to make the same delivery.

Definition
The chart gives the parameters of blood pressure readings as defined by the American Heart Association and American Stroke Association

Causes
Modifiable Risk Factors: (something you can change about yourself)
- Smoking and exposure to secondhand smoke
- Diabetes
- Being obese or overweight
- High cholesterol
- Unhealthy diet (high in sodium, low in potassium, and drinking too much alcohol)
- Physical inactivity
- Obstructive sleep apnea
- Stress
Non-Modifiable risk factors:
- Race
- Family History
- Age (chances increase with age)
- Gender (more common in men)

Prevention
Work on all the modifiable risk factors to reduce and prevent high blood pressure
- Aim to consume no more than 1,500 mg/day of sodium (salt). Even reducing your current daily intake by 1000 mg can help
- Eat foods rich in potassium. Aim for 3,500 – 5,000 mg of dietary potassium per day.
- Limit alcohol to no more than one drink per day if you’re a woman or two drinks a day of you’re a man.
- Be more physically active. Aim for at least 90 to 150 minutes of aerobic and/or dynamic resistance exercise per week.
- Stop smoking

Management
The more you work on these lifestyle measures the easier it is to control your blood pressure and achieve good health.
Nutrition : Low salt, low cholesterol diet that is rich in potassium. A Mediterranean diet rich in antioxidants and low salt is the appropriate diet. Med-Dash diet
Exercise : 150 minutes of exercise per week
Sleep Hygiene : Lack of sleep results in elevated blood pressure. Having a proper sleep routine that promotes refreshing sleep is important.
Stress : It is important to work on managing your stress since the elevated cortisol increases your blood pressure among other effects.
Supplements : Can be discussed with the doctor
Monitoring : Important to discuss with your doctor
Medications : There are many classes of medications that are effective for BP management. Your doctor chooses them for various reasons. The various classes that are used commonly include ACE/ARB, diuretics, b-blockers, calcium channel blockers, and others. Often times a combination approach is preferred because that is what is going to work for a patient.

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Scott has experienced weight loss and has less heartburn symptoms and less joint pain. His highest weight was 245 pounds, he is now at 194 pounds and his current goal is 185 pounds. His A1C started at 10.1 and is currently 6.9. At the highest point his triglycerides were 446 and are currently 203.
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