In 2008, the prevalence of hypertension increased to 25.3% from 22.5% in 2003. Moreover, the survey revealed that 11 in every 100 Filipinos (10.8%) have pre-hypertension or a BP reading at the range of 130-139/85-89 millimeter mercury (mmHg). This becomes alarming as high BP increases with age starting from age 40-49 years.
Aside from hypertension, more Filipinos also have high fasting blood sugar, and high cholesterol and triglyceride levels. These conditions are risk factors for cardiovascular diseases, diabetes, and other lifestyle-related diseases.
According to the Philippine Society of Hypertension (PSH), treatment of high BP need not be too complicated. Although medicines are needed by most patients to control their BP, the mainstay in the treatment of hypertension and other risk factors is still strict compliance in practicing simple lifestyle changes.
High BP is diagnosed when the BP is consistently equal or higher than 140/90 mmHg. For most patients with uncomplicated hypertension, keeping the BP lower than 140/90 mmHg reduces their cardiovascular risks.
The PSH advised that the BP should be ideally less than 130/80 mmHg in high-risk patients with diabetes, previous heart attack or stroke, chronic kidney disease and multiple risk factors.
Lifestyle changes are especially important for people who have risk factors that cannot be changed. These are the so-called nonmodifiable risk factors which include family history, gender, race or age.
The following lifestyle changes can prevent hypertension:
• maintain a normal weight, with a body mass index of 18.5 to 23, computed by dividing weight in kilogram (kg) by height in meter (m) squared;
• reduce sodium in the diet to about 2.3 grams a day, which is about one teaspoon of salt (salt in cooking is allowed but not table sources of salt; salt substitutes like spices and herbs may be used);
• exercise that raises the heart rate for at least 30 minutes a day (such as brisk walking, jogging, dancing or aerobics);
• avoid alcoholic drinks;
• do not smoke and avoid people who smoke to prevent secondhand smoke;
• get 3,500 milligrams (mg) of potassium in the diet everyday which can be obtained by ample servings of fruits and vegetables;
• manage stress with enough sleep, recreation, meditation and relaxation techniques; and
• regular deep, slow breathing (having regular sessions of deep slow breaths consisting of deep inhalation and slow exhalation through pursed lips with rate of less than 10 breaths per minute can help lower BP).
The PSH also advocates for the Dietary Approaches to Stop Hypertension or DASH diet. It is an eating plan that may help lower the BP and other metabolic problems such as diabetes, high cholesterol and obesity. This diet is low in fat but rich in low-fat dairy foods, fruits and vegetables.
In those borderline or pre-hypertension stage, the DASH diet together with other lifestyle changes may help prevent the development of definite hypertension. Likewise, cholesterol problems of either high low-density lipoprotein (LDL) or bad cholesterol, or low high-density lipoprotein (HDL) or good cholesterol can be sigificantly improved with the DASH diet.
In the DASH diet, whole grains, fish, poultry, nuts, seeds and dried beans (legumes) are recommended as part of a balanced diet. In implementing the DASH diet:
• Avoid processed foods such as snack items, luncheon meats, and canned soups, will reduce the amount of sodium in the diet.
• Eat a diet high in calcium, potassium and magnesium may also help lower BP. The rich sources of potassium are fruits and vegetables while low-fat diary products are high in calcium and magnesium. DASH recommends eight to 10 servings of fruits and vegetables and three servings of fruits and vegetables and three servings of low-fat dairy products each day.
• Cut down on both saturated fat and total fat. Fats are good sources of calories but only 30 percent of one’s total calories should be from fat, with only seven to 10 percent from saturated fats. Saturated fat is abundant in meat, cheese, butter, poultry, snack foods and other processed foods.
• In general, vegetarian diets which comply with all requirements of the DASH diet help reduce BP. The DASH diet could be a vegetarian diet with legumes substituting for meat as protein source. Vegetarian diets tend to be higher in potassium, magnesium and calcium, as well as fiber and unsaturated fat than other diets.
• Together with regular exercise, weight can be better controlled with the DASH diet without the need of expensive and unsafe treatments.
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