Controlling Your Blood Pressure Archive

These are the most effective ways to protect yourself.

Here are some alarming statistics about heart attacks:

• Every 40 seconds, someone in the United States has a heart attack.
• Every year, about 805,000 Americans have heart attacks, 75% of which are first-time attacks.
• The average age of a first heart attack among men: 65.

However, the most troubling fact about heart attacks is that many people don't take steps to protect themselves, says Dr. Deepak L. Bhatt, executive director of interventional cardiovascular programs at Harvard-affiliated Brigham and Women's Hospital Heart & Vascular Center. "Reducing your risk of cardiovascular disease is the best way to guard against heart attacks," he says. "There are simple ways to do this, but unfortunately, many people still don't follow them as they should."

Here's a look at five ways you can protect yourself from cardiovascular disease, and thus possible heart attacks, and avoid being another statistic.

Ask the doctor

Q. I recently had an echocardiogram because my doctor heard a murmur, and I was told that my heart valves and heart function were both normal. But when I looked at the report, it indicated that I had an enlarged left atrium. What does that mean?

A. The left atrium is one of your heart's four chambers. Located in the upper half of the heart on the left side of your body, it receives freshly oxygenated blood from your lungs. This blood then surges down through the mitral valve into the left ventricle (the lower left chamber of the heart). Then, the blood travels up through the aortic valve and finally out to supply the body with oxygen.

Ask the doctors

Q. I had a fainting spell the other day. Should I be concerned? What should I do?

A. Fainting, which your doctor may refer to using the medical term syncope, is not uncommon. Experts say as many as one in three adults experiences at least one fainting spell over time. In most cases, it's not related to a serious medical condition, but if you faint, you should always get an evaluation by a doctor to rule out more serious causes, including heart-related problems.

When it comes to preventing and treating high blood pressure, one often-overlooked strategy is managing stress. If you often find yourself tense and on-edge, try these seven ways to reduce stress.

1. Get enough sleep. Inadequate or poor-quality sleep can negatively affect your mood, mental alertness, energy level, and physical health.
2. Learn relaxation techniques. Meditation, progressive muscle relaxation, guided imagery, deep breathing exercises, and yoga are powerful relaxation techniques and stress-busters.
3. Strengthen your social network. Connect with others by taking a class, joining an organization, or participating in a support group.
4. Hone your time-management skills. The more efficiently you can juggle work and family demands, the lower your stress level.
5. Try to resolve stressful situations if you can. Don't let stressful situations fester. Hold family problem-solving sessions and use negotiation skills at home and at work.
6. Nurture yourself. Treat yourself to a massage. Truly savor an experience: for example, eat slowly and really focus on the taste and sensations of each bite. Take a walk or a nap, or listen to your favorite music.
7. Ask for help. Don't be afraid to ask for help from your spouse, friends, and neighbors. If stress and anxiety persist, talk to your doctor.

Along with these ways to reduce stress, add in a healthy lifestyle — maintaining a healthy weight, not smoking, regular exercise, and a diet that includes fruits, vegetables, whole grains, lean protein, and healthful fats — and high blood pressure could be a thing of the past.

Timing may improve potency and help you cope with side effects.

We all want our medicines to be as effective as possible, and that requires effort on our part. It may be necessary to avoid taking pills with certain foods or drinks, and to check that medications won't interfere with each other.

And in some cases, it may be important to take a drug at a particular time of day. This approach, known as chronotherapy, is gaining attention as research suggests a relationship between when we take medications and how well they work.

Ask the doctor

Q. I've taken blood pressure medicines every morning for many years, and they keep my pressure under control. Recently, my doctor recommended taking them at bedtime, instead. Does that make sense?

A. It actually does make sense — based on recent research. For many years, there have been at least three theoretical reasons for taking blood pressure medicines before bedtime. First, a body system that strongly affects blood pressure, called the renin-angiotensin system, has its peak activity during sleep. Second, circadian rhythms cause differences in the body chemistry at night compared with daytime. Third, most heart attacks occur in the morning, before medicines taken in the morning have a chance to "kick in."

Research we're watching

A long work week may raise your blood pressure, according to a study published online Dec. 19, 2019, by Hypertension. Researchers found that among more than 3,500 Canadian workers, those who worked 49 hours a week or more were more likely to have high blood pressure than workers who were on the job fewer than 35 hours a week. Blood pressure was measured at the start and end of the five-year study as well as once midway through. Readings were taken by both a trained technician and a wearable monitoring device. Even after adjusting for other factors, the 49-hour-plus workers were 70% more likely to have a type of high blood pressure called masked hypertension (normal blood pressure readings at doctor visits but high outside of that setting) and 66% more likely to have sustained hypertension (defined as consistently high blood pressure readings both in and outside of the doctor's office). People who worked 41 to 48 hours a week also had higher blood pressure than those who worked fewer than 35 hours a week.

Image: NicoElNino/Getty Images

Chronic stress is associated with an increased risk of heart disease, heart attacks, and strokes. These strategies can help you manage it.

People often complain about stress, but it's actually a natural reaction with an essential purpose.

When the body senses danger, it starts its fight-or-flight response. Your nervous system releases hormones like adrenaline and cortisol, which jolt the body into a protective mode. Your heart pounds faster, muscles tighten, blood pressure rises, breathing quickens, and your senses sharpen.

In the journals

People with high blood pressure may benefit from taking their antihypertension medication at bedtime instead of the morning, according to a study published online Oct. 22, 2019, by the European Heart Journal.

The researchers looked at about 19,000 people (most of them men) who took blood pressure medication. Participants took their daily dose either upon waking or before going to bed. Everyone's blood pressure was checked over 48 hours once a year for six years.

Ask the doctors

Q. I have a very stressful job, and recently my blood pressure readings started going up. Could my job stress be the reason why?

A. Yes, chronic stress can affect blood pressure. Several hormones affect your heart's rhythm, including epinephrine and norepinephrine. When these hormone levels rise, your heart starts to work harder. Stress hormones can also constrict your blood vessels, causing temporary blood pressure spikes.