High Blood Pressure Treatment (cont.)
In this Article
Obesity
Obesity is common among hypertensive patients, and its prevalence, especially in aging patients, can contribute to hypertension in several ways. In obese people the heart has to pump out more blood to supply the excess tissue. The increased cardiac output then can raise the blood pressure. In addition, obese hypertensive individuals have a greater stiffness (resistance) in their peripheral arteries throughout the body. Insulin resistance and the metabolic syndrome also occur more frequently in the obese. Finally, obesity may be associated with a tendency for the kidneys to retain salt. Weight loss may help reverse obesity-related problems and may lower blood pressure. Blood pressure may be decreased 0.32 mm Hg for every 1 kg (2.2 pounds) of weight lost down to a person's ideal body weight.
Some very obese people have a syndrome called sleep apnea, characterized by periodic interruption of normal breathing during sleep. sleep apnea may contribute to the development of hypertension in this subgroup of obese individuals. Repeated episodes of apnea cause a lack of oxygen (hypoxia), causing the adrenal gland to release
adrenaline and related substances which cause a rise in the blood pressure.
Exercise
A regular exercise program may help lower blood pressure over the long term. Activities such as jogging, bicycle riding, power walking, or swimming for 30 to 45 minutes daily may lower blood pressure by as much as 5 to15 mm Hg. There also appears to be a relationship between the amount of exercise and the degree to which the blood pressure is lowered. So the more you exercise (up to a point), the more you lower the blood pressure. This beneficial response occurs only with aerobic (vigorous and sustained) exercise programs. Any exercise program must be recommended or approved by a physician.
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