Tackling Hypertension -- Joe Montana & Nancy Valone, RN -- 09/18/2003
By Joe Montana
Joe Montana seemed nearly invincible during his professional quarterback days, but his recent hypertension diagnosis proves that even gridiron greats can have high blood pressure. He joined us, along with WebMD's hypertension expert, Nancy Valone, RN, to tackle your questions.
The opinions expressed herein are the guest's alone and have not been reviewed by a WebMD physician. If you have questions about your health, you should consult your personal physician. This event is meant for informational purposes only.
Moderator: Joe, how did you discover that you had hypertension?
Montana: Actually I went in for a normal checkup, and this time, unlike others, my doctor sent me to a cardiologist and informed me that my blood pressure was high. So it was shocking to say the least to find out. Obviously I thought I was doing the right things to take care of myself, but obviously I wasn't.
Moderator: Do you have a family history of heart disease?
Montana: Yes, I do. My mother has high blood pressure and my mother's father passed away at age 54 from heart disease.
Member question: How did your family react to the news of your blood pressure problem, Joe?
Montana: Actually, it's become a team effort at home. When I sit down to dinner my daughters remove the saltshaker from in front of me. Because my business requires a lot of travel, even locally, I spend a lot of time in my car, my wife has found a place by my office where I can leave a little earlier and make sure I get my workout in.
They may have taken it more seriously than I did. As an athlete, it's almost treated as an injury. We always feel we're pretty good recovering from injury. I may look at it differently than they do. But they're probably right.
Moderator: This is a lifetime commitment to recovering, so to speak.
Montana: That's true. It is a lifetime commitment.
Moderator: Nancy, what role does genetics play in hypertension?
Valone: We suspect it's rather a setup for hypertension, so family history does play a part. Even though people may do everything right as far as lifestyle habits are concerned, they may still develop hypertension.
Moderator: Joe, did you find that you were doing things that were harmful?
Montana: I think I was doing things that had the possibility of being harmful, probably more so in my eating habits. I love, for example, potato chips and salt and things of that nature. So one of the things in the program I'm involved with, "Take the Pressure Off with Better Blood Control, with Dr. James Rippe," is a three-pillar approach: Proper diet, increased physical activity, and finding the right medication, which starts with beginning that dialogue with your physician. For me, obviously cutting out chips was a key.
On our web site, takethepressureoff.com, there are some great tips and tools on how to begin to do things better on the diet and the physical activity side, along with questions you might think of asking your doctor during your visits.
Member question: Hi Joe. How hard has it been to change your diet? I guess when you were playing football you were encouraged to eat a lot of food and the healthiness of it wasn't so important. Or is that just the linemen?
Montana: Players' diets years ago, in athletics, prior to even when I was playing, were completely different. It was eat as much as you could eat, but over the years they've really refined that to eating as much as you want but the proper foods. We had a guy who, if any player wanted to, could sit with him and talk about proper nutrition. I don't think that was the case a few years before I started in the NFL.
Moderator: Nancy, what kind of diet recommendations do you make to people who want to avoid hypertension?
Valone: The general recommendations are to decrease sodium in the diet and to increase fruits and vegetables, and of course we always recommend a low-fat, low-cholesterol diet, as well. We know there is protection in fruits and vegetables. I'm not sure what has exactly been isolated, but they do make a difference in reducing the heart and hypertension risk.
Member question: I've been taking blood pressure medication for several years. How do I know if I still need it or not?
Valone: This would be a good question to raise with your physician. Generally it is the medication that is keeping your blood pressure under control. In some cases blood pressure will drop very low, and that's also a time to talk to your physician about medication changes. A person should never go off their hypertension medicine without consulting with their physician.
Member question: Joe, my husband says he doesn't have to worry about eating right because he is taking medication and his pressure is under control. Should I stop worrying about putting salt in my cooking?
Montana: I'll tell you my approach has been. We believe it's a combination of all the things you do, not just the medication and then once you get it under control it's a free for all; it's maintaining to keep it under control and going forward with that in your life.
Valone: Exactly right. Over time it's not uncommon for blood pressure to rise, and by following good healthy lifestyle habits it often will decrease the need for increased doses of medication or more medication over time.
Member question: It seems like everybody has high blood pressure -- it's not really such a big deal is it?
Valone: Yes, it is a big deal. High blood pressure damages the organs (kidneys and heart) over a period of time. It can lead to kidney or heart disease.
Montana: Undetected high blood pressure is a major concern, because this is referred to many times as the silent killer, so there are no symptoms, and it may be too late by the time you figure it out.
Member question: Joe, do you feel any different now that you're controlling your blood pressure? I've heard people can't tell if it's high or not. Seems like that makes it hard to stick with the changes if you can't tell the difference.
Montana: I can't tell the difference, but I know there is because I monitor my blood pressure on a constant basis. Knowing that is a comfort, rather than knowing it's high and doing nothing about it. I also had the start of a clogging of an artery, so that really made me want to make sure I'm controlling my blood pressure.
Moderator: Joe, you mentioned diet and exercise as lifestyle changes that can help control hypertension. We've talked about your dietary changes. What did you do regarding exercise?
Montana: I thought I was getting enough in the simple things I was doing, but one of the points I need to stress is that I believe it's a combination of all the things, it wasn't just the diet or increasing my physical activity. When we talk about physical activity it can even be small changes that make a big difference, but also finding the right medication. What works for me doesn't mean it will work for everyone.
Getting to your physician and finding out what medication is right for you is key. I happen to be taking a medication that is a combination of two medications in one pill and it's called Lotrel. I was, prior to Lotrel on another medication that was not working for me.
Valone: I often have questions on the board about medications and people having problems with medications. I encourage people to talk with their physician and to explore other medications if needed. There are now over 40 medications to treat hypertension, so there are many options for treatment now.
Moderator: And again, you both recommend a comprehensive program that stresses lifestyle change to manage your hypertension.
Member question: Joe, thanks for the advice. Frankly, I don't really understand what a good blood pressure is. What is normal?
Valone: The range for normal, for most people is 140/90. However, lower is better. Treatment, as in medication and so forth, generally begins when the blood pressure rises about 140/90. However, lifestyle change is highly recommended for everyone, but particularly those people with 130 to 140 systolic.
Montana: In our program, there was a recent study that says now the normal they would like to see 120/80, and that's what I push for on my side. I am now under that, which I'm very happy about.
Valone: The recent guidelines do say that normal is 120/80. We are pushing for people to keep their blood pressure under that. Then that area between 120/80 and 140/90 is a gray area where we are increasing out watchfulness with these patients and increasing our encouragement towards healthy lifestyle change.
Member question: How often should someone who has no blood pressure problems get a reading? Can it just pop up out of the blue, or will it slowly rise over time, alerting you to the potential danger?
Valone: It generally creeps up over time, and a blood pressure check every six months would be reasonable. If it seems to be creeping up and you talk to your doctor about it, check it every week for three weeks.
Member question: Joe, I want more info about what you're doing about blood pressure, because my husband LOVES YOU. Where can I get it?
Montana: Two places. One is our web site, takethepressureoff.com, and the other is our toll free number, 877-GETBP-DOWN
Moderator: We are out of time. Thanks to Joe Montana for sharing his experience with us. And thanks to Nancy Valone for sharing her expertise with us today. For more information, you can visit takethepressureoff.com, sponsored by Novartis Pharmaceuticals Corporation. Nancy Valone answers your questions on the hypertension message board. And please explore our many articles and archived Live Events on the subject of hypertension.
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