1. Hypertension or high blood pressure is a ‘silent disease’ that occurs when your blood pressure is more than 140/90. The top number or systolic is just as important as the bottom number or diastolic. The range for a normal blood pressure is from 90/60 to 140/90.

Low blood pressure occurs when the blood pressure is less than 90/60, and in some cases higher than that, if accompanied by signs of low blood pressure – such as light-headedness.

2. Bulks up the heart muscle: Hypertension places the heart under strain, leading to increased thickening of the heart muscle, and over time, if not controlled, can lead to enlargement of the heart and a weak heart.

The majority of patients in our local heart clinics develop heart failure as a consequence of hypertension damage to the heart.

3. High blood pressure damage to the heart is reversible: High blood pressure damage to the heart may be reversible if picked up early and the hypertension is treated and controlled with medication and lifestyle changes.

Within the medical community, it used to be taught that once your heart has been damaged by high blood pressure, the changes are not reversible. In the past 10 years or so, research has shown that with good blood pressure control for six months or more, the heart muscle thickness can be reversed.

If the heart has started to enlarge or weaken, these changes are less likely to be reversible

4. Medications can be used to control hypertension and reverse some of the early changes of hypertensive heart disease and slow progression of advanced hypertensive heart disease. Any medication that controls the blood pressure will help.

Medications for hypertension are “lifetime”. There is a common misconception that if you treat the hypertension and the blood pressure becomes normal, you can stop the treatment. Once you have been diagnosed with hypertension, you will likely need medication for the rest of your life. You should not stop the medication without doctor’s orders. In some cases, with drastic lifestyle changes the number of medication and dosage may be cut, sometimes to nothing, but you will still require monitoring.

5. Medications and sexual activity/erectile dysfunction: This is a common concern for male patients being treated for hypertension. Whereas there are a few medications that may affect the ability to generate an erection, the majority of patients under treatment experience erectile dysfunction as a result of the high blood pressure damage to the blood vessels in the penis that help to initiate and sustain an erection.

6. Salt/sodium: Though its role in causing hypertension is controversial, we do know that salt restriction helps in lowering the blood pressure by 5-8 mmHG. The daily recommended maximum salt intake for a hypertensive is 1500 mg.

It is important to take stock of what you eat daily to track your salt consumption. It is not just salt that you add to meal before eating, or meals that taste “salty” that are problematic. There are “hidden” sources of salt in all processed foods. We recommend that you read the nutrition label on each item to see the sodium content.

7. Brisk walking drops blood pressure by 4-9mmHG. Aerobic exercise is known to lower the blood pressure naturally. During exercise, the blood pressure and heart rate will increase, to meet the increased demands of the body. Over time, with sustained activity, the blood pressure will lower. Thirty minutes per day for five days a week of moderate intensity aerobic exercise or 50 minutes per day for three days a week of high intensity aerobic exercise, total 150 minutes per week.

Patients may say: “But I walk to work, or I sweep the house.” That is not sustained long enough to have the benefits to the heart, but is good for general health to keep active.

8. Weight loss helps to reduce blood pressure. Loss of as little as 10 lbs or 4.5kg helps to reduce your blood pressure. This is especially so, if the weight lost helps to reduce your “belly”. In addition to the other health benefits of weight loss, such as less risk of diabetes as joint issues. This is so for persons who are overweight or obese, so that BMI is more than 25kg/m2.

9. Natural remedies: While there are several “natural remedies” that are touted for reducing blood pressure, the only one I know which has scientific support is lemon grass (fever grass).

This has been studied extensively in Cuba and has been shown to reduce blood pressure by as much as 8mmHG from baseline. It can help as a tea or fresh lemonade.

The benefit of garlic, etc has not been proven.

10. Hypertension may be a sign of other problems. In majority of cases, hypertension is not caused by another underlying medical problem, that is essential hypertension. In five to 10 per cent of cases, hypertension is caused by an underlying medical problem such as: Obstructive sleep apnoea, overactive thyroid gland, and kidney failure.

It is important to have a full evaluation by your family doctor to exclude some of these potentially treatable causes. This is especially so for young people (younger than 40 years old), without a strong family history of hypertension.

Dr Claudine Lewis is an adult cardiologist and medical director at Heart Smart Centre in Montego Bay. She is also a cardiologist at the Cornwall Regional Hospital and an associate lecturer with the University of the West Indies. Questions may be sent to questions@heartsmartcentre.com and for additional information call 684-9989 or visit the website www.heartsmartcentre.com