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Heart Institute’s Dr. Ernst von Schwarz Speaks on High Blood Pressure Dangers during American Heart Month

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The presidential proclamation for American Heart Month was signed by Pres. Lyndon B. Johnson in 1963 after Congress issued a joint resolution requesting the president issue an annual proclamation, which was first held in Feb. 1964. Pres. Johnson urged “the people of the United States to give heed to the nationwide problem of the heart and blood-vessel diseases, and to support the programs required to bring about its solution.”

In conjunction with American Heart Month, Southern California Hospital Heart Institute Medical Director Dr. Ernst von Schwarz spoke about the importance of maintaining healthy levels of blood pressure. 

Question: What are the dangers of high blood pressure?

Dr. Schwarz: High blood pressure is one of the main risk factors for atherosclerosis, meaning hardening of the blood vessels, which can lead to heart attacks, strokes, renal failure, sexual dysfunction, and blindness. 

Question: Is it true that high blood pressure usually doesn’t have any symptoms?

Dr. Schwarz: Yes. This is the main reason why we call high blood pressure “the silent killer.” People don’t feel a difference between 120 over 80 or 180 over 120. Therefore, if there are no warning signals, it’s even more important to check one’s blood pressure regularly. That doesn’t mean 50 times a day, and I have some patients who do that, but ideally once or twice a day. The goal is less than 135 over 85. If one’s blood pressure is regularly higher than that, treatment might be needed, such as medications, reduction of salt, exercise, and weight loss. 

Question: What foods or drinks should one avoid to maintain healthy blood pressure?

Dr. Schwarz: First of all, we all should be on a low-salt diet, which means less than two grams a day. Everything has salt in it, and we really shouldn’t put extra salt on our food if we have high blood pressure. People should also avoid stimulants. I don’t have an issue with coffee in moderation, but excessive caffeine brings the blood pressure up. The worst are energy drinks, with people ending up in emergency rooms. People with high blood pressure should definitely avoid these. 

Question: What types of physical activity are good for those experiencing high blood pressure?

Dr. Schwarz: What you want to do if you have high blood pressure is focus on cardio, rather than strength training, because the goal is to keep the blood vessels elastic. Heavy lifting puts enormous strain on the vascular walls, and that could be dangerous or even life threatening. High intensity isometric contractions, when we lift or push, rupture blood vessels, and in the brain that can be life-threatening. On the other hand, light exercise and cardio train the heart and keep the blood vessels elastic. This can be brisk walking, swimming, road biking or using an elliptical... anything that keeps us a little short of breath is usually beneficial. 

Question: What’s the correct way to measure blood pressure?

Dr. Schwarz: Use a measuring device, usually on the left arm, in a sitting position, after 15 mins of rest. Technology has improved so much that today’s electronic devices are really reliable. But no matter if it’s a wrist smartwatch or traditional pump and release device, bring it to your doctor’s office, and have it checked with a sphygmomanometer, which are calibrated to verify its accuracy. 

Question: Is high blood pressure something that only older people need to worry about?

Dr. Schwarz: No. Over the past 25 years we haven’t really been differentiating between people 18 years old versus 85 when it comes to blood pressure. We often see elevated blood pressure in young people, and it not being taken seriously enough. We often see people in their 40s ending up on dialysis due to uncontrolled high blood pressure in their earlier years.

I always tell my patients there are different medications to treat high blood pressure, and what works for one might not work for another. It often takes several attempts with different medications due to side effects and other factors, and it might take several months to get high blood pressure under control. But the side effects of high blood pressure are often much worse than any medication side effects.