Hypertension (high blood pressure) and obesity

Hypertension and obesity

Our blood pressure increases as we age, but this is much more pronounced in the developed world: Western diet and lifestyle habits seem to be the root cause.

A diet high in saturated fats and a sedentary lifestyle are major contributory factors for arteriosclerosis, the stiffening and narrowing of blood vessels that in turn leads to hypertension (high blood pressure).

Excess weight can either cause or worsen hypertension. If you are overweight your risk for developing hypertension is six times greater than for someone of normal weight. If you are obese, it is eight times greater.

Am I overweight?

It may sometimes be difficult to distinguish between a healthy weight, and the artificial “ideal” body image as portrayed by the media.

Rather, use Body Mass Index (BMI) and waist circumference measurement to assess whether you are overweight.

BMI:

Visit the BMI calculator to calculate your body mass index.  You can also do the calculation by dividing your mass in kg by your  height in (m)2

A BMI of 19 to 24 is within normal limits; 25 to 29 is considered overweight; 30 and higher is seen as obese. If you are obese it means you are 20% or more above your ideal weight.

Waist circumference:

Measure your waist circumference with a tape measure positioned horizontally halfway between your lowest rib and the top of your hipbone, roughly in line with your belly button. Make sure the tape is snug against your skin, but without compressing the surface. Breathe out normally.

A waist measurement of over 94 centimetres for men and over 80 centimetres for women indicates an increased risk for developing a chronic disease. The risk becomes greatly increased at over 102 centimetres for men and over 88 centimetres for women.

What is the role of body shape

If you tend to carry excess weight around the waist, you are more “apple-shaped”. Men especially tend to gain weight around the belly. The fat in this abdominal area is more metabolically active, and is released into the circulation and ends up in the blood vessels. This body shape is associated with greater health risks, particularly cardiovascular disease and diabetes. Measuring and keeping an eye on your waist circumference is very helpful.

In the typical female shape, fat is mainly confined to the hips, buttons and thighs. This “pear-shaped” body seems to be associated with lower health risks. However, it’s important to note that however weight is carried on the body, overweight and obesity increase risk for heart disease.

Which factors commonly lead to being overweight?

Genetic influence is strong: a family history of obesity makes you more prone to being overweight, and may influence your metabolic rate (i.e. how easily you burn fat). Keep in mind, however, that families also tend to have similar lifestyle habits. Some studies suggest that overfeeding during childhood can increase fat cells in the body.

Gender also plays a role, and being male is usually an advantage. Men tend to have more muscle tissue, which is more metabolically active and burns more energy, even at rest.

A sedentary lifestyle is a major contributor to weight gain. Alarmingly, this also accounts for the rising number of obese children. The other major contributor is the high fat and refined food content in the Western diet. Over-eating and under-exercising inevitably leads to weight gain.

Does losing excess weight really help control hypertension?

Dropping those extra kilos is one of the most effective ways of lowering blood pressure without using drugs. People with borderline or stage I hypertension are often able to control their blood pressure with lifestyle modification alone. If drugs are still needed, then losing weight often makes it possible to reduce the dosages required.

Hypertension cannot always be controlled with weight loss alone, because your genetic blueprint and other factors also play an important role. However, losing excess weight has many other advantages for your cardiovascular system. This includes lowering the level of harmful blood fats, LDL cholesterol and triglycerides, which are major factors in the development of arteriosclerosis. A healthy body weight also decreases the risk of developing adult-onset diabetes.

What other lifestyle modifications are needed?

Correct body weight and composition are indispensable to health. To achieve the best result, however, a holistic health plan is required, which includes regular exercise, not smoking and avoiding excess alcohol, salt, saturated fat and refined foods.

Eating ample portions of fruit, vegetables and low-fat dairy helps supply minerals and anti-oxidants. Fatty fish like salmon, mackerel and tuna contain essential fatty acids that are good for the heart.

Can supplements help hypertension?

Hypertension may be reduced, or managed at least in part, by supplements containing CoQ10, vitamin C and omega-3 fatty acids.

What diet should I follow?

The DASH (Dietary Approaches to Stop Hypertension) diet is a user-friendly eating plan, and so healthy and effective that medical experts recommend it for everyone, not only people wanting to lower their blood pressure.

The diet includes foods rich in potassium, calcium and magnesium, and avoids foods high in saturated fats, refined sugars and salt. The bulk of the diet consists of legumes (lentils, beans), and fresh fruit and vegetables. Low fat dairy, lean meat, poultry and fish are permitted on the diet, but only in small amounts.

Fruit and vegetables contain significant amounts of potassium, which appears to replace and eliminate excess sodium from the body’s tissues, enabling dilation of the blood vessels and lowering of blood pressure.

A maximum of two portions of meat, poultry or fish, and three portions of low-fat or fat-free dairy  per week is recommended to lower fat consumption (to counteract obesity and elevated blood fat levels) and excessive protein consumption (and thereby hidden fats, as well as preventing possible kidney failure due to high protein intake).

What is the deadly quartet?

The consequences of obesity are many, ranging from arthritis in the weight-bearing joints to hypertension. Hypertension, obesity, abnormal blood fats and diabetes or insulin resistance together form a particularly dangerous set of risk factors.

Abnormal blood fats refer to raised LDL cholesterol (bad cholesterol), low HDL cholesterol (good cholesterol), and high triglycerides.

Insulin resistance means a decrease in the body’s ability to metabolise and store sugar in the muscle. The cells do not respond to insulin and more insulin is secreted in response. The blood levels of insulin become elevated. Eventually this leads to adult onset diabetes or type 2 diabetes.

The quartet of obesity, hypertension, abnormal blood fats and insulin resistance/diabetes is a health hazard. It leads to cardiovascular damage like heart attack, stroke, heart- and kidney failure, retinal damage (damage to eyesight) and blood vessel abnormalities.

How should I go about losing weight?

Firstly, know what you want to achieve. Calculate your BMI and waist measurement and determine how many kilograms and centimetres you need to lose. Remember that body composition is very important, which means lean muscle must be preserved. Muscle adds to weight and therefore you need not become a slave of the scale. How your clothes fit and how you look in the mirror can be useful tools to measure your progress too.

Your goals should be written down, not only your target weight but also your goal blood pressure. Keep your goals realistic and manageable, but not static. Be prepared to adapt to changing circumstances.

Focus on improving your health in general, and not only on “being slim”. Add to your list the other benefits you can achieve by losing excess fat – such as more energy, greater productivity, a better sex life and keeping up with the children.

Always talk to your doctor before starting an exercise routine, and then get moving. Don’t despair if you dislike the “health-club” scene. Find any form of movement that you enjoy, and do that regularly, whether it’s walking the dog, tap-dancing or martial arts.

Commit yourself to exercise at least four times a week from the start, even if you can manage only 10 minutes at a time initially. Some people enjoy the support of a group, which has the added benefit of social interaction.

Don’t give up if you default on your master plan. It‘s not about putting in a huge effort for a week. It’s about making small, permanent, consistent changes to your habits. Over-commitments that are unsustainable could just end up eroding your self-belief.

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