What is normal blood pressure and how can you monitor yours?

Sean O'Neill, 36, was part-nervous, part-excited about getting the Sinopharm vaccine for the first time last year. However, when the nurse did a routine blood pressure check, she found the advertising executive's levels were through the roof at 190/95. He was not only sent back without the shot, but also was advised to monitor the levels closely and regularly.

So while weight loss and healthy eating resolutions are all very well, might we suggest making 2022 the year when you start taking your blood pressure seriously? Yes, even if you’re otherwise healthy, relatively young and mostly okay.

Wait, what? Has anyone heard of healthy blood pressure as a fitness goal? It isn’t for most, but there’s seriously good reason – and bad numbers – suggesting why it should be.

According to the Ministry of Health and Prevention, close to 30 per cent of the adult UAE population has high blood pressure (hypertension), including residents and Emiratis. Globally, 1.28 billion adults suffer from hypertension, according to an August 2021 report by the World Health Organisation.

Damningly, 46 per cent of these people were unaware of their condition, and only 42 per cent were being treated. These figures are based on the results of the most comprehensive global study on hypertension, analysing data from 184 countries covering 100 million people.

“Hypertension is a silent killer,” says Dr Mourad Alsharkawy, a cardiologist at Ibrahim Bin Hamad Obaidullah Hospital. “Most patients don’t know they have it because they are asymptomatic. But untreated blood pressure can, over time, damage the blood vessels, heart, brain, kidney and eyes.”

What is blood pressure?

Let’s start with the basics. Blood pressure is the measurement of the pressure of your blood against the blood vessels. It is made up of two readings. The top number is systolic blood pressure, which measures the pressure against the blood vessels when the heart is actively pumping blood to the body.

The bottom number is the diastolic blood pressure or the pressure between heartbeats. A reading of systolic/diastolic pressure of about 120/80 is considered normal and desirable in the absence of mitigating health circumstances.

“High blood pressure causes a burden over the heart because it is forced to pump the blood against this pressure. It needs more energy and more work to ensure adequate blood supply to the body. Over time, high blood pressure can cause hypertrophy of the cardiac muscles or the thickening of the walls of the heart,” explains Alsharkawy.

“It can damage the blood vessels and make them lose their elasticity, reducing the flow of blood to vital organs such as the heart, brain, and kidneys causing strokes, failures, haemorrhages and a host of other life-threatening issues.”

Ways to maintain healthy blood pressure

Fortunately, there’s light at the end of what sounds like a bleak tunnel. More than one light, in fact. Surprisingly simple lifestyle interventions can go a long way in helping you maintain a healthy blood pressure and good heart health.

Diet and nutrition play key roles. Most of us tend to instantly think of salt and sodium in relation to blood pressure when it comes to diet. Our kidneys are tasked with the job of filtering our blood and maintaining its water balance. Excessive sodium intake can make the body hold on to more water, making it difficult for the kidney to flush it out.

This increases the amount of fluid around the cells and the blood in our stream. Which means the heart now has to work harder to ensure blood flow around the body. Over time, this increased pressure can lead to thickening of the vessels, causing hypertension.

“Reducing sodium intake is important, but it goes hand-in-hand with all cardiovascular indicators such as the lipid profile and blood glucose levels. When people say that their blood cholesterol is high, but their blood pressure is fine, quite often they’re living in denial,” says Stephanie Karl, a clinical nutritionist at Up and Running Sports Medicine Centre.

“The aim of a heart-healthy diet is to reduce salt so there is less pressure on the heart to improve arterial fluidity or flexibility, so that blood can flow smoothly. And we need to start including foods that improve nitric oxide.”

This is an important variable in the blood pressure equation. Nitric oxide acts as a natural vasodilator, dilating blood vessels so that blood can flow through them more easily. “Foods that are high in l-arginine, an amino acid, helps improve nitric oxide levels in the body. Also vegetables such as beetroot and dark leafy greens are rich in nitrates, which are converted into nitric oxide in the body,” says Karl.

Next comes exercise.

There is plenty of literature and research on the importance of exercise in regulating blood pressure, especially preventatively. A brisk exercise session is directly linked to a reduction in blood pressure in the hours that follow, and the benefits are even greater for physically active people who were not yet on medication. However, “it’s important to listen to your body and brain”, says Deanne Panday, celebrity fitness trainer and author of Balance and I’m Not Stressed.

“Being fit and physically active can nip a lot of problems, including blood pressure, and can help you avoid a situation where you need a battery of pills to keep things going. But the kind of exercise you need changes with your life stage and mental condition.

“Is your blood pressure caused due to extreme levels of stress at work? Is it because of poor nutrition? Is it a hereditary issue, exacerbated by a sedentary lifestyle? One person might need structured intense cardio, while another might need a digital detox and long walks in the forest more than anything else.”

Mental health and blood pressure have a chicken-and-egg relationship, according to clinical psychologist Mina Shafik from Thrive Wellbeing Centre. “Mental health problems such as anxiety can affect blood pressure, but also high blood pressure can make people anxious, angry, volatile and on edge. They will be easily triggered and reactive. While low blood pressure is linked to depression, especially in elderly patients,” he says.

“Your physical symptoms will affect your emotions and your psychological state will manifest physically. So it’s important to know your emotional triggers and work with an expert who can help you come up with strategies so your mental and physical responses to situations are measured and don’t cause you harm.”

Lifestyle tips for controlling blood pressure

Medical advice

• Monitor your blood pressure every three months even if you’re otherwise fit, every month if you’re over the age of 50, and every week if you have co-morbidities such as heart ailments, diabetes, and obesity.
• Stop smoking and reduce alcohol consumption drastically.
• Get eight hours of sleep daily.
• Don’t shy away from treatment. If you’ve been diagnosed and your doctor is recommending a treatment plan, don’t self-medicate with herbs and assume that lifestyle changes will “take care of it”. Follow a sustainable path and keep your medical practitioner informed.

Dr Mourad Alsharkawy, cardiologist

Fitness regime

• Maintain a healthy body weight.
• Do different things – cardio and HIIT workouts on some days, light yoga and a simple walk on others.
• Give your body a break by resting and doing nothing every once in a while.
• Aim to do a physical activity for 30 to 40 minutes four or five times a week as this can release endorphins, help you de-stress and reduce blood pressure.

Deanne Panday, fitness trainer

Nutrition plan

• Eat plenty of fruits and veggies, especially the green, leafy ones.
• Follow a low-carbohydrate diet if you’re vulnerable to hypertension, since fewer carbs means better blood glucose levels, which means lower arterial load.
• Follow a low-fat and high-protein diet if your lipid profile needs correction.
• Reduce your sodium intake to less than five grams of salt in a day, which means cutting back on processed foods drastically.

Stephanie Karl, clinical nutritionist

Mental health checklist

• Meditate. It will help you calm down and ground you, especially when it comes to high blood pressure.
• Practise deep breathing by inhaling for four seconds, holding for another four and exhaling for the final four – but you need to do this for at least five minutes every day for it to impact your blood pressure positively.

Mina Shafik, clinical psychologist