Dr. Tracz discusses the correlation between high blood pressure and hypertension, and what you can do to prevent it.
Transcription:
Prakash Chandran: Did you know that more than 70 million Americans have high blood pressure and a third of those people are unaware of it. Today we'll learn about how this relates to hypertension and what you can do to prevent it. We're going to learn about it today with Dr. Michael Tracz, a Nephrologist with Highland Medical PC, Rocklin Renal Associates. This is Sound Advice. The podcast from Highland Medical PC. I'm Prakash Chandran. So first of all, Dr. Tracz, let's start with the basics here. What exactly is hypertension?
Dr. Tracz: Hypertension is basically an increased blood pressure within our heart and our vasculature inside of our bodies. And we have been struggling with defining what a normal number is, but at this point we consider 120 over 80 millimeters of mercury being a normal reading.
Host: Okay, and just as a lay person, are you getting that number when you are a strapping yourself to that blood pressure monitor? Is that what it's feeding back to you?
Dr. Tracz: It should. Although one of the most important questions I get from my patients is this, they come into my office, they rush, they've been rushed through the waiting area. They just sit down and their splits on the monitor and it reads 138 over 90 let's say, and they wonder, you know, my blood pressure is high. I tell them, you have to relax for about five minutes before we take it again to which they answer, well I don't relax during the day. Therefore it probably, that's what is this all the time, and that's a very big misunderstanding. That number needs to be arresting blood pressure. The way there's blood pressure number, 120 of 80 was first arrived at, it's basically probably several decades ago.
There was a huge experiment, I believe in Boston somewhere, I'll say Harvard, I'm not sure, where they took these people into a quiet room and ask them to sit still for six minutes. Took their blood pressure six times and an average that for each person average that across many, many, many different people. And that's where it came out to be 120 over 80 in other words, this was not people walking around the kitchen, I could venture to tell you that if you are walking around the kitchen, your blood pressure probably will be 140 over 90 and if you run a marathon, the healthiest person in the world, you may be 160 over 90 and that's okay, because what only matters is what it is when you are resting. And yes, if you do it right at home, you should be 120 over 80.
Host: I see. So the importance is just remaining still for a couple of minutes and then taking that reading. That's so interesting. So getting back to hypertension, when you hear hypertension that, does that just mean high blood pressure?
Dr. Tracz: Correct. It's just another word for high blood pressure to be perfect. You want to be 120 on the top. That's called systolic blood pressure. That's the blood pressure. When the heart squeezes and 80 on the bottom, that is the relaxation blood pressure. We call it diastolic and that's when the blood, when the heart relaxes. And when the heart squeezes, that squeeze, this pressure wave goes through our entire body. That's what pushes our, you know, our blood all throughout and when it relaxes is when the kind of system relaxes for a second. And both of these numbers are important.
Host: I see. You know, when you have high blood pressure or hypertension, what are the main causes of that?
Dr. Tracz: I would say we have two types of high blood pressure as far as our [inaudible03:13] concerned. The most common is something called essential hypertension. Essential hypertension or essential high blood pressure is basically a term given to, we don't know where it comes from. That's exactly what it means. It's about 80% to 85% of our patients walk into our office with high blood pressure and we in 2020 do not have an exact idea why that happens. We attribute to several things. We are attributed to age. It's more likely to be with age. We attributed to obesity, sedentary lifestyle, possibly diabetes, etcetera, etcetera. So there are, you know, all these factors that factor into it, but we still haven't figured out exactly why that is. So we'll label them essential and leave it at that. The other 15% of patients are very different. Those are called secondary hypertension and they may have a problem and the problems can come from either from the kidneys or the glands, adrenal gland, thyroid gland, etcetera. And there's a special workup that we do for all of these patients.
Host: Okay. I see. And you know, and doing a little bit of research for this, I understand that there are four stages of hypertension. Can you talk to us a little bit about that?
Dr. Tracz: That's very interesting because there are stages in hypertension, just like there are stages in chronic kidney disease, which is another thing that I do, but I've never found stages to be that useful. I tell you what they are useful for. They're useful for magazines to write about them and medical students to study them. And that's about it. Okay. It's under, it's important to understand where the danger zones are. So I would say 120 over 80 is your perfect. Okay. This is when you were 17 years old and you were perfect and you were fine. Then when you are in thirties in your forties, I just want you to know that going over 130 is already a little bit of a problem and over 140 you definitely need to talk to a doctor. And if you are every day over 160 you really need to, you know, you really need to worry about long-term effects. But that is very different from why I get phone calls about, people call me and say my blood pressure is 180 over 100, do I need to go to the ER? And you know, do I, am I going to get a stroke? And the answer to that is most likely no.
None of it can be taken in generalities. This has to be always in discussions in you, you know, between the patient and their doctor. But I often reassure the patients that majority of blood pressure is a problem that is basically going into effect you over time. It is rarely an issue in the immediate situation. But then the patients press me, okay, so when do I go to the ER? And I would say, well you definitely are calling a doctor on 180, but probably about the 200 systolic and above, that's when you start to really be concerned about strokes and such. Famously, Franklin Delano Roosevelt died of a stroke from high blood pressure because it was not often treated back then. And as far as I read somewhere, his blood pressure at the time was 250 over 150. Crazy numbers and this is what, this is what killed him. So as far as the stages go, when patients focus on the stages, they kind of miss the big picture, which is keep your blood pressure as low as possible, and talk to your doctor as to how you can achieve that through both medications and lifestyle by the way.
Host: Okay. Understood. That's kind of really interesting to hear. I'm curious as to if there are any physical warning signs when someone's blood pressure is high or they're experiencing that hypertension, are there things that people can be aware of before they go to actually measure themselves?
Dr. Tracz: You know, they don't call it the silent killer for nothing. In other words, you may have zero, zero symptoms and yet walk around with blood pressure we would consider high such as 160, let's say, and above. One common symptoms people do have is headache, you know, but that's very haphazard. It may happen in some people may not in others, so you cannot wait for the headache to check yourself. Basically what it really comes down to is prudent screening. Heart disease kills most Americans, out of all other conditions. You, I, anybody else, you know, all the editors who are going to cut this interview. We all need to check. We all need to check our blood pressures once in a while. If you're a healthy adult, if you're a healthy adult, and everything is going well, you know, checking it twice a year probably suffices. If you’re somebody with risk factors, obesity, diabetes, kidney disease, you definitely need to be checking it on monthly basis, if not more frequently. And that's the only way you're going to catch it. You will never catch it looking for symptoms.
Host: And just for the audience here, I'm sure we know, but why is it so important to seek treatment, if you notice that your blood pressure is consistently high?
Dr. Tracz: Because it thickens your blood vessels on the inside, which will then lead to organ damage and eventually death. Basically as the heart is trying to pump through blood, pump blood through increasingly higher blood pressures, it has to thicken itself. So the heart is at risk. As this blood is pumping through other organs at high pleasure. The way the blood vessels on the inside of our bodies adapt to that is by growing stronger for themselves, which hurts us the people, kidney fails. You could have problems with the brain, you could have a stroke, etcetera, etcetera. So it's all comes down to the fact that the only defense our poor little vessels have against high blood pressure is to be thicker. Once they become thicker, our organs fail. It's as simple as that.
Host: Now, you talked about diet and exercise as something that we could do as a prevention mechanism to lower our blood pressure. But is there any medication that people can take if they experience high blood pressure that will help it lower it immediately?
Dr. Tracz: You know, we all grew up in this world where, where people tell us about exercise and weight loss and then kind of wash yourself of our heads. So we don't really take it seriously. But here's how I make it very clear for my patients. I basically ask them, you have high blood pressure, we could treat it with chemicals or self-discipline, it's your choice. You know, people come into me and say, Doc, I'm on so many medicines. Well, I'm telling you, again, you've got two choices. You've got chemicals or you've got self-discipline because it is really about that. I have so many patients that have basically gotten this self discipline aspect, lost 15 pounds, started to avoid salt in their diet, etcetera, etcetera, and their blood pressure gets better without any medicines. So it really is, you know, it's real, it's a real thing and it's hard to make it real after we've heard it 100,000 times and totally ignore it. So as a doctor. Most doctors will do that. We will not just sit and tell you this, we will actually work with you and we will actually, I keep my patients away from medicine for as long as I can. If you come to my office with a blood pressure of 145, 150 my first instinct is not to give you the medicine. I will really make you work for it. I'll make you check your blood pressures at home.
I'll make you tell me exactly what you're eating. I want to see some weight loss and I'll work with you. And I'll make you understand how much this will help you. Only if you fail that after several months will we start talking about medicines. And to answer your questions about whether or not to start something. Well, you know, there's two types of patients. Those who are in emergency situation, maybe they are coming into the hospital for high blood pressures. We certainly have medicines for those people. Very rarely will you be needing medicine immediately. Let's say somebody takes their blood pressure in their kitchen and it's elevated 150, over 95. Very rarely do I need to go to the doctor immediately. They should contact their doctor, make an appointment and we will then, you know, work with you. But there's never a situation where a [inaudible 10:50] patient that's never had high blood pressure should be thinking about, you know, using a medication on an immediate basis.
Host: I love the way that you articulated that. How do you want to cure this with chemicals or self-discipline? I think it really frames it for that person and really shows them that they are in control and of course who wouldn't prefer not putting chemicals in their body.
Dr. Tracz: And let's not forget that most recently all of our chemicals that we treated with, i.e. Medicines, have been contaminated and there've been basically a recall after recall of the common blood pressure medicines. So yet another reason to stay away from them.
Host: Very good to know. So just as we wrap up here, is there anything that we didn't cover here today that you would like our audience to know?
Dr. Tracz: Yes. We need practicalities on what I said earlier. For example, salt, it is very important to know what the salt number should be, intake and it is 250 milligrams of sodium per serving. Basically that thing that shows, you know that the thing on the label you're going to look, they will have a sodium number and you are striving for 250. The reason I say that is people for example know they're not supposed to eat cold cuts so they get low salt ham. Well, low salt ham, you know, regular ham may have 800 and low salt 600, it's technically low salt for manufacturer, but it's still way too much. So therefore you cannot look at the front of the package. You cannot be fooled by the low salt labels. You've got to flip it about and look at the number. And 250 is the magic figure you're looking for.
Host: Okay, great to know. Well, Dr. Tracz, I truly appreciate your time today. This has been very informative. That's Dr. Michal Tracz, a Nephrologist with Highland Medical PC Rocklin Renal Associates. Thanks for checking out this episode of Sound Advice. Call 1-866-550- HMPC to make an appointment with Michal Tracz or another provider. If you've got this podcast helpful, please share it on your social channels and be sure to check out the entire podcast library for topics of interest to you. Thanks and we'll talk next time.
Prakash Chandran: Did you know that more than 70 million Americans have high blood pressure and a third of those people are unaware of it. Today we'll learn about how this relates to hypertension and what you can do to prevent it. We're going to learn about it today with Dr. Michael Tracz, a Nephrologist with Highland Medical PC, Rocklin Renal Associates. This is Sound Advice. The podcast from Highland Medical PC. I'm Prakash Chandran. So first of all, Dr. Tracz, let's start with the basics here. What exactly is hypertension?
Dr. Tracz: Hypertension is basically an increased blood pressure within our heart and our vasculature inside of our bodies. And we have been struggling with defining what a normal number is, but at this point we consider 120 over 80 millimeters of mercury being a normal reading.
Host: Okay, and just as a lay person, are you getting that number when you are a strapping yourself to that blood pressure monitor? Is that what it's feeding back to you?
Dr. Tracz: It should. Although one of the most important questions I get from my patients is this, they come into my office, they rush, they've been rushed through the waiting area. They just sit down and their splits on the monitor and it reads 138 over 90 let's say, and they wonder, you know, my blood pressure is high. I tell them, you have to relax for about five minutes before we take it again to which they answer, well I don't relax during the day. Therefore it probably, that's what is this all the time, and that's a very big misunderstanding. That number needs to be arresting blood pressure. The way there's blood pressure number, 120 of 80 was first arrived at, it's basically probably several decades ago.
There was a huge experiment, I believe in Boston somewhere, I'll say Harvard, I'm not sure, where they took these people into a quiet room and ask them to sit still for six minutes. Took their blood pressure six times and an average that for each person average that across many, many, many different people. And that's where it came out to be 120 over 80 in other words, this was not people walking around the kitchen, I could venture to tell you that if you are walking around the kitchen, your blood pressure probably will be 140 over 90 and if you run a marathon, the healthiest person in the world, you may be 160 over 90 and that's okay, because what only matters is what it is when you are resting. And yes, if you do it right at home, you should be 120 over 80.
Host: I see. So the importance is just remaining still for a couple of minutes and then taking that reading. That's so interesting. So getting back to hypertension, when you hear hypertension that, does that just mean high blood pressure?
Dr. Tracz: Correct. It's just another word for high blood pressure to be perfect. You want to be 120 on the top. That's called systolic blood pressure. That's the blood pressure. When the heart squeezes and 80 on the bottom, that is the relaxation blood pressure. We call it diastolic and that's when the blood, when the heart relaxes. And when the heart squeezes, that squeeze, this pressure wave goes through our entire body. That's what pushes our, you know, our blood all throughout and when it relaxes is when the kind of system relaxes for a second. And both of these numbers are important.
Host: I see. You know, when you have high blood pressure or hypertension, what are the main causes of that?
Dr. Tracz: I would say we have two types of high blood pressure as far as our [inaudible03:13] concerned. The most common is something called essential hypertension. Essential hypertension or essential high blood pressure is basically a term given to, we don't know where it comes from. That's exactly what it means. It's about 80% to 85% of our patients walk into our office with high blood pressure and we in 2020 do not have an exact idea why that happens. We attribute to several things. We are attributed to age. It's more likely to be with age. We attributed to obesity, sedentary lifestyle, possibly diabetes, etcetera, etcetera. So there are, you know, all these factors that factor into it, but we still haven't figured out exactly why that is. So we'll label them essential and leave it at that. The other 15% of patients are very different. Those are called secondary hypertension and they may have a problem and the problems can come from either from the kidneys or the glands, adrenal gland, thyroid gland, etcetera. And there's a special workup that we do for all of these patients.
Host: Okay. I see. And you know, and doing a little bit of research for this, I understand that there are four stages of hypertension. Can you talk to us a little bit about that?
Dr. Tracz: That's very interesting because there are stages in hypertension, just like there are stages in chronic kidney disease, which is another thing that I do, but I've never found stages to be that useful. I tell you what they are useful for. They're useful for magazines to write about them and medical students to study them. And that's about it. Okay. It's under, it's important to understand where the danger zones are. So I would say 120 over 80 is your perfect. Okay. This is when you were 17 years old and you were perfect and you were fine. Then when you are in thirties in your forties, I just want you to know that going over 130 is already a little bit of a problem and over 140 you definitely need to talk to a doctor. And if you are every day over 160 you really need to, you know, you really need to worry about long-term effects. But that is very different from why I get phone calls about, people call me and say my blood pressure is 180 over 100, do I need to go to the ER? And you know, do I, am I going to get a stroke? And the answer to that is most likely no.
None of it can be taken in generalities. This has to be always in discussions in you, you know, between the patient and their doctor. But I often reassure the patients that majority of blood pressure is a problem that is basically going into effect you over time. It is rarely an issue in the immediate situation. But then the patients press me, okay, so when do I go to the ER? And I would say, well you definitely are calling a doctor on 180, but probably about the 200 systolic and above, that's when you start to really be concerned about strokes and such. Famously, Franklin Delano Roosevelt died of a stroke from high blood pressure because it was not often treated back then. And as far as I read somewhere, his blood pressure at the time was 250 over 150. Crazy numbers and this is what, this is what killed him. So as far as the stages go, when patients focus on the stages, they kind of miss the big picture, which is keep your blood pressure as low as possible, and talk to your doctor as to how you can achieve that through both medications and lifestyle by the way.
Host: Okay. Understood. That's kind of really interesting to hear. I'm curious as to if there are any physical warning signs when someone's blood pressure is high or they're experiencing that hypertension, are there things that people can be aware of before they go to actually measure themselves?
Dr. Tracz: You know, they don't call it the silent killer for nothing. In other words, you may have zero, zero symptoms and yet walk around with blood pressure we would consider high such as 160, let's say, and above. One common symptoms people do have is headache, you know, but that's very haphazard. It may happen in some people may not in others, so you cannot wait for the headache to check yourself. Basically what it really comes down to is prudent screening. Heart disease kills most Americans, out of all other conditions. You, I, anybody else, you know, all the editors who are going to cut this interview. We all need to check. We all need to check our blood pressures once in a while. If you're a healthy adult, if you're a healthy adult, and everything is going well, you know, checking it twice a year probably suffices. If you’re somebody with risk factors, obesity, diabetes, kidney disease, you definitely need to be checking it on monthly basis, if not more frequently. And that's the only way you're going to catch it. You will never catch it looking for symptoms.
Host: And just for the audience here, I'm sure we know, but why is it so important to seek treatment, if you notice that your blood pressure is consistently high?
Dr. Tracz: Because it thickens your blood vessels on the inside, which will then lead to organ damage and eventually death. Basically as the heart is trying to pump through blood, pump blood through increasingly higher blood pressures, it has to thicken itself. So the heart is at risk. As this blood is pumping through other organs at high pleasure. The way the blood vessels on the inside of our bodies adapt to that is by growing stronger for themselves, which hurts us the people, kidney fails. You could have problems with the brain, you could have a stroke, etcetera, etcetera. So it's all comes down to the fact that the only defense our poor little vessels have against high blood pressure is to be thicker. Once they become thicker, our organs fail. It's as simple as that.
Host: Now, you talked about diet and exercise as something that we could do as a prevention mechanism to lower our blood pressure. But is there any medication that people can take if they experience high blood pressure that will help it lower it immediately?
Dr. Tracz: You know, we all grew up in this world where, where people tell us about exercise and weight loss and then kind of wash yourself of our heads. So we don't really take it seriously. But here's how I make it very clear for my patients. I basically ask them, you have high blood pressure, we could treat it with chemicals or self-discipline, it's your choice. You know, people come into me and say, Doc, I'm on so many medicines. Well, I'm telling you, again, you've got two choices. You've got chemicals or you've got self-discipline because it is really about that. I have so many patients that have basically gotten this self discipline aspect, lost 15 pounds, started to avoid salt in their diet, etcetera, etcetera, and their blood pressure gets better without any medicines. So it really is, you know, it's real, it's a real thing and it's hard to make it real after we've heard it 100,000 times and totally ignore it. So as a doctor. Most doctors will do that. We will not just sit and tell you this, we will actually work with you and we will actually, I keep my patients away from medicine for as long as I can. If you come to my office with a blood pressure of 145, 150 my first instinct is not to give you the medicine. I will really make you work for it. I'll make you check your blood pressures at home.
I'll make you tell me exactly what you're eating. I want to see some weight loss and I'll work with you. And I'll make you understand how much this will help you. Only if you fail that after several months will we start talking about medicines. And to answer your questions about whether or not to start something. Well, you know, there's two types of patients. Those who are in emergency situation, maybe they are coming into the hospital for high blood pressures. We certainly have medicines for those people. Very rarely will you be needing medicine immediately. Let's say somebody takes their blood pressure in their kitchen and it's elevated 150, over 95. Very rarely do I need to go to the doctor immediately. They should contact their doctor, make an appointment and we will then, you know, work with you. But there's never a situation where a [inaudible 10:50] patient that's never had high blood pressure should be thinking about, you know, using a medication on an immediate basis.
Host: I love the way that you articulated that. How do you want to cure this with chemicals or self-discipline? I think it really frames it for that person and really shows them that they are in control and of course who wouldn't prefer not putting chemicals in their body.
Dr. Tracz: And let's not forget that most recently all of our chemicals that we treated with, i.e. Medicines, have been contaminated and there've been basically a recall after recall of the common blood pressure medicines. So yet another reason to stay away from them.
Host: Very good to know. So just as we wrap up here, is there anything that we didn't cover here today that you would like our audience to know?
Dr. Tracz: Yes. We need practicalities on what I said earlier. For example, salt, it is very important to know what the salt number should be, intake and it is 250 milligrams of sodium per serving. Basically that thing that shows, you know that the thing on the label you're going to look, they will have a sodium number and you are striving for 250. The reason I say that is people for example know they're not supposed to eat cold cuts so they get low salt ham. Well, low salt ham, you know, regular ham may have 800 and low salt 600, it's technically low salt for manufacturer, but it's still way too much. So therefore you cannot look at the front of the package. You cannot be fooled by the low salt labels. You've got to flip it about and look at the number. And 250 is the magic figure you're looking for.
Host: Okay, great to know. Well, Dr. Tracz, I truly appreciate your time today. This has been very informative. That's Dr. Michal Tracz, a Nephrologist with Highland Medical PC Rocklin Renal Associates. Thanks for checking out this episode of Sound Advice. Call 1-866-550- HMPC to make an appointment with Michal Tracz or another provider. If you've got this podcast helpful, please share it on your social channels and be sure to check out the entire podcast library for topics of interest to you. Thanks and we'll talk next time.
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