Selected Podcast

Measure Up, Pressure Down

Summit Medical Group is participating in the American Medical Group Foundation (AMGF) Measure Up/Pressure Down National Campaign.

This campaign is created to raise awareness among patients, employers, and communities about the dangers of uncontrolled high blood pressure and to achieve lasting improvements in blood pressure control that lead the way to greater health for all Americans.

Do You Know Your Numbers? If you have a family history of high blood pressure or a history of hypertension yourself, studies show that you should at least strive for an initial goal to keep blood pressure below 140/90.

For more information: Measure Up Pressure Down

High Blood Pressure Contender For Your Health

Measure Up, Pressure Down
Featured Speaker:
Ellen Lunenfeld,, M.D.,FACP, FASH
Ellen Lunenfeld, MD, FASN, FACP, is an internist specializing in clinical hypertension, kidney disease, and internal medicine, with a focus on preventive care. In addition to her position at Summit Medical Group, Dr. Lunenfeld teaches and supervises residents in nephrology and hypertension at Overlook Medical Center in Summit, New Jersey, and she is a member of the Memorial Sloan-Kettering Cancer Center Consultant Medical Staff. She is a member of the American College of Physicians, Medical Society of New Jersey, Union County Medical Society, and American Society of Nephrology.


Transcription:

Melanie Cole (Host): Summit Medical Group is participating in the American Medical Group Foundation Measure Up/Pressure Down national campaign. This campaign is created to raise awareness among patients, employers, and communities about the dangers of uncontrolled high blood pressure and to achieve the lasting improvements in blood pressure control that lead the way to greater health for all Americans. My guest is Dr. Ellen Lunenfeld. She is an internist and nephrologist specializing in clinical hypertension at Summit Medical Group. Welcome to the show. Dr. Lunenfeld, tell us please what is blood pressure.

Dr. Ellen Lunenfeld (Guest): Blood pressure is the force the blood against the walls of the arteries. We measured it in two ways. We measure a systolic pressure and diastolic blood pressure. The systolic is while the heart is beating and pressing against the walls of the arteries and the diastolic blood pressures is when the heart starting to relax.

Melanie: What causes high blood pressure? How this is even measured?

Dr. Lunenfeld: We don't know exactly what causes high blood pressure for a lot of patients. It’s measured by again the systolic and the diastolic readings and blood reading over 140/90 with the systolic readings over 140 and the diastolic over 90 is how we measure recording of high blood pressure.

Melanie: Other certain risk factors that would predispose somebody to having high blood.

Dr. Lunenfeld: Certainly, someone who is overweight as we get older we are at higher risk, someone who is inactive, patients with diabetes and other medical conditions are at higher risk as well as people who have a family history of high blood pressure.

Melanie: So, let’s speak about treatment for high blood pressure because so many Americans suffer from high blood pressure. Speak about medications Dr. Lunenfeld. What do you do is the first line of defense for someone who comes to see you, who is over 140/90 or pre-hypertensive sort of on the line there.

Dr. Lunenfeld: So, the first thing we talk about is lifestyle modification and what that means is trying to improve our daily life, so that the blood pressure improves or for someone who is kind on the borderline that we don't need medication and the big things that I talked about our maintaining a healthy weight, so even losing 5 to 10% of your body weight if you are overweight is enough to help the blood pressure. For some people that’s 5 to 10 pounds. Increasing your exercise, so at least 30 minutes, three times per week has also been shown to help the blood pressure and the last thing that I talk to people about is something called the DASH diet, DASH diet with dietary advances to stop hypertension and it’s a diet that is very effective at controlling the patient's blood pressure along with other lifestyle modification and medications when necessary.

Melanie: Where the salt play a role because we hear that people with high blood pressure should avoid too much salt and sodium.

Dr. Lunenfeld: Currently, the salt plays a big effect. It’s a part of the DASH diet as well, but there is also a role in terms of increasing our foods and vegetables and potassium intake which is one of the big factors played in the DASH diet as well.

Melanie: What does that mean for people listening? What is the DASH diet specifically how can it help people? Give us a little bit of an example.

Dr. Lunenfeld: What they found and for most patients is that by increasing your fruits and vegetables and someone that involve eating less processed foods which are very high in sodium, the patients can lower their blood pressure by about five points on average and certainly salt does play a role in that because processed foods have a large amount of salt, but the biggest thing was actually increasing the fruits and vegetable intake.

Melanie: And you mentioned potassium and calcium, where can people find those to make sure they're getting enough?

Dr. Lunenfeld: Most sources of potassium are found in fruits and vegetable and really just trying to increase and get your five servings a day, but you well on the way to getting a good amount of potassium in your diet.

Melanie: And now speaking of medications. When does it come time that you do put somebody on medications?

Dr. Lunenfeld: It really depends on the degree of hypertension. For someone who has stage II hypertension, when their blood pressure is 150/100 or higher, we usually start them right away because at that point you know really at a dangerous level you know had a higher risk for stroke or other complication. For someone whose blood pressure is lower more than 140/90, but less than that 150/100 range, we often will try first to monitor over a period of few weeks to try to see if changing those lifestyle factors and get the blood pressure under control, but when they can't that’s when we start medications.

Melanie: And if there is a family history of high blood pressure and your family does that predispose you more?

Dr. Lunenfeld: Certainly that doesn't mean that you necessarily always going to get high blood pressure, but it’s a good reason at that point to make sure you are getting regular screening and that you are watching and trying to prevent it as well.

Melanie: And tell us about regular screening, Dr. Lunenfeld. How often should people check their blood pressure?

Dr. Lunenfeld: At least once a year for most patients. Certainly, when we get older and may need to be more frequent especially when we have other medical conditions such as diabetes, but for most young you know otherwise healthy people without other medical problems once a year would be reasonable, twice a year if you start to get to a borderline range.

Melanie: And if you are someone who suffers from high blood pressure, then how often. Should you keep track of your blood pressure every week, so that you can let your doctor know, should you get a blood pressure cuff or go to you know one of the drug stores that keep them there. What do you recommend?

Dr. Lunenfeld: I think it really depends on the person. Some people get very anxious checking their blood pressure on a regular basis and for them it might cause more of a burden to have a blood pressure cuff, but for many people having a good working home blood pressure cuff gives them a sense of reassurance that they're keeping an eye on their blood pressures. Usually seeing your doctor, at least having the blood pressure checked twice a year even if you are under excellent control, it’s still a good idea.

Melanie: And what role Dr. Lunenfeld the stress play in blood pressure and you mentioned that some people get a little anxious taking their blood pressure which could raise it anyway, but the stress that we all you know go through every day, can that raise your blood pressure and what do you recommend to your patients to help control their stress?

Dr. Lunenfeld: Certainly stress can worsen the blood pressure and won't necessarily cause the high blood pressure in the first place, but for many patients especially those predispose; it can certainly make the blood pressures worse and that is, where exercise and you know other forms of relaxation come into play. Whether it’s yoga or some other forms of meditation or just a regular aerobics exercise. They can all be helpful in managing your stress.

Melanie: And what about alcohol. Do we need to cut down on alcohol if you're someone that suffers from high blood pressure?

Dr. Lunenfeld: Limiting yourself to one drink a day if you are a woman or up to two drinks a day for a man is certainty a good idea.

Melanie: Tell us about the Measure Up/Pressure Down campaign. What do you want people to take from this?

Dr. Lunenfeld: The main key with the Measure Up/Pressure Down, I think that majority of patients under good control. The goal was less than 140/90 and most patients can achieve that pressure goal and achieving that over a large population that such as we see here at Summit Medical Group can help decrease the risk of complications such as stroke and heart attack.

Melanie: And back to medication for just a minute doctor if somebody is on medication, what medications might they be on and is it something that then they have to be on for the rest of their lives?

Dr. Lunenfeld: Common medications will use for management of high blood pressure are diuretics such as hydrochlorothiazide, chlorthalidone, calcium channel blockers such as Norvasc, also called amlodipine is the generic, sometimes beta-blockers are used, metoprolol is the common one, other medications you may see us using are ACE inhibitors or angiotensin receptor blockers especially in patients with kidney problems or with diabetes and some other medications names you may hear of are lisinopril, Accupril, or Benicar.

Melanie: And is this something they need to take for the rest of their lives or do you often see people with high blood pressure? They take medication, they get their lifestyle under control, and then their blood pressure no longer needs to be controlled by medication.

Dr. Lunenfeld: I have seen many patients who really make the effort to change their lifestyle to lose weight to get in shape, who have been able to come off many times more than one medication to the point where they don't need any other, but it really takes quite a bit of effort, but it can definitely be achievable.

Melanie: And your best advice, please doctor for those listening with a loved one with high blood pressure or if they have high blood pressure for the Measure Up/Pressure Down campaign, your best advice that you give your patients everyday about controlling their blood pressure?

Dr. Lunenfeld: Make sure you get your blood pressure checked, if you don't know that you have high blood pressure, you can’t control it, keeping a healthy diet, maintaining a healthy weight, regular exercise, and increasing your fruits and vegetables intake, and keeping a healthy diet that’s lower in sodium. All good ways to prevent and to treat high blood pressure as well.

Melanie: Thank you so much, Dr. Ellen Lunenfeld. For more information you can go to summitmedicalgroup.com. You are listening to SMG radio. I am Melanie Cole. Thanks for listening.