Drs. Oz & Roizen: The Second Most Important Number

What we are excited about today is your blood pressure. A new survey (we tell you about it below) reminded us of how important blood pressure is, so let us remind you: Your blood pressure is the second most important number for you to know (your spouse’s birthday is No. 1).

Low-density lipoprotein (LDL) and high-density lipoprotein (HDL) cholesterol, triglycerides and blood sugar are on that list, too, but blood pressure (BP) swamps those in importance. Moving from the worst to the best cholesterol numbers makes about a six-year positive difference in your RealAge.

But moving from high to normal BP makes as much as a 25-year difference.

First, what do the numbers measure? Here’s the scoop: The top number—known as systolic pressure—reflects the pressure created in your arteries when your heart squeezes blood out into your blood vessels. The bottom, or diastolic, number indicates the pressure when your heart relaxes. Both numbers indicate what is pushing against your arterial walls.

Moving from the U.S. average (129/86) to 115/75 can make you nine years younger. Put another way, when veterans with an average age of 55 years had untreated diastolic BPs in the 90-plus range, more than 35 percent of them died in five years, as opposed to less than 7 percent when they got that diastolic BP under 85.

So what did the survey say? In this 2,400-person survey, about nine out of 10 adults (89 percent) who self-reported having high blood pressure believe the condition is a cause for concern and want to understand what is going on in their bodies to cause it. But less than a third knew their numbers or knew if they had good control. Ugh.

We feel compelled to say anyone, yes, everyone we’ve seen, can get their BP lower than 135/85, and more than nine out of 10 can get it to less than 120/80.

If you heard that your systolic blood pressure should be 100 plus your age, you heard what used to be commonly stated but wrong. Also outdated is the assumption that 120/80 is healthy. The BP you want is 115/75 or less. If your day-to-day BP is consistently higher than optimal, you have work to do.

Let’s be blunt: You don’t need to be a statistic. Having high numbers makes you part of a real health epidemic, one that will be responsible for more than 60,000 deaths this year in the United States and more than 6,000 in Canada. In fact, cardiovascular disease is the largest killer in North America, responsible for 900,000 deaths a year in the United States alone.

And here’s motivation for knowing the number and aiming lower: If you’re 55 years old, every five-point increase above that optimal top number of 115 makes your RealAge one year older. Ditto a seven-point increase in the bottom number. Healthy (and good-tasting) food choices and physical activity often will bring the numbers down—see below. And if you lose waist, even better: Shedding just 10 percent of the weight you gained since you were 18, or 2 inches of waist, will bring both numbers down and make your arteries years younger.

If you know your numbers and you and your doc set a goal, you can start aiming for lower readings and start doing more of the things that we know help people reach their blood pressure goals. Get a device and measure it—we’d like you to aim for 115/75, but work with your doc.

Looking for a Cause

There are a lot of things we can blame high blood pressure on: the dollar menu at the corner fast-food joint, the burden of pending mortgage payments, our family heritage. And it’s true that things like poor diet, stress and genetics can play a role. So can a lack of walking.

But there are also changes that happen inside your body that can lead to high blood pressure. And you may never know the real reason your numbers are high.

But here’s what is certain: how to get that number to where it ought to be. First, there are lifestyle changes: Eating more vegetables, less meat, less saturated fat and more healthy fat instead, such as olive oil, canola oil and other omega-3 fats like DHA Having more real friends—people whom you trust totally and can confide in, hopefully like your significant other, but the more friends you can confide in, the better Walking daily

In addition to these, your doctor may prescribe medication to help lower your numbers. In fact, we ask our patients who need medicines to think of them as friends—steady, stable friends who help you reach a goal when other things don’t get you there. And there are more medication options than ever to help you do this job. Then why don’t people do so? More than 30 percent don’t fill their BP prescriptions when they do not have to pay for them. Maybe it is the side effects, or maybe they don’t realize how important it is.

But you have to be a smart patient and tell your doc what is bothering you about the medication. There are more classes of drugs than ever, so side effects can be minimized, or you can even find side effects that you like (one pill increases libido, one decreases it). In fact, there are at least 10 major classes of blood pressure pills available today, including the newest class of medication that targets a chemical system responsible for the normal rising and falling of blood pressure: the renin system. In some people, the renin system is too active, and that can lead to high blood pressure.

Your doctor may even start you on more than one type of pill, because combining pills can work in different ways at lower doses, maximizing benefits while minimizing side effects.

Whatever course of action you and your doctor decide is right for you, stick with it. Every point drop in blood pressure could mean that much more health, that much more life, that much younger in RealAge, and that much less risk for high blood pressure dangers like erectile dysfunction, poor-quality orgasms, kidney failure or even the big ones: heart attack and stroke. We want you to keep reading this column. So find out your number, and then get it to your ideal. Talk to your doc about more friends or use the tools at RealAge.com to aim lower.


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