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Can stubborn high blood pressure 
be tamed?

Nov 26, 2014 09:00AM ● Published by Cate Reynolds

They call it resistant hypertension and it can pose a serious threat to your heart health. According to the Harvard Health Letter, September 2014, nearly 10 percent of people who have been prescribed multiple medications to treat their hypertension still have dangerously elevated blood pressure readings. Part of the problem may be that patients are not taking their medications. The sheer number of pills patients may have to take can be daunting—both in ease of administration and ease of payment. But many of the meds are available in generic form, and convenient combination medications (with more than one medicine in them) can help streamline the pill-taking process.

And there are steps to be taken other than pharmacological. At the top of the Harvard list is lose weight if you are overweight, and get regular exercise. You should also consider the following steps:

Eat more potassium-rich fruits and vegetables. Good choices include tomatoes, spinach, sweet potatoes, avocados, dried apricots, bananas, oranges, and cantaloupe.

Avoid processed and restaurant-prepared foods. These foods can be loaded with sodium, which raises blood pressure. Common sources of extra sodium include cold cuts and cured meats, pizza, soups, sandwiches, and cheese.

Don’t drink too much alcohol. Because it raises blood pressure, don’t have more than two drinks a day if you’re a man, and one if you are a woman.

Check your over-the-counter meds. Common drugs can boost blood pressure including OTC painkillers such as Advil, Motrin, and Aleve, as well as cold and flu medications that contain decongestants such as pseudoephedrine and phenylephrine.

Bottom Line: Dr. Joshua Beckman, a cardiologist at Harvard-affiliated Brigham and Women’s Hospital, believes in making the medication process as simple as possible for a patient. “Initially, doctors often prescribe single-ingredient medications because it is easier to adjust the dosage. But once you get to a certain dose on several drugs, it’s better to switch to a combination drug,” he says.

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The blood pressure you didn’t know you had to worry about


Did it ever occur to you that your blood pressure measurement might vary substantially from arm to arm? Me either. But wiser minds prevailed when researchers at Harvard-affiliated Massachusetts General Hospital measured blood pressure—in both arms—in nearly 3,400 men and women age 40 and older with no signs of heart disease. The average arm-to-arm difference was about five points in systolic blood pressure. About 10 percent of the participants had differences of 10 points or more. Over the next 13 years, people with arm-to-arm differences of 10 points or more were 38 percent more likely to have had a heart attack, stroke, or related problem than those with less than a 10-point difference.

Large differences suggest the presence of artery-clogging plaque in the vessel that supplies blood to the arm with higher blood pressure. Such plaque is a sign of peripheral artery disease—which indicates there is a likelihood that arteries in the heart and brain are also clogged. This boosts the odds of having a heart attack or stroke.—S.H.

Bottom Line: Cardiologists routinely check blood pressure in both arms; primary care doctors do not. “Our study suggests that a baseline blood pressure measurement in both arms by primary care clinicians may provide additional information about cardiovascular risk prediction,” says study co-author Dr. Christopher O’Donnell, a cardiologist at Massachusetts General Hospital and associate professor at Harvard Medical School.
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