The Hindu Business Line : When pressure mounts...

Understand blood pressure: Your blood pressure (BP) readings have two numbers. Why Exercise? authors Dr David Ashton and Dr Bruce Davies explain their significance: "When the heart contracts to force blood through the arteries, the contracting pressure is called `systolic'. When the heart stops contracting to rest between beats, the resting level pressure is termed `diastolic'. Hence, BP is expressed as 120/80 (systolic/diastolic or contracting/resting).

What is high BP? Excellent blood pressure is up to 120/80. The upper limit of normal BP is when the diastolic resting pressure is 90. Borderline is 95. Mild: 96-104. Moderate: 105-114. Severe: 115-129. Dangerous: 130 and over. Simply put, high BP means the heart works at high pressure even while resting — a busman's holiday.

Should you take medicine? When the resting pressure is 130 and over, it must be immediately controlled with intravenous injections, perhaps. Between 105 and 129, long-term medication is required. Between 90-104, Dr Norman Kaplan, University of Texas Health Science Center, Dallas, advises "the non-drug approach as the first line of defence." However, follow your physician's advice as it is based on your individual medical history. To ensure accuracy, always measure your BP after you've rested quietly for 5-10 minutes. If you've walked/driven/argued/drunk coffee, your BP would be high.

Talk to your doctor: Remember, BP rises slowly and steadily over the years, not overnight. So also, it takes months/years to lower and sustain it at a healthy level. The important thing is to take charge now. Note down the date, time and your BP reading, and keep track as you hit lower levels.

Check when you can start walking regularly — exercising is a must to lower BP. Ask what you should and should not eat. Let the proactive hands-on manager/executive in you take over — like you're receiving a brief from your CEO. You will become more composed, charged and ready to make changes to reach your target. A patient tends to be vulnerable and confused. Once you've walked out of the clinic, return to your regular life, making small, healing, permanent changes in your food content, activity-level and way of thinking as follows:

Medicine is food: For the next few months, your medicine is as much part of your diet as rice. Take it regularly and on time, as specified by the doctor. You will realise its value as your BP level starts reducing. Don't miss your appointments with your doctor to keep tab on your progress.

Food is medicine: Fresh juicy fruits, raw crunchy vegetables, steamed rice, ghee-free rotis, oil-less spiced dals, and chunky soya oil-less curries are easy on your workaholic heart. Its resting level reaches restful zones when your digestion is effortless. Fat in foods is indigestible, fat on your body burdens — both hinder the heart from resting after contraction. Cutting out fats is a great way of restoring healing properties to your foods. Examples: Raw mango is healthier when not in an oily pickle. Urad dal is nutritious when not greased into a papad.

Less salt, more potassium also balance electrolyte levels and restore rhythm to your heart. Tip: five grams of table salt is the maximum allowed per day. Balance it with thrice the amount of potassium — 15 grams. Sweet potatoes, colocasia, rohu fish, sweet lime, peaches, plums and musk melons are rich potassium sources.

Can I walk, doctor?: "We usually start people with a 4-minute-quarter-of-a-mile brisk walk," says Dr Robert Cade, University of Florida College of Medicine. "Then we increase it to a brisk 15-minute-mile." Aerobic exercises — walking, swimming and biking — open up blood vessels. With the blood flowing through them freely, its pressure decreases and the heart becomes more restful between contractions.

Buy your own BP machine: I recommend the electronic kit with automatic cuff inflation. You strap it around your wrist, bend your elbow until the wrist is at level with your heart. Press `Power'. It shows `O'. Press `Start'. It inflates, then deflates and stops. Compare the reading with your doctor's mechanical one to match its accuracy. This is extremely useful as it helps you monitor your emotions.

A New York Hospital-Cornell University Medical Center study found: Happiness lowers the heart's resting level; anxiety elevates the heart's contracting level. So, aim for calm contentment. In the years to come, you will halve your dosage and your BP will read 110/64. It will prove your superb management skills.

Finally, a word on low blood pressure: If you feel dizzy or faint when you quickly rise from your chair, you could have low BP. It is caused by consuming diuretics, alcohol, antidepressants, and tranquilisers. "Have a strong cup of coffee," some doctors advise. More dos:

Drink 12 glasses of water daily.

Squeeze an isometric handgrip before rising.

Sleep with your head elevated.

Do light weight-training daily to raise the BP.

Ask your doctor to change your medicine if it is causing low BP.

The writer is co-author of the book `Fitness for Life'

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