Why Blood Pressure is So Important & How to Lower It
Category
🛠️
LifestyleTranscript
00:00Have you ever wondered why blood pressure is so important?
00:03I mean, this is a vital that is checked during nearly every visit with a healthcare provider.
00:08And besides giving us some important information on the current status of the cardiovascular system,
00:13blood pressure, or at least high blood pressure, is known as a silent killer.
00:18Because over time, if left untreated, it can increase your risk of stroke, heart attack, kidney failure, and even aneurysms.
00:25So today, we're going to define what blood pressure is, the numbers you want to have,
00:30how to measure it, and things that you can do to keep it at healthy levels.
00:34So, let's jump right into this anatomical and physiological awesomeness.
00:44So before I show you some really cool things on this body,
00:47I want to start by saying that blood pressure, like many other processes in the human body, follows the Goldilocks principle.
00:54You don't want the blood pressure too low, and you don't want the blood pressure too high.
00:58You want it just right, or just enough, to perfuse the tissues throughout the body with enough blood.
01:03If it's too low, these tissues won't get enough oxygen.
01:06And if it's too high, or at least too high for an extended period of time,
01:10that increased pressure can literally damage the tissues, and even damage things like blood vessels,
01:16which can lead to other health conditions that we'll talk about in a little while.
01:19Now, you may have experienced a temporary decrease in pressure, to say, like your brain,
01:23when you stand up too quickly and get a little lightheaded.
01:26But overall, the vast majority of people deal with too high of blood pressure, rather than with too low.
01:32And we call high blood pressure hypertension.
01:35But when it comes to understanding blood pressure, we need to realize that blood is a fluid,
01:39and fluids exert pressure on the walls of the container that they fill.
01:44Like how water in a hose would exert pressure on the walls of the hose,
01:47or water in a balloon would exert pressure on the walls of the balloon.
01:51So blood pressure is the force of the blood pushing against the walls of your arteries,
01:55as the heart pumps blood throughout the body.
01:58So if you look at the drawing over here on the whiteboard,
02:00you can see as the blood is pumping through the artery,
02:03it's also going to exert pressure on the wall of that artery.
02:08And the equation for blood pressure is,
02:10blood pressure equals cardiac output times systemic vascular resistance.
02:15Cardiac output is the amount of blood pumped out of the heart per minute,
02:19which is influenced by heart rate and how forcefully the heart contracts with each beat.
02:24And in general, as cardiac output goes up, so does blood pressure.
02:28Systemic vascular resistance is the amount of resistance created by the blood vessels throughout the body.
02:34We could spend a lot of time on systemic vascular resistance,
02:37but think of this resistance being influenced by the tone of the blood vessels,
02:41like how constricted or how relaxed the smooth muscle is in the arterioles.
02:46Generally, more constriction increases blood pressure.
02:50The length of the blood vessels also influences vascular resistance and blood pressure,
02:55as well as the compliance of the blood vessels.
02:58And what I mean by compliance is, if you look at this aorta,
03:00and you can see me poking it and just bouncing up and down on the aorta,
03:04you can see that it recoils.
03:06And that's what I mean by compliance.
03:08Arteries have elastic connective tissue built into the wall.
03:12And so if the blood gets pushed into an artery that's healthy and is compliant,
03:16that artery will stretch, but it won't just stretch once the blood gets pumped into it.
03:21After it stretches, it will recoil.
03:23And what that does is it'll shoot the blood further downstream.
03:26And that's free.
03:28And what I mean by free is that it doesn't require any extra ATP or any extra work by the heart.
03:34It's easier on the heart to pump into a nice, stretchy, compliant artery.
03:39Think of the opposite, like a diseased or atherosclerotic artery that's stiff and non-compliant,
03:44and the heart tries to pump into that.
03:46You don't get that stretch and recoil.
03:47And so overall, that will be harder on the heart and will increase blood pressure.
03:52And this is one of the many reasons why you want to have healthy arteries.
03:56You often hear about the link of cholesterol and plaque buildup in the arteries.
04:00Yes, plaque building up in the arteries can occlude and block the arteries.
04:03And sometimes those plaques can rupture and travel further downstream and cause all sorts of different problems.
04:09But it also can stiffen the arteries and make them less compliant.
04:13Again, potentially raising blood pressure.
04:15And with all this talk about blood pressure,
04:17I want to mention something that helps to take some pressure off of me.
04:20And that's the sponsor of today's video, Grammarly.
04:23As a medical provider, anatomy and physiology teacher,
04:26and with running our education team here at the lab,
04:28I'm constantly working across multiple platforms,
04:31such as Google Docs, Slack, Canva, as well as addressing a lot of emails.
04:36So in other words, I have a lot of writing to do.
04:38And I want to ensure that my writing is clear, professional, and impactful.
04:42And this is where Grammarly comes in.
04:43Grammarly is my AI writing partner that helps me get my work done faster with higher quality writing.
04:49And again, what sets Grammarly apart is that it works where I work,
04:52across over 500,000 apps and websites.
04:56Which means no more copying and pasting unlike other AI tools.
04:59For instance, I use Grammarly to help me generate an outline for a video script on Google Docs.
05:04And once I'm ready to post on YouTube or Instagram,
05:07I use Grammarly's rewrite feature to help me condense my captions,
05:11which helps make some of my content creation so much more efficient and streamlined.
05:16Grammarly also has 15 years of best-in-class communication AI
05:20and provides personalized writing suggestions based on my audience, goals, and context.
05:25It's trusted by tens of millions of professionals
05:28and 96% of users report that Grammarly helps them craft more impactful writing.
05:33And here's one of the best parts.
05:35Grammarly is free to use and try out.
05:37So sign up and download it for free using my link grammarly.com slash ioha.
05:43Thanks again to Grammarly for sponsoring today's video.
05:45And now, let's get back to blood pressure.
05:48Now I'm sure all of you have had your blood pressure checked at some point in your life.
05:52And blood pressure is measured in millimeters of mercury
05:54and recorded with two numbers.
05:56Systolic pressure, which is the top number,
05:59represents the pressure in your arteries when your heart beats.
06:03The second number, or the bottom number, is the diastolic pressure
06:06and represents the pressure in your arteries when your heart rests between beats.
06:11And so for example, if your blood pressure is 120 over 80,
06:15120 is the systolic pressure and 80 is the diastolic pressure.
06:19And so where do you want your blood pressure to be?
06:22For normal blood pressure, you would want your systolic pressure to be less than 120
06:27and your diastolic pressure to be less than 80.
06:30Elevated blood pressure is a systolic reading between 120 to 129
06:34and a diastolic less than 80.
06:37Stage 1 hypertension is when systolic is between 130 and 139
06:42or diastolic between 80 and 89.
06:45Stage 2 hypertension is when systolic is 140 and above
06:49or diastolic is 90 or higher.
06:52Now it is very important that you measure the blood pressure properly
06:56because obviously we want the numbers to be as accurate as possible.
06:59And the proper way to measure blood pressure is to have the person relax,
07:04sitting in a chair, feet on the floor, and back supported
07:07for at least five minutes before taking the reading.
07:10You also want to avoid caffeine, exercise, and smoking
07:13for at least 30 minutes before taking the measurement
07:15as well as to ensure that the bladder is empty.
07:18So you want to use the restroom prior to taking your blood pressure.
07:21Also, the patient and the observer should not talk during the rest period
07:26or during the measurement.
07:27And the arm should be supported like maybe resting on a desk by their side.
07:31Now sometimes all of these steps don't always occur in a clinic
07:35and this could be due to the type of clinic
07:37or the reason why someone is at the doctor's office.
07:39For example, I work in urgent care.
07:41It's a pretty fast-paced environment where we don't manage long-term conditions
07:45such as hypertension.
07:46We're managing urgent conditions.
07:49And often patients are sick or injured
07:51and so this can temporarily elevate the blood pressure.
07:54And so in some of these cases, we may take those mild elevations with a grain of salt.
07:59But in a family practice or primary care setting
08:02where one of the main goals is to assess blood pressure,
08:05those steps should be followed.
08:07And if you are doing blood pressure readings at home,
08:10you should also follow those steps.
08:12So why do we really care about blood pressure?
08:14And why should you be motivated to keep it at a healthy level?
08:17Well, as I already implied at the beginning,
08:19long-standing untreated hypertension can lead to other more serious health conditions.
08:25And the reason why it is nicknamed the silent killer
08:27is because hypertension is mostly asymptomatic.
08:31The only time people really ever feel symptoms
08:33is when hypertension becomes severe
08:35with numbers of like 180 for systolic and or over 120 for diastolic.
08:41And even then, sometimes people may only feel a mild headache.
08:44But again, even the long-term unmanaged stage 1 or stage 2 hypertension
08:50can lead to problems with the heart.
08:52Over time, the heart becomes overworked
08:54and this could potentially lead to heart failure.
08:57I also mentioned earlier that high blood pressure can damage the blood vessels.
09:01And the reason for this is think of high blood pressure
09:04as creating a mechanical type of damage to the inside lining of the blood vessels.
09:09This makes it easier for plaque to build up in the arteries.
09:12And if this plaque builds up in a coronary artery that feeds the heart,
09:16this could eventually lead to a heart attack.
09:18Or if it was plaque building up in a carotid artery that feeds the brain,
09:22this could potentially lead to a stroke.
09:24The kidneys are also very susceptible to unmanaged hypertension.
09:28The microvasculature, the small blood vessels in the kidney,
09:32can get damaged leading to kidney disease and potentially kidney failure.
09:36I also mentioned aneurysms at the beginning of the video.
09:39High blood pressure is a risk factor for developing an aneurysm.
09:43And an aneurysm is an abnormal bulge in an artery.
09:46And if this aneurysm is in an artery that is in the brain,
09:49and this aneurysm bursts, this could cause a hemorrhagic stroke.
09:53So enough of the gloom and doom.
09:55What can you do to lower your blood pressure?
09:57Well, if you've watched our channel before,
09:59it's probably not going to be a shock that I'm going to mention exercise.
10:03Exercise has many benefits for your heart and cardiovascular health.
10:07But it can also lower blood pressure.
10:09I mean, technically, your blood pressure goes up during exercise.
10:13But we're talking about the overall long-term effect
10:16that this has on your overall blood pressure.
10:18And consistent exercise can lower this.
10:21Aerobic exercise combined with resistance training
10:23can decrease systolic blood pressure by about four to six millimeters of mercury
10:28and diastolic pressure by about three millimeters of mercury.
10:32Now, four to six points may not sound like a lot.
10:35But this improvement is independent of weight loss.
10:39So if you don't lose any weight at all and you just add exercise,
10:43you can improve by four to six points systolic and three points with diastolic.
10:47But if you also were to lose weight,
10:51studies have shown that blood pressure can decrease from about 0.5 to 2 millimeters of mercury
10:57for every kilogram of body weight that is lost.
11:00And a kilogram is about 2.2 pounds for us non-metric people.
11:05Now, obviously, this depends on the person and how much weight they have to lose.
11:09But that's a pretty impressive improvement.
11:12Many people can also get improvements with reducing the amount of sodium in their diet
11:16with a potential overall decrease of about 4.8 systolic and 2.5 diastolic.
11:22The DASH diet, which stands for the Dietary Approaches to Stop Hypertension,
11:27has also helped people to improve their numbers.
11:30This diet is high in vegetables, fruits, low-fat dairy products, whole grains, poultry, fish, and nuts,
11:36and is also low in sweets, sugar-sweetened beverages, and red meats.
11:41And because of the types of foods incorporated in this type of diet,
11:45people consequently ingest foods that are rich in potassium, magnesium, calcium, protein, and fiber,
11:52but low in saturated fat, total fat, and cholesterol.
11:56Limited alcohol intake also has been linked to better blood pressure numbers,
12:00as women who consume two or more alcoholic beverages per day
12:04and men who are consuming three or more drinks per day
12:06have a significantly increased incidence of hypertension compared with non-drinkers.
12:11So it is recommended that adult men with hypertension, if they are going to drink,
12:16consume less than two drinks per day.
12:18And for women with hypertension, that would be no more than one drink per day.
12:22Now, I do want to mention that the numbers I quoted for the amount that you can decrease your blood pressure
12:27with these lifestyle modifications came from UpToDate,
12:30which is a medical database that compiles a whole bunch of different research studies,
12:34and this is what many medical providers will reference when treating their patients.
12:38But keep in mind, these numbers can vary from person to person,
12:41but even though there can be variation,
12:44it is recommended that almost everyone who has elevated blood pressure, stage 1 or stage 2 hypertension,
12:50that they all participate in these lifestyle modifications.
12:53Because if you can't get the blood pressure under control with these lifestyle modifications,
12:58then we get to move on to medications.
13:01Now, personally, I'm one of those who tries to avoid medications if I can,
13:05but I do need to say that there are definitely situations where medications are appropriate.
13:09Sometimes, just based on uncontrollable factors like age and genetics,
13:13you can only get your blood pressure so low with lifestyle modifications.
13:17So again, there are situations where managing hypertension with medications is recommended
13:23because the alternative for having long-standing unmanaged hypertension
13:27is not something that we want to deal with later in life.
13:30Thank you so much for watching today's video, everyone.
13:32We truly appreciate all the support you give this channel,
13:35and hopefully, we give you guys some valuable information that you can use in your everyday life.
13:39And if you're interested in learning more about like cardiovascular health,
13:42we have a video about how the heart changes with exercise.
13:45And if you want to check out Grammarly, we've got that link in the description below.
13:49And we'll see you in the next video.