High Blood Pressure

December 2017 Issue 7

This blog provides an introduction to high blood pressure and the benefit of massage.

High blood pressure or hypertension results from either (i) faster rate of blood flow by the heart beating faster, (ii) constriction and/or hardening and narrowing of the arteries or (iii) both.

High blood pressure is defined as a systolic pressure (where the heart contracts to push blood into the circulation) of 140 mm of mercury or a diastolic pressure ( where the heart is at rest between beats) of 90 mm of mercury or both.

Normal blood pressure is less than 120 mm and less than 80 mm of mercury. The range between 120-139 mm and 80-89 mm of mercury being classified as pre-hypertension.

Of those with hypertension around 85% have no identifiable cause and around 15% are the result of other conditions such as poor kidney function.

Risk factors associated with hypertension are smoking, obesity, lack of exercise, stress, high levels of fats and salt in the diet and age and family history.

Signs, Symptoms and Complications

Hypertension is known as the silent killer as its onset is often symptomless and does not become apparent until complications set in.

Hypertension can lead to hardening of the arteries and, in a two-way process, hardening of the arteries can lead to hypertension. Unchecked this can lead to other conditions such as heart failure, heart attacks, stroke, aneurysm or kidney damage.

Treatment and Management

Treatment is with one or more of an array of antihypertensive medications and management of the risk factors.

Drug therapy can include medications that impact on blood pressure and/or designed to prevent the onset of complications. These include:

Drug class

Impact

Diuretics

Increase the removal of salt and water from the blood

Beta blockers

Blocks the effect of adrenalin relaxing the heart

ACE inhibitors

Inhibits the enzyme that constricts blood vessels

Angiotensin II receptor blockers

Blocks the effect of enzyme that constricts blood vessels

Calcium channel blockers

Slows flow of calcium into blood vessel walls and heart muscle and relaxes the blood vessels

Vasodilators

Dilates blood vessels lowering blood pressure

Although the above array of medications aim to reduce blood pressure and prevent the onset of complications, they come with an array of side effects. The severity of these side effects varies from individual to individual, but tend to increase with the dosage of the medication.

To help minimise the need for the medications or increases in their dosage and the concomitant side effects, it makes sense to implement self help measures to reduce the risk factors that cause and exacerbate high blood pressure.

Risk factor

Measures

Smoking

The simple answer is to give up smoking. Vaping introduces nicotine into the body which raises blood pressure. Nicotine patches or gum may be an aid to quitting smoking but in the short term is still introducing nicotine into the body.

Weight

Obesity and being overweight are risk factors that increase blood pressure. Reducing weight reduces the risk. This does not require extreme diets but rather balanced nutrition to steadily reduce weight.

Nutrition

Even someone who is not obese may not be eating a balanced diet.

Some foodstuffs when taken in large amounts have an adverse impact on blood pressure. Other foodstuffs and minerals and vitamins have beneficial impacts in lowering blood pressure.

Adverse excessive consumption foodstuffs include: salt, caffeine, alcohol. Herbs that raise blood pressure include Aniseed, St. Johns Wort, peppers (green, yellow, orange and red), Parsley, Licorice, Ginger and Ginseng among others.

Beneficial consumption of foodstuffs include:

Vitamins – folic acid (vitamin B9), vitamin D

Minerals: potassium (greens, fruits, beans and pulses, nuts and seeds) and magnesium (greens, beans and pulses, seeds, nuts and grains, fish)

Exercise

Exercising for 30 minutes per day can reduce blood pressure. Walking is very beneficial in this respect. Most urban localities have their version of ‘Walking for Health’ groups. Swimming, cycling or gardening are all good forms of exercise.

Heat

Cold weather constricts the arteries and increases blood pressure. To minimise the constriction of arteries and blood vessels in cold weather keep warm: wear thermals, wear a hat, use either a hot water bottle or electric blanket at night, keep the home well heated.

Massage and High Blood Pressure

Various small scale studies indicate that a reduction in systolic and diastolic pressure for those with hypertension receiving massage with one research study showing a reduction in stress hormones in urine and saliva.

A massage therapist needs to conduct a very thorough preliminary consultation for those with high blood pressure as the range of severity can be very diverse from controlled with little complications, various complications (eg heart disease and vascular disease) through to poorly controlled blood pressure.

As hardening and narrowing of the arteries is usually a concomitant with high blood pressure a conservative approach is to be adopted avoiding massage pressure to artery pulse points (especially the carotid arteries).

Massage to the abdomen is contraindicated due to the potential for reflexive action in slowing heart rate and leg arterial dilation.

Poorly controlled blood pressure requires slow even rhythmic massage with gradual transitions to avoid sympathetic activity. Where there are additional risk factors that make it more likely there is also a risk of deep vein thrombosis, then very light pressure and little movement of joints in at risk areas is to be used.

Careful management of risk factors including suitable massage can significantly contribute to the control, stabilisation and reduction of high blood pressure when implemented in combination with an effective treatment regime. With mild high blood pressure an effective treatment and risk management regime can reduce blood pressure and the risk of complications.

Sources:

Association of Massage Therapists Ltd, “Evidence Based Massage: Stress and Hypertension “ [http://www.amt.org.au/downloads/practice-resources/AMT-Evidence-Based-Generic-stress-and-hypertension.pdf Accessed 18 November 2017]

Dharmananda, Subhuti “Safety Issues Affecting Herbs: Herbs That May Increase Blood Pressure” [http://www.itmonline.org/arts/hypertension.htm Accessed 19 November 2017]

Walton, Tracy (2011) “Medical Conditions and Massage Therapy: A Decision Tree Approach” Lippincott Williams & Wilkins

Those with suspected or actual high blood pressure should always consult a doctor.

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