Harold Oshiro has been an HMSA member for more than 50 of his 79 years. About four
years ago, his doctor referred him to HMSA’s
Care Connection to help him manage his cardiac, diabetes and kidney problems.
At that time, Oshiro, who is 5 feet 6 inches tall, weighed 258 pounds and his systolic
blood pressure was over 200. Today, he weighs 210 pounds and his systolic blood
pressure is down to 140.
How did he do it? “Every day, I checked my blood pressure and weight and sent
it by computer to the Kapolei clinic,” he explains. “If it was too high,
they called me up. They sent me pamphlets and told me what to do. If it wasn’t
for those nurses, I’d be dead by now.”
Oshiro is an excellent role model for others with hypertension (high blood pressure)
who need to make significant lifestyle changes. Hypertension is called the “silent
killer” because it usually has no noticeable warning signs or symptoms until
serious medical problems arise. Anyone, including athletes and children, can develop
hypertension; almost one-fifth of them don’t know that they have it.
The bad news is that one in every three American adults has hypertension, one of
the most common and potentially serious health conditions in the nation. An estimated
197,400 people in Hawai‘i have high blood pressure, according to the 2008
Hawai‘i Health survey.
The direct and indirect costs of high blood pressure topped $73 billion nationally
in 2009, according to the American Heart Association. “Hypertension is the
most prevalent chronic condition in the adult population,” says John Berthiaume,
M.D., HMSA’s vice president of Care Management. “Recognition of the
importance of identifying, educating and adequately treating individuals with the
disease is one of the highest priorities for HMSA’s Care Management department.”
The good news is that blood pressure can be controlled. Risks for hypertension include
a lack of exercise, poor diet, obesity, older age, drinking too much alcohol, eating
too much salt, and having a family history of hypertension. Researchers at the National
Institutes of Health blame the nation’s current obesity epidemic as a major
contributing cause for hypertension.
What is high blood pressure?
Blood pressure is measured by evaluating how hard the blood pushes against the walls
of your arteries. It’s normal for blood pressure to go up and down throughout
the day, but if it consistently stays high for too long, it is called hypertension.
The measurement for blood pressure is written as two numbers, for example, 120 over
80 or 120/80. The first, or top, number represents the pressure when your heart
contracts. This is called systolic pressure. The second, or bottom, number represents
the pressure when the heart rests between beats. This is called diastolic pressure.
Normal blood pressure is a systolic pressure of less than 120 and a diastolic pressure
of less than 80. For adults, hypertension is defined as a systolic blood pressure
of 140 or higher or a diastolic blood pressure of 90 or higher. Pre-hypertension
is defined as a systolic blood pressure of 120 to 139 or a diastolic blood pressure
of 80 to 89.
What are the dangers of uncontrolled hypertension?
When your blood pressure remains high, it begins to damage your blood vessels, heart
and kidneys. It can lead to serious medical problems, such as cardiovascular disease,
which is the leading cause of death in Hawai‘i and the nation. Key risk factors
from hypertension include:
- Atherosclerosis, a disease of the arteries caused by a buildup of plaque, or fatty
material, on the inside walls of blood vessels.
- Heart disease, including heart failure (the heart cannot adequately pump blood),
ischemic heart disease (the heart tissue doesn’t get enough blood), and hypertrophic
cardiomyopathy (an enlarged heart).
- Kidney problems. Hypertension can damage the blood vessels and filters in the kidneys,
so they cannot properly excrete body waste products.
- Eye disease. Hypertension can damage the very small blood vessels in the retina;
in some cases, it can cause blindness.
Strategies to control your blood pressure
Uncontrolled hypertension can lead to life-threatening outcomes. The solution to
controlling it is lifestyle management, which includes:
Maintaining a healthy weight. Losing as little as 10 pounds can
reduce your blood pressure significantly.
Staying active. Studies show that regular aerobic exercise lowers
blood pressure. Adults should engage in moderate physical activities, such as brisk
walking, for at least 30 minutes on most days of the week.
Following a healthy diet. An overall healthy diet can help maintain
normal blood pressure levels. This requires eating lots of fresh fruits and vegetables,
and lowering or cutting out salt.
Avoiding excessive use of alcohol. High alcohol consumption is
related to an increase in blood pressure. People who drink alcohol should do so
Not smoking. Smoking injures blood vessels, speeds up atherosclerosis,
and is a major risk for heart disease and stroke. If you don’t smoke, don’t
start. Quitting smoking lowers your risk of heart attack and stroke.
Taking your medications as prescribed. Regular doctor visits and
continuing to take your medications as prescribed are critical to keeping your blood
pressure in check.
Reducing stress. Researchers have shown that people who practice
daily stress-reduction techniques, such as meditation, have significant reductions
in their blood pressure.
How can HMSA help you manage your hypertension?
HMSA offers various programs for members with high blood pressure:
HMSA’s Care Connection. Our team of specially trained registered
nurses, dietitians and health coaches can help you manage your hypertension by giving
you the tools, information and support you need. Care Connection reaches over 90,000
HMSA members currently living with a chronic condition such as diabetes, heart disease,
asthma, chronic obstructive pulmonary disease (COPD), or kidney disease. Care Connection
is available to all HMSA members; call 1 (800) 499-5036 for more information.
HMSA’s HealthPass offers a variety of resources to help
you set goals to manage your blood pressure, including health coaching services
and wellness and health education programs. HealthPass has six convenient locations
throughout the state. For more information or to schedule an appointment, call the
HealthPass call center at 432-9220 on O‘ahu or 1 (800) 525-6548
toll-free on the Neighbor Islands.
Ready, Set, Quit! HMSA’s program is designed to help
you quit smoking and stay smoke-free. To enroll, HMSA members can call 952-4400
on O‘ahu or 1 (888) 225-4122 toll-free on the Neighbor Islands.
HMSA’s workbook, Managing Your Blood Pressure with a Healthy Lifestyle,
includes information, tools, resources and local recipes designed for HMSA members
with high blood pressure. To receive a copy at no cost, eligible members can schedule
a HealthPass visit by calling (808) 432-9220 on O‘ahu or 1 (800) 525-6548
on the Neighbor Islands. You can also download a copy of the brochure