Keep close tabs on BP during the winter months
You’re probably aware of some of the well-known risk factors of high blood
pressure, such as genetics and age. Lifestyle factors including unhealthy
diets and stress are also associated with this widespread condition, known
What you may not know is that high blood pressure tends to be more
difficult to control during the winter months.
large nationwide study
published several years ago, researchers reviewed health records of more
than 400,000 veterans over a five-year period. The research showed that
among 60 percent of the participants studied, blood pressure readings were
consistently higher during the winter. This followed an
that indicated increases in blood pressure during winter months might be
particularly problematic for the elderly.
“One reason for increased winter blood pressure may be that cold
temperatures trigger a‘fight or flight’ response,” says
Airley E. Fish, MD, MPH
, a cardiologist at Beth Israel Deaconess Medical Center (BIDMC) who sees
patients in both Boston and
. “This causes the heart to beat faster and can cause blood vessels to
constrict and blood pressure to rise.”
But cold temperatures may not be the only factors underlying blood pressure
increases: Sedentary lifestyles and winter weight gain — as well as
decongestants and cold medications — can also raise blood pressure.
“No matter what the underlying cause, we recommend that patients take extra
care to monitor their blood pressure throughout the winter months,” says
Know Your Numbers
Blood pressure measures the force of blood pushing against the heart’s
arteries. Blood pressure readings are given in two numbers: systolic
pressure (when the heart is contracting) over diastolic pressure (when the
heart relaxes between beats).
According to the
American Heart Association
, a normal healthy blood pressure reading is less than 120/80. Hypertension
is diagnosed at 140/90 or higher (130/80 for patients with diabetes or
kidney disease). A systolic blood pressure reading between 120 and 139, or
diastolic pressure reading between 80 and 89, is considered
“High blood pressure affects one in three adults in the U.S.,” says Fish.
“It’s often referred to as a 'silent killer' since it often has no symptoms
and can go undetected for decades.”
In fact, the AHA reports that more than 20 percent of those with high blood
pressure are unaware that they have the condition, and more than half of
those diagnosed with hypertension are not being treated for it.
“If the heart is pumping against high pressure for a long time, like any
other muscle it thickens and eventually becomes less effective," says Fish.
“Uncontrolled hypertension raises a person’s risk for stroke, heart attack,
heart failure and kidney disease.”
Know the Risk Factors
Because arteries narrow over time, age is one of the biggest risk factors
for high blood pressure. Until a person reaches middle age, both systolic
and diastolic pressures can be expected to increase; around age 50,
diastolic pressure tends to level off, while systolic pressure often
continues to rise.
“Even if your blood pressure reading has been normal in the past, regular
checks are necessary as you get older,” explains Fish.
To assess your risk, check out the AHA’s
High Blood Pressure Health Risk Calculator
Other risk factors include:
High blood pressure is more common in men until middle age. Women are
more prone to hypertension after menopause.
High blood pressure often runs in families.
40 percent of African Americans
have hypertension, and it often develops earlier in life.
Excess weight, poor diet, lack of activity, smoking and stress can all
contribute to high blood pressure.
Know How to Control Blood Pressure
Lifestyle changes are the first step in controlling blood pressure, says
Fish. According to guidelines from the AHA, the following steps can help
keep blood pressure in check:
Get regular exercise (30 minutes of moderate intensity activity, such
as brisk walking, five days a week)
Eat a heart-healthy diet, such as the
DASH (Dietary Approaches to Stop Hypertension) Diet
Avoid excess alcohol (no more than one drink per day for women and two
If you smoke, quit
When Do You Need Medication?
If blood pressure readings are higher than 140/90 on two or more occasions
(or 130/80 for individuals who have diabetes or kidney disease), and
lifestyle changes have not led to any improvements, one or more medications
may be prescribed to lower or control blood pressure levels. There are a
number of different types of blood pressure medications, including
diuretics, beta blockers, calcium-channel blockers, ACE inhibitors and
alpha-2 receptor agonists.
“Some patients tolerate lower doses of two medications better than a higher
dose of a single agent, and therefore, in some cases, we may recommend two
different medications to control blood pressure,” says Fish, who also
recommends patients buy an at-home blood pressure monitor to keep close
tabs on their readings, and suggests patients first visit with their
physicians to make sure the monitors are accurate and carefully calibrated.
“See your physician regularly, exercise and eat well, and — if you need
hypertensive medication — take it as prescribed,” says Fish. “Prevention is
the best medicine to keep blood pressure in check and avoid life-changing
cardiac events — in winter months, and throughout the year.”
Above content provided by the CardioVascular Institute at Beth Israel
Deaconess Medical Center. For advice about your medical care, consult