TH E HARVARD M EDICAL SCHOOL GUI DE TO LOWERI NG YOUR B L O O D P RESS U RE Also from McGraw-Hill and Harvard Medical School Living Through Breast Cancer, by Carolyn M. Kaelin, M.D., M.P.H., with Francesca Coltrera Eat, Play, and Be Healthy, by W. Allan Walker, M.D., with Courtney Humphries Beating Diabetes, by David M. Nathan, M.D., and Linda M. Delahanty, M.S., R.D. Lowering Your Cholesterol, by Mason W. Freeman, M.D., with Christine Junge Healing Your Sinuses, by Ralph B. Metson, M.D., with Steven Mardon Achieving Optimal Memory, by Aaron P. Nelson, Ph.D., with Susan Gilbert Overcoming Thyroid Problems, by Jeffrey R. Garber, M.D., with Sandra Sardella White The No Sweat Exercise Plan, by Harvey B. Simon, M.D. Raising an Emotionally Healthy Child When a Parent Is Sick, by Paula K. Rauch, M.D., and Anna C. Muriel, M.D., M.P.H. TH E HARVARD M EDICAL SCHOOL GUI DE TO LOWERI NG YOUR B L O O D P RESS U RE AGGIE CASEY, R.N. , M.S. , AND H ERBERT BEN SON, M.D. WITH BRIAN O’N EI LL Copyright © 2006 by The President and Fellows of Harvard College. All rights reserved. Manufactured in the United States of America. Except as permitted under the United States Copyright Act of 1976, no part of this publication may be reproduced or distributed in any form or by any means, or stored in a database or retrieval system, without the prior written permission of the publisher. 0-07-149039-6 The material in this eBook also appears in the print version of this title: 0-07-144801-2. All trademarks are trademarks of their respective owners. Rather than put a trademark symbol after every occurrence of a trademarked name, we use names in an editorial fashion only, and to the benefit of the trade- mark owner, with no intention of infringement of the trademark. Where such designations appear in this book, they have been printed with initial caps. McGraw-Hill eBooks are available at special quantity discounts to use as premiums and sales promotions, or for use in corporate training programs. For more information, please contact George Hoare, Special Sales, at Professional Want to learn more? We hope you enjoy this McGraw-Hill eBook! If you’d like more information about this book, its author, or related books and websites, please click here. I, Aggie Casey, dedicate this book to my daughter, Ali Barros, and to my husband, Charlie, for their continuous love and support. I would also like to thank my parents, Agnes and Bill Casey, for believing in me. I love all of you with my life. I, Herbert Benson, am forever grateful to my wife, Marilyn. This page intentionally left blank For more information about this title, click here Contents Acknowledgments xi Introduction xiii C H A P T E R 1 1 Understanding Hypertension Hypertension: An Important Update 1 Blood Pressure Basics 2 Understanding the Numbers 3 Different Kinds, Varying Degrees 5 So You’ve Been Diagnosed with Hypertension 8 When Is Medication Necessary? 9 Why Is Hypertension Dangerous? 10 Next Steps 11 C H A P T E R 2 13 Understanding Why Hypertension Develops Risk Factors You Cannot Change 14 Risk Factors You Can Change 15 Measuring Your Blood Pressure at Home 17 Carol’s Story 21 John’s Story 22 Next Steps 24 vii CONTENTS C H A P T E R 3 25 Managing Stress Using Version-1 Software in the Modern World 25 Introduction to the Stress Response 26 What’s Stressful? 29 Is Stress a Problem for You? 29 The Many Faces of Chronic Stress 30 The Relaxation Response: Short-Circuiting Stress 33 Dealing with Cognitive Distortions 44 Taking the Sting Out of Ten Common Stressors 48 Next Steps 50 C H A P T E R 4 51 DASHing Your Way to Healthier Blood Pressure Now DASH Away, DASH Away, DASH Away All 52 Looking for Hidden Salt 56 Alcohol: Friend or Foe? 57 Shed the Pounds, Lower the Numbers 59 Cholesterol: The Good and the Bad 64 The Other Players 66 Balancing Your Plate 71 Next Steps 74 C H A P T E R 5 75 Exercise How Exercise Helps People with Hypertension 76 The Benefits Just Keep on Coming 79 A Note of Caution 82 Designing the Right Program for You 84 Getting Started: What Works for You? 92 Exercise: Great for Mind and Body 95 Carol’s Story 98 Staying in It for the Long Haul 99 Next Steps 103 viii