National Emergency Medicine Assoc. (NEMA)
"THE HEART OF THE MATTER"
Week: 603.6 Pt.1
Guests: Dr. Claude Lenfant, Heart Institute, Dr. Sheldon Sheps, The Heart, Lung and Blood Institute, Dr. Edward Rocella, Heart Institute
Topic: New high blood pressure guidelines
Reporter: Aaron Cohen
Host/Producer: Steve Girard
NEMA: Doctors and their patients are being urged by federal health officials to take the consequences of high blood pressure more seriously. The National Heart, Lung and Blood Institute reports that high blood pressure, which already afflicts 50 million Americans, is making a comeback...and officials have released new guidelines to combat this killer. Aaron Cohen has Health on the Hill....
COHEN: The new figures were like a bolt out of the blue...more Americans are dying from stroke, the prevalence of heart failure and kidney disease has risen and the death rate from heart disease, the number one killer in America, is now also on the rise. Whats more, Heart Institute director Claude Lenfant says a recent survey indicates fewer Americans are aware of the risks posed by high blood pressure, and fewer are treating the disease...or trying to keep hypertension under control. With obesity, another risk factor for all manner of heart maladies, also out of control, Dr. Lenfant says he is very concerned.
LENFANT: The second thing, which we think....is occurring, is that people are becoming complacent. The treatment of hypertension is a life-long treatment. It requires some discipline...in the medication one must take, and the lifestyle changes...and when you have to do these things over a period of time, it is very difficult to get people to do it.
COHEN: Americans lax attitude towards what are serious health problems prompted a Heart, Lung and Blood Institute expert panel to update its 1993 high blood pressure guidelines...and borrowing the Forest Services credo, chairman Sheldon Sheps said, "Only you can prevent high blood pressure"...
SHEPS: Since the goal of prevention and treatment is to reduce hypertension related deaths and illness, by the least intrusive means possible...the new guidelines emphasize lifestyle changes. For some patients, lifestyle changes alone may be adequate therapy...they should always be part of any treatment plan for hypertension.
COHEN: Dr. Sheps, with the Mayo Clinic, says lifestyle changes mean a better diet and more cardiovascular exercise...and it means closely monitoring your pressure, and if necessary, taking precisely determined drugs to keep high blood pressure in check. The Joint National Committee recommends what they call the "DASH" diet, which is an acronym for Dietary Approaches Stop Hypertension. It includes 8 to 10 helpings of fruits and vegetables a day, plus 2 to 3 servings of low fat dairy products...and of course, cut back on saturated fats, cholesterol, alcohol and salt. Dr. Rocella, with the Heart Institute, says the DASH diet isnt that bad...
ROCELLA: It calls for up to ten fruits and vegetables...its a 2 thousand calorie diet, which is a pretty good diet. Its reachable. Its not so spartan that you want to walk away from it...its quite a good diet.
COHEN: Normal blood pressure reads 120 over 80. The first number measures the force of blood pumping through your arteries, the second records your heart at rest. The new guidelines say a strict regimen of diet and exercise will suffice until your blood pressure reaches 140 over 90. Thats considered high, and must be treated with drugs that for the first time, the National Heart, Lung and Blood Institute recommends with some specificity. They recommend certain drugs if a patient also has diabetes of kidney disease. One reason Americans are suffering more heart disease, heart failure, stroke and kidney disease is because they are not taking their medication. Thats something Dr. Sheps and his team of experts has taken into account...
SHEPS: The joint national committee is well aware of the cost of drug therapy can interfere with hypertension control. The report describes many cost cutting measures, including combination tablets, generic drugs, and dividing some types of large dose tablets.
COHEN: The recent downturn in good heart news has prompted the National Heart, Lung and Blood Institute to take tot he airwaves...theyre also conducting outreach in churches, at sporting events and in the deep South, which they call the stroke belt, to convince people, especially older people and blacks, to take high blood pressure seriously. Again, Dr. Rocella...
ROCELLA: Lowering blood pressure will save lives, prevent strokes and heart attacks. Hypertension can be controlled, and lifestyle changes can prevent it altogether.
COHEN: Dr. Edward Rocella with the National Heart, Lung and Blood Institute. For Health on the Hill, Im Aaron Cohen.
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