Participants: Don Mackintosh (Host), Victor E. Herry
Series Code: HFAL
Program Code: HFAL000191
00:50 Hello and welcome to Health for a Lifetime.
00:52 I'm your host Don Mackintosh. 00:53 We're glad you're with us today. 00:54 We're also glad that our special guest, Dr. Victor Herry, 00:58 is with us. 00:59 Dr. Herry is a specialist in internal medicine. 01:02 He's also had schooling in allergy and your immune system 01:06 He practices in Washington, D.C. since about 1982. 01:12 Yes. 01:13 So you've been at this for a while. 01:14 For a long time. 01:15 One of the big concerns in America, you were telling me, 01:20 and the subject for this program is hypertension. 01:22 What exactly is hypertension? 01:26 What is blood pressure? 01:28 What are we going to be talking about? 01:29 Hypertension is a term used for high blood pressure. 01:34 Blood pressure is the force of the heart. 01:39 The heart is a pump and as it pumps through the arteries of 01:42 the body that force is blood pressure. 01:47 So when the heart pumps you get the top blood pressure 01:52 which is the systolic and when the heart relaxes you get the 01:55 bottom blood pressure which is diastolic. 01:57 The blood pressure is written as numbers, one above the other, 02:00 systolic and diastolic. 02:02 Systolic is when the heart pumps and then the other is 02:07 when it relaxes. 02:08 And hyper means - higher than one expects. 02:12 Higher tension than one would expect. 02:14 So what are those numbers that we're looking at there? 02:18 Normal blood pressure is less than 120 over 80 millimeters of 02:23 mercury - that's normal blood pressure. 02:26 So the top needs to be 120. 02:28 If you have a blood pressure of 120 over 80 that's normal. 02:32 Anything above that is referred to as pre-hyper tension 02:36 when it falls between 120 and 139. 02:39 Then of course 140 and above is hypertension. 02:44 And that too has stages. 02:46 You have stage one which is 140 over 90. 02:51 Stage two begins at 160. 02:54 So we have four categories. 02:57 1. is normal blood pressure 120 over 80 and lower. 03:02 Then you have pre-hypertension above 120 over 80 and 03:07 less than 130 over 80- that's pre-hypertension. 03:10 Then you have stage one hypertension which is above 03:13 130 over 80. 03:15 Then you have stage two hypertension which is above 160. 03:20 So these are numbers given to us for hypertension. 03:22 Now usually they say that when you go to a doctor and they take 03:27 your blood pressure it goes up just because you're 03:28 talking to a doctor. 03:30 Well, there are some people who have what is called 03:32 "White Coat Hypertension. " 03:34 That is they go in to an environment to see the physician 03:38 and the blood pressure shoots up. 03:39 and that is an unusual situation. 03:42 Those persons are sometimes asked to check the blood 03:45 pressure outside of the doctor's office. 03:47 That would determine whether that person is 03:50 hypertensive or not. 03:52 What are some of the symptoms of high blood pressure? 03:55 You know it's very interesting that you ask the question 03:57 because hypertension is referred to as the "silent killer. " 04:01 There may be no symptoms at all. 04:04 So the only way you can determine if you are 04:07 hypertensive is that you must have your 04:10 blood pressure checked. 04:11 So you really need to know your numbers, 04:14 know where you stand on this. 04:17 It's important to know the numbers because one can 04:20 not determine if one has high blood pressure except 04:22 one checks the blood pressure. 04:24 What are the causes of high blood pressure - hypertension? 04:27 Causes vary. 04:29 In some cases where there are some diseases 04:32 some blood pressure rises. 04:35 Some of the causes would be increased salt intake, 04:38 for instance, sedentary lifestyle, 04:41 smoking cigarettes, all of these can cause 04:45 blood pressure to rise. 04:47 Even drinking coffee can cause your blood pressure to rise. 04:50 So sedentary, you mean sitting around? 04:52 Yes, people who simply do not exercise at all. 04:54 They sit around and lack of exercise certainly that causes 04:59 the blood pressure to go up. 05:00 So sedentary lifestyle, lack of exercise, coffee drinking... 05:06 how does that work? 05:07 Well, that stimulates the heart. 05:09 Anything that stimulates the heart and causes it to beat 05:11 faster can cause your blood pressure to go up. 05:14 Alcohol intake does the same thing. 05:17 A person may go into the doctor's office after having had 05:21 much alcohol and would find that the blood pressure 05:24 is elevated. 05:25 So alcohol drinking can cause your blood pressure to rise. 05:30 Interesting. 05:32 Any other causes you want to bring out? 05:33 Well, there are other things one must consider. 05:36 For instance, depending upon groups - African American, 05:41 for instance, have a pre-disposition to high 05:43 blood pressure. 05:44 So being African American is something that one must 05:48 consider with regards to hypertension. 05:50 So what are the statistics on that? 05:52 Of course I'm not African American but what 05:56 are the statistics on the number of African Americans 05:59 as opposed to white Americans? 06:01 In the United States, for instance, there are 50 million 06:04 hypertensive's, approximately 1 in 4. 06:07 That are diagnosed, is that what you mean? 06:11 Yes, diagnosed hypertensive's. 06:13 So there are maybe those who do not know that they have 06:15 hypertension because they have never checked their numbers. 06:18 Talk to me a little bit about these risk factors. 06:22 Just being African American is a risk factor? 06:25 Being African American is a risk factor. 06:27 Being over age 35 is a risk factor. 06:29 Smoking cigarettes is a risk factor. 06:32 Drinking alcohol is a risk factor. 06:34 Sedentary lifestyle is a risk factor. 06:37 Taking in too much sodium or salt is also a risk factor. 06:40 What it does tell us is that hypertension 06:44 is affected by lifestyle so that if one changes one's lifestyle 06:50 that can influence whether that person may develop 06:53 hypertension or not. 06:54 Regular exercise - if you get regular exercise daily 07:01 that can reduce your blood pressure. 07:03 We need to talk about what to do about this, but you said 07:06 something, you gave me a list of risk factors, but some of 07:10 those are not things you can do anything about with your 07:13 lifestyle. 07:14 Like the fact that I am 35 and a 1/2, or a little bit more. 07:19 I can't do anything about that. 07:20 That's true, because as one ages the blood pressure 07:24 tends to rise. 07:26 However, if your lifestyle is such that engenders 07:33 lower blood pressure if you exercise on a regular basis, 07:37 that makes the arteries more pliable and as a result the 07:41 blood pressure goes down. 07:42 You can't change your age but you can change your lifestyle. 07:46 So you actually, in a sense, change your age through 07:50 behavior patterns. 07:53 What's the big deal? 07:56 So I got a little hypertension! 07:57 I mean you know, Doctor, I mean, it's just numbers, what's the 08:00 big deal? 08:01 Are there any real effects? 08:03 I'm so glad you asked the question because as the 08:06 blood pressure rises the organs of the body are affected. 08:11 Now, stroke is the result of high blood pressure. 08:14 Kidney disease is the result of hypertension. 08:18 Blindness can come as a result of hypertension. 08:21 So it is important to recognize your numbers. 08:24 Not only that, but the heart is also effected. 08:27 The heart can become enlarged because the heart has to pump 08:31 so much against that pressure. 08:33 Now if you think about lifting weights. 08:36 As you lift more and more weights your muscles become 08:40 bigger and bigger. 08:41 That's how you can muscles. 08:43 It's the same thing with the heart. 08:44 As the heart pumps against greater pressure, 08:47 the heart enlarges. 08:49 With high blood pressure the effect on the body is that it 08:55 causes enlargement of the heart which can result in failure of 08:59 the heart - a congestive heart failure, the heart not being 09:02 able to pump properly. 09:03 It get's big for a while and it helps but then it's not helpful. 09:07 That's right. 09:08 It's not healthy. 09:09 So there are some real effects. 09:12 The one person I was talking with said that it even can 09:16 effect your intelligence. 09:17 Is that correct? 09:18 Well, it can effect your intelligence to the extent that 09:22 the blood flow to the brain is compromised. 09:26 What happens with some of the risk factors is they can cause 09:31 the hardening of the arteries. 09:32 As your arteries become harder the blood flow to the brain 09:37 becomes compromised. 09:39 And of course, if that becomes compromised then that can 09:42 effect your thinking over time. 09:44 Hypertension among the African American community 09:50 usually happens after 35 or do we have hypertension happening 09:55 even before that now? 09:56 What we've noticed today, not only in the African community 10:00 but in many of the communities in the United States, is that 10:04 even children are getting high blood pressure. 10:07 Part of that has to do not only with genetics 10:10 but also in lifestyle. 10:12 We notice that children today are not exercising as much as 10:16 they used to. 10:17 With the computers at home, with looking at television, and 10:20 eating a lot, we have increased weight gain - obesity - and 10:24 that's a problem. 10:26 That's one of the risk factors of hypertension. 10:27 We have children getting hypertension, we have older 10:31 people getting hypertension. 10:32 Now talk to me about that obesity, weight gain, and 10:35 hypertension. 10:36 How does that work? 10:37 What's the process? 10:39 If you think about it. 10:40 If you think about the heart being a pump. 10:42 And you think about the arteries being wires or tubes. 10:49 The greater the number of tubes, the greater the distance 10:52 the heart has to pump, the greater the force it uses. 10:56 So that as you gain weight the heart has to pump harder 11:00 to get the blood all over. 11:02 And then the resistance caused by the vessels not being very 11:06 pliable - so increased size causes blood pressure to go up. 11:11 Increased size causes resistance against the heart. 11:14 Someone told me it's about 200 miles per extra pound you weigh. 11:19 Have you ever read anything about how many extra 11:22 miles it is? 11:23 Well, it is some miles. 11:25 The exact number I don't recall at the moment. 11:27 But that's the problem. 11:29 It just overwhelms the pump. 11:31 That's exactly right. 11:33 Ok, detecting this. 11:35 We've talked about taking a measurement with a 11:41 blood pressure cuff, but are there any other ways 11:43 to detect it other than that? 11:45 There is no other way to detect your blood pressure elevation 11:49 but to check your blood pressure. 11:51 Every person who is 35 and over, yet every young person 11:55 even in schools now, we have school nurses checking the 12:00 blood pressure of children, especially of those children 12:02 who are over weight. 12:04 One of the things noticed in France, for instance, there is 12:08 such great increase in obesity and here in the United States, 12:12 that the children are being monitored for their weight. 12:16 So if you have increased weight in childhood we recognize 12:19 that there is increase and problems later on - increase 12:22 in high blood pressure. 12:24 But to know the blood pressure you must have it checked. 12:28 There's no other way. 12:30 You can't say, "Well, I'm feeling dizzy this morning 12:32 my blood pressure is probably up and I'm not dizzy 12:35 today and my blood pressure is down. " 12:36 It doesn't work that way. 12:38 So we really need to know our numbers. 12:40 Yes, we do. 12:41 We've been talking with Dr. Victor Herry. 12:43 We've been talking about hypertension. 12:45 It's a real problem. 12:46 Once you get hypertension many times it lasts for a lifetime. 12:49 But on Health For A Lifetime we don't want it to last for 12:52 a lifetime. 12:53 We want to not just know about the causes. 12:55 We want to have some good news and I think we'll find some 12:58 about the cure. 13:00 Join us when we come back. 13:03 Are you confused about the endless stream of new and often 13:07 contradictory health information? 13:09 With companies trying to sell new drugs? 13:12 Special interest groups paying for studies that spin the facts? 13:15 Where can you find a common sense approach to health? 13:18 One way is to ask for your free copy of Dr. Arnott's 13:21 24 Realistic Ways To Improve Your Health. 13:24 Dr. Timothy Arnott in the Lifestyle Center of America 13:27 produced this helpful booklet of 24 short, practical health 13:31 tips based on: 13:37 For example: 13:47 Find out how to: 13:49 and much more. 13:50 If you're looking for help not hype, then this booklet 13:53 is for you. 13:54 Just log on to: 14:03 Welcome back. 14:04 We've been talking with Dr. Victor Herry. 14:06 We've been talking about hypertension. 14:08 Before the break we talked about the causes of hypertension 14:12 and now we're going to talk about what everybody wants 14:15 to know - the cure! 14:16 Is there a cure for hypertension, Dr. Herry? 14:18 You ask about a cure. 14:20 Hypertension - the better word I would like to say is control. 14:26 Now, in some disease states that may cause hypertension, 14:30 such as, if there's a tumor that's causing the 14:34 blood pressure to rise, when you remove that tumor 14:36 then the blood pressure goes away. 14:38 However, most hypertension is called essential hypertension 14:43 meaning that we really don't have any cause for it. 14:47 So, in those cases we talk about the control 14:50 of the blood pressure. 14:51 Now you can control blood pressure by, first of all, some 14:55 basic lifestyle changes. 14:57 1. Exercise daily is very important 15:01 How long, what kind, where? 15:03 20 minutes every day of exercise. 15:07 It could be aerobic exercise, it could be walking, 15:10 it could be swimming, any form of exercise 15:12 20 minutes per day would help to reduce your blood pressure. 15:16 What about weight lifting? 15:17 Weight lifting is part of exercise too but you need 15:21 some other kinds other than weight lifting. 15:23 Ok, 20 minutes a day at of exercise at least. 15:26 At least 20 minutes per day. 15:27 Exercise on a regular basis that helps to lower blood pressure. 15:32 Now let's talk about exercise on one side then you have to talk 15:36 about diet on the other. 15:37 Because exercise without proper eating does not help. 15:41 So one has to eat properly. 15:43 What do I mean by eating properly? 15:45 Look at your salt intake. 15:46 A low sodium diet is important because earlier on we mentioned 15:51 that high sodium causes blood pressure to rise. 15:54 So a low sodium diet is very important with regards to 15:59 lowering your blood pressure. 16:01 I notice you say low but you don't say, "no" sodium. 16:04 That's right. 16:05 I said not no but low. 16:06 Why do you say that? 16:08 Because no sodium is almost impossible. 16:13 You require less than 2 grams of sodium a day. 16:18 In the American diet we have over 3 to 5 grams of sodium 16:23 every day. 16:24 So we need to lower the sodium content of our diet. 16:28 Ok, that's easy to say but how would I do that? 16:30 I'm going to the store and I want something low sodium 16:33 what do I stay away from? 16:34 First of all read your labels. 16:36 That's one thing. 16:38 The other aspect of it is eat differently. 16:40 Fruits, vegetables, greens, those are the kinds of things 16:44 that strengthen the body and enable you to lower your 16:48 blood pressure also. 16:49 What about these salt substitutes? 16:51 They put potassium in it. 16:55 I'm glad you mentioned potassium. 16:57 It has been found that potassium lowers blood pressure 17:01 so that any diet high in potassium would help to lower 17:05 blood pressure. 17:06 So in your diet if you eat high potassium foods, assuming 17:11 however, that you do not have kidney disease. 17:14 Because high potassium foods would be lethal in a person 17:18 who has kidney disease. 17:19 Assuming that your kidneys function very well, then 17:23 your fruits, vegetables, greens are all very important 17:27 in terms of aiding your lifestyle and lowering your 17:31 blood pressure. 17:32 So we've mentioned exercise and diet. 17:35 Those are two very important things. 17:37 Now one of the things you mentioned in the pamphlet 17:40 you've written, "All You Need to Know About Hypertension" 17:44 you mention the DASH diet. 17:48 Is this what the DASH diet is? 17:50 It's a diet that talks about less than a 2,000 calories a day 17:55 diet and you have vegetables, fruits, make sure you drink 18:00 enough water, and lower the sodium content of your eating. 18:06 I sometimes do not like to push people to a specific diet. 18:11 But give them the understanding of how they should eat. 18:16 Fruits, vegetables, grains, those things, then lower your 18:21 sodium, increase your exercise activity. 18:25 Those are things that enable us to have a healthier lifestyle. 18:30 You talk about Health for a Lifetime. 18:33 Those are the things we want to put in so that over your 18:36 lifetime you can have a lower blood pressure. 18:39 Now we mentioned earlier that you already have hypertension. 18:42 These lifestyle changes help in lowering blood pressure, 18:47 getting rid of obesity, lowering the fat content of your diet, 18:52 lowering your cholesterol. 18:53 Now those are important. 18:55 And then of course having done all of those things 18:58 then we can talk about medications. 19:01 Ok, so lifestyle things first then talk about medications. 19:06 But before we get there, the lifestyle approach... let's say 19:11 someone goes out and starts to adopt this. 19:14 How soon will their blood pressure go down? 19:16 It's difficult to give you any specific time but after 19:21 exercising for at least 3 months you will notice that 19:27 there is a change in your blood pressure. 19:30 Now if you were to exercise. 19:31 Five minutes after you exercise you will notice that your 19:37 blood pressure will drop from 19:38 your exercise blood pressure to your resting blood pressure 19:42 and will even drop below your normal resting blood pressure. 19:45 Now how does that work? 19:46 What is the physiology of that? 19:51 Now you've put me to the test! - laughter - 19:54 What happens here is this. 19:56 During exercise the vessels, the arteries of the body become 20:02 pliable. 20:04 So the smooth muscles of the arteries as they become pliable 20:10 when one exercises the arteries expand and the expansion of the 20:17 arteries cause the blood pressure to drop. 20:19 Those are some of the things that really help us here. 20:24 Now, one other thing. 20:25 You said exercise and then you said diet, fruits, nuts, grains, 20:29 vegetables, in other words foods as grown, but the real 20:34 issue with people many times... ok they got their 20:36 collard greens but then they add butter or other toppings. 20:41 What do you tell your patients about the toppings? 20:44 Let's remember that increased cholesterol causes hardening 20:50 of the arteries. 20:51 Therefore, your diet should be one that would tend to lower 20:55 your cholesterol. 20:56 Because high cholesterol causes hardening of the arteries 21:00 resulting in higher blood pressure. 21:02 Ok, now here's another dilemma as I listen to you. 21:04 You say, "Wait a minute, try the lifestyle first. " 21:07 But let's say you have what you term malignant hypertension 21:10 You're 160 in your systolic, the top number and you're in danger. 21:16 Would you give them medication and then have them do the others 21:18 until it got down? 21:20 Certainly, medication comes first in such a case. 21:23 Now, if you are in the pre-hypertensive stage 21:27 which we mentioned earlier on, it would be a blood pressure 21:30 of 130 over 80- pre-hypertension 21:33 That's where lifestyle changes become very, very important. 21:37 It's important throughout the gamut, the spectrum, however, 21:42 if your blood pressure is already high 160 over 100 or 21:46 160 over 90, medication becomes important. 21:49 Let's talk about the medication. 21:51 There are up sides to it and down sides to it. 21:53 I'm sure you might mention both of those. 21:55 What are the up sides, what are the kinds of medicines you give 21:58 people and what can be some of the down sides? 22:00 There are various categories of medications 22:01 that physicians use. 22:03 There are diuretics and those are fluid pills, so to speak, 22:08 that causes reduction in volume. 22:10 Reduction in blood volume reduces blood pressure. 22:14 Then there are medications like calcium channel blockers 22:17 that prevents calcium from entering into the cells. 22:21 As calcium is stopped from entering into the cells 22:25 these vessels dilate and cause the blood pressure to go down. 22:31 Then there are beta blockers. 22:33 Beta blockers are those medications that slow the 22:37 heart down. 22:38 And as they slow the heart down, that decreases the force and 22:42 decreases blood pressure. 22:43 Then there are other newer medications such as 22:47 ACE inhibitors. 22:48 Those work in different ways but they all work to lower your 22:52 blood pressure. 22:54 It's your job to figure out what's the best for that person. 22:59 For that particular patient, yes. 23:00 That is probably just a fine balancing act depending on 23:05 what's going on with them. 23:07 One has to balance it very carefully because every 23:10 medication may have some side effects. 23:12 One has to choose the patient and choose the medication 23:15 for that particular patient. 23:18 What are some of those side effects? 23:20 Because lots of people in this culture... you watch the news 23:24 and you notice that usually on the nightly news 23:27 the companies that buy those slots before or during the news, 23:33 which is when lots of people watch television, 23:34 are drug companies. 23:36 They're talking about their medications and it's almost 23:39 as if I've got that problem there's got to be a drug for it. 23:42 Are there down sides? 23:44 There are side effects of every medication. 23:47 However, it is the physician's responsibility to determine 23:51 which medication has the minimum effect 23:55 on that particular patient. 23:57 So it is an individual thing between the physician 24:00 and the patient to determine which medication is best 24:04 for the patient. 24:05 In dealing with blood pressure one has to, 24:09 as we mentioned before, lifestyle changes become 24:11 very important. 24:13 I would mention that because prevention is better than cure. 24:18 Since when you develop hypertension there is no cure 24:21 but there is control. 24:23 Lifestyle change in the pre-hypertensive state is 24:27 extremely important. 24:28 So prevention for a lifetime is important in controlling 24:33 your blood pressure. 24:34 We've talked about exercise, diet, medication. 24:40 Is there anything else in trying to get a grip on this in terms 24:45 of education that needs to happen? 24:47 The patient must be educated as to the danger of hypertension. 24:53 Because hypertension is a very dangerous disease 24:56 and it is a disease. 24:57 Let us not forget it. 24:59 It is a disease that has its toll in billions of dollars on 25:04 this society and world wide. 25:07 It is responsible for many heart attacks, strokes, 25:13 congestive heart failure, blindness, debility where people 25:22 are unable to carry out their function. 25:25 It is the disease that in the early stages that one can get a 25:34 grip on before the body's effected totally 25:37 by that disease. 25:38 We've been talking with Dr. Victor Herry. 25:41 We've been talking about hypertension and we've 25:45 got a really good picture from you of what the problem is 25:48 and some solutions. 25:50 Now you also are a Christian physician. 25:53 Are there spiritual aspects to blood pressure control 25:58 or disease that you bring in as you talk to your patients? 26:02 One of the things that may cause blood pressure to continue to 26:06 stay high is stress. 26:09 Now we all live in a world of stress. 26:12 We can't get away from stress. 26:13 But as a Christian one of the things that we are taught 26:17 is to take it and lay it at the feet of the Master, 26:21 isn't that correct? 26:22 That's right. 26:23 When we learn to do that, we learn to elevate 26:26 and reduce our stressors. 26:27 And reduction of stress is a very important factor in the 26:31 control of blood pressure. 26:32 Do you pray with your patients? 26:34 With those who request it. 26:35 Wonderful! 26:37 We've been talking with Dr. Victor Herry. 26:38 We've been talking about blood pressure, its causes, and 26:43 not its cure but rather it's control. 26:46 I really encourage you if you've been watching, to know your 26:50 numbers. 26:51 We've heard this message again and again from Dr. Herry, 26:53 isn't that right? 26:54 Let's go out, get your blood pressure taken. 26:56 Secondly, know your family history. 27:00 We haven't talked a lot about that but if you're from a family 27:03 history of hypertension make doubly sure you get it checked 27:07 and then know how you can control it through lifestyle, 27:11 what you eat, how you exercise, your relationship with God, 27:15 and of course medication may be something you need. 27:19 Check in with your physician about that. 27:20 Dr. Herry, we're really thankful you've joined us from that busy 27:24 practice there in Washington, D.C. 27:25 Glad you could be with us. 27:27 Thank you kindly. 27:28 And we're also glad that you could be with us today 27:31 on Health for a Lifetime. 27:32 You know, with such a significant problem 27:36 like hypertension we're aware of some of the 27:39 things we can do but most importantly what God can do. 27:42 We're thankful that God has inspired people to go into 27:45 medicine like Dr. Herry. 27:47 But he also can inspire you to take charge of your life 27:52 to get that blood pressure checked and to find out how 27:57 to have health that lasts for a lifetime. |
Revised 2014-12-17