- The Washington Times - Monday, October 24, 2005

Joe Montana is still a vision of vitality a decade after retiring from the National Football League. In person, the 49-year-old looks fit enough to strap on his pads and take a few snaps.

But the Comeback Kid isn’t a kid anymore, a fact hammered home three years ago when his doctor diagnosed him with hypertension, or high blood pressure.

The San Francisco 49ers legend visited the District last week with cardiologist Dr. James M. Rippe to talk about identifying and fighting hypertension as part of the BP Success Zone plan sponsored by Novartis Pharmaceuticals.

It’s a message District residents need to hear.

The Centers for Disease Control and Prevention says 48 percent of District residents ages 55 to 64 have been diagnosed with hypertension. Overall, more than 65 million Americans suffer from high blood pressure, and 70 percent of those don’t have it under control.

Blood pressure is a measurement of the force created when the heart beats, referred to as systolic pressure, and when the heart is at rest, known as diastolic pressure. High blood pressure increases the chances of having a heart attack or stroke.

As Mr. Montana proves, even people who appear healthy can have it.

“The main reason Joe is an effective spokesperson is because his situation is so typical,” Dr. Rippe says. “People don’t get symptoms with high blood pressure.”

The diagnosis shook the ex-quarterback, known for his fourth-quarter heroics.

“I knew it was serious. I thought it would make things so different,” says Mr. Montana, whose family has a history of hypertension. Thanks to some minor adjustments to his diet and workout routine, life post-diagnosis changed very little.

Dr. Rippe, director of the Rippe Lifestyle Institute in Shrewsbury, Mass., cautions that a family history doesn’t guarantee someone will inherit the condition. Better indicators include obesity, poor diet and a sedentary lifestyle, he says.

Dr. Patricia Davidson, a cardiologist at the Washington Hospital Center in the District, says the majority of people will have to cope with hypertension one day.

Three-quarters of those older than 70 will suffer from high blood pressure, Dr. Davidson says, often because of lifestyle choices such as eating diets rich with salt and processed foods.

“As our arteries become stiff, our blood pressure goes up,” Dr. Davidson says.

Patients routinely get their blood pressure checked when visiting their doctors, but a high reading doesn’t instantly require treatment. False readings can be caused by stress or other temporary conditions. Usually, Dr. Davidson says, a physician will take a second reading or ask the person to come back in a week for another test to make sure the blood pressure truly is elevated. Doctors also can perform an echocardiogram to see if the heart muscle has begun to thicken, a sign of hypertension.

Patients should have blood pressure rates around 120/80. If the first number in a patient’s rate is in the 120 to 130 range, some lifestyle modifications can bring it back to a healthy range. When the first number rises above 130, medications often are required because the risk of stroke increases with that kind of reading.

Medical treatments for hypertension remain a contentious area in heart-medicine circles, Dr. Davidson says.

“I prefer to use the drugs that have the greatest benefit on the artery wall,” she says. For that she recommends a diuretic plus calcium channel blockers.

The latest philosophies on drug treatments involve improving the artery walls to prevent additional damage and using combinations of drugs with low doses to minimize potential side effects.

Dr. Rippe says the medications taken by today’s heart patients are a quantum leap from those available 25 years ago in terms of side effects.

“This is not your father’s medicine,” he says.

All the medication in the world won’t be enough for some patients who lose sight of their increasing waistlines.

Dr. Cedric Bryant, chief exercise physiologist with the American Council on Exercise, says losing weight “can have the most consistent and profound effect on blood pressure.”

Shedding 10 percent to 15 percent of one’s body weight can yield a 7 percent to 10 percent reduction in blood pressure, Dr. Bryant says, adding that it also can reduce the need for medications.

That can be crucial for those on fixed incomes.

Experts say steady exercise can reduce blood pressure rates.

That doesn’t mean running marathons or trying extreme sports, Dr. Bryant says.

“Mild exercise like walking may reduce blood pressure rates just as much as, say, jogging,” he says, adding that activities such as tai chi are ideal for blood pressure patients. Patients also can track how many steps they take each day and figure out ways to increase those numbers gradually by, for example, using the stairs instead of elevators.

The extra effort can help patients shed some weight and keep stress under control.

“There’s a connection between stress and our response to stress that can manifest itself [in] elevation of our blood pressure,” Dr. Bryant says.

Hypertension patients also must reconsider what they drink. Men should limit alcohol to no more than two drinks a day and women to only one, he says.

Mr. Montana, a married father of four, works out regularly on a treadmill and other low-impact devices and keeps his salt intake to a minimum. Those measures, along with medication, keep his blood pressure within an acceptable realm.

He says he once ate all the foods we know aren’t nutritious, particularly potato chips. Now, he surprises himself by ordering asparagus while traveling.

The Hall of Famer has simple advice for anyone recently diagnosed with hypertension.

“Make the [lifestyle] changes as quickly as you can,” he says.

For more information on high blood pressure, visit www.getbpdown.com.

Copyright © 2018 The Washington Times, LLC. Click here for reprint permission.

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