MARIAN was afraid! Without warning, her nose had begun to bleed profusely. "I thought I was going to die," she recalls. A doctor informed Marian that her nosebleed had been caused by high blood pressure (arterial hypertension). "But I feel fine," answered Marian. "Many people do not know that they have high blood pressure because they have no symptoms," she replied.

What about your blood pressure? Could your current life-style cause high blood pressure in the future? What can you do to keep your blood pressure under control?

Blood pressure is the force blood exerts against blood vessel walls. It can be measured using an inflatable rubber cuff, which is wrapped around the upper arm and connected to an apparatus that records pressure. Two readings are obtained. For example: 120/80. The first number is called systolic blood pressure because it indicates blood pressure during the heartbeat (systole), and the second number is called diastolic blood pressure because it indicates blood pressure while the heart is relaxed (diastole). Blood pressure is measured in millimeters of mercury, and physicians classify patients as hypertensive when their blood pressure is above 140/90.

What makes blood pressure increase? Imagine that you are watering your garden. By opening the faucet or by reducing the caliber, or diameter, of the jet of water, you increase the pressure of the water. The same occurs with blood pressure: Increasing the rate of flow of blood or decreasing the caliber of the blood vessel elevates the blood pressure. How does high blood pressure occur? Many factors are involved.

Factors You Cannot Control

Researchers have discovered that if a person has relatives with high blood pressure, his chances of suffering from the disease are greater. Statistics indicate a higher incidence of hypertension in identical twins than in fraternal twins. One study refers to the "mapping of the genes responsible for arterial hypertension," all of which would confirm the existence of a hereditary component responsible for high blood pressure. The risk of abnormally high blood pressure is also known to increase with age and to be greater among black males.

Factors You Can Control

Watch your diet! Salt (sodium) can boost blood pressure in some people, especially people with diabetes, those with severe hypertension, older people, and some blacks. Excess fat in the bloodstream can create deposits of cholesterol on the internal walls of blood vessels (atherosclerosis), thus reducing their caliber and increasing blood pressure. People who are more than 30 percent above their ideal body weight are liable to have high blood pressure. Studies suggest that increasing the intake of potassium and calcium may lower blood pressure.

Smoking is related to a greater risk of atherosclerosis, diabetes, heart attack, and stroke. That being so, smoking and high blood pressure are a dangerous combination that can lead to cardiovascular diseases. Although the evidence is contradictory, caffeine-contained in coffee, tea, and cola drinks-and emotional and physical stress may also aggravate high blood pressure. In addition, scientists know that intensive or chronic consumption of alcoholic drinks and lack of physical activity can increase blood pressure.

Healthful Life-Style

It would be a mistake to wait for high blood pressure to develop before taking positive steps. A healthful life-style should be a concern from an early age. Taking care now will result in a better quality of life in the future.

The Third Brazilian Consensus on Arterial Hypertension defined the life-style changes that favor a decrease in arterial blood pressure. They are a helpful guide to people with high or normal blood pressure.

For the obese, researchers recommended a balanced low-calorie diet, avoiding fast and "miracle" diets, while maintaining a program of moderate physical exercise. With regard to salt, they suggested a consumption of no more than six grams or one teaspoon per day. In practice, that means cutting to a minimum the use of salt in food preparation, as well as minimizing canned foods, cold cuts (salami, ham, sausage, and others), and smoked foods. Salt intake can also be reduced by refraining from adding extra salt during the meal and by checking the packaging of processed foods to see how much salt has been added.

The Brazilian Consensus also suggested increasing the intake of potassium because it may have an "antihypertensive effect." That being so, a healthful diet should include "foods that are low in sodium and rich in potassium," such as beans, dark green vegetables, bananas, melons, carrots, beets, tomatoes, and oranges. Keeping alcohol intake at a moderate level is also important. Some researchers indicate that hypertensive males should consume no more than one ounce [30 ml] of alcohol per day; and women or those with low body weight no more than one half ounce [15 ml].

The Brazilian Consensus concluded that regular physical exercise decreased blood pressure and thus lowered the risk of developing arterial hypertension. Moderate aerobic exercise, such as walking, cycling, and swimming, for 30 to 45 minutes, three to five times a week is beneficial. Other factors that have been associated with a more healthful life-style include quitting smoking, controlling blood fats (cholesterol and triglycerides) and diabetes, getting an adequate intake of calcium and magnesium, and controlling physical and emotional stress. Some drugs may increase blood pressure, such as nasal decongestants, antacids high in sodium, appetite moderators, and caffeine-containing painkillers for migraines.

Certainly, if you have arterial hypertension, your doctor is in the best position to give you advice on your diet and habits, according to your personal needs. Regardless of your situation, however, adopting a healthful life-style from an early age is always beneficial, not only for hypertensive people but for all the members of the family. Marian, mentioned at the beginning of this article, had to make changes in her life-style. Currently she takes medication and leads a normal life despite her health problem.