Questions & Answers
1. Do people of normal weight who exercise regularly still have to be checked for high cholesterol and high blood pressure?
Although it is true that people who are overweight are more likely to have these conditions, they can affect people who eat very well, exercise daily, and are at ideal body weight. Genetic factors can contribute to both of these conditions, so people who are overweight can have normal blood pressure and cholesterol, while people who are at ideal weight can have high blood pressure and high cholesterol.
2. If the nutrition label on my favorite food indicates it has no cholesterol, does that mean it’s a heart-healthy food?
Nutrition labels on food are very helpful when choosing heart-healthy foods, but you need to know what to look for. Many “low-cholesterol” foods contain high levels of saturated fat and/or trans fat — both of which contribute to high blood cholesterol. Even foods that claim to be “low-fat” may have a higher fat content than expected. On the list of ingredients, the first ingredient listed is the one used most in the product, so choose products where fats and oils appear later in the listing.
3. If someone is on medication for high cholesterol or high blood pressure, is it all right to eat anything he or she wants?
Drug therapy is usually prescribed for those who — despite adequate dietary changes, regular physical activity and weight loss — still have elevated levels of cholesterol or high blood pressure, or those who have elevated risks for heart disease and stroke. But making diet and lifestyle changes — as well as taking the medication your doctor prescribes — is the best way to help prevent heart disease. You should still eat a heart-healthy diet and get at least 30 minutes of physical activity most (preferably all) days of the week. It’s also very important to take your medication exactly as your doctor has instructed so it can work most efficiently.
4. Is it necessary to take blood pressure medicine even when a person feels fine?
High blood pressure is a lifelong disease. It can be controlled but not cured. If your doctor has prescribed medication for you, take it exactly as prescribed for as long as the doctor tells you to take it. Decreasing dosage or not taking the medication is dangerous. It’s also important to make the right lifestyle changes by eating a low-salt, low-saturated-fat diet; maintaining a healthy weight; getting plenty of physical activity (30 - 60 minutes on most or all days of the week); and staying away from tobacco products. This will help control your blood pressure and thus reduce your risk for stroke, heart attack, heart failure and kidney disease.
5. What over-the-counter drugs should a person with high blood pressure avoid?
People with high blood pressure should know that taking certain cold, cough and flu medications could be dangerous. Decongestants (particularly those that contain pseudoephedrine) have been reported to increase blood pressure and may interfere with blood pressure medications. If you’re one of the 65 million Americans who have high blood pressure, make sure to choose cold and flu medications that don’t contain decongestants.
Maria-Pamela Janairo of the Disparities Solutions Center assisted in the preparation of these responses.
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Joseph R. Betancourt, M.D.
Director of the Disparities Solutions Center, Massachusetts General Hospital
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