Add some spring into your step with these useful articles on health and wellness.
Hypertension: Don’t let it sneak up on you…
by Sharin Mithani
Though there is some natural variability in the population, normal blood pressure is classically defined as levels of less than 120/80 – the top number being systolic (maximum pressure, when the heart contracts), and the bottom number, diastolic (minimum pressure, when the heart is at rest). Your family physician is best able to discern if an elevation from your normal may be classified as high blood pressure, or hypertension. Generally, diagnosis of hypertension requires elevated pressure readings, averaged over three to six visits, of systolic levels greater than 140 or diastolic levels greater than 90 (Chobanian et al, 2003).
CAUSES AND RISK FACTORS
Upon diagnosis of hypertension, an attempt is made to identify the cause. For the most common form of hypertension, primary (or essential) hypertension, the exact cause is unknown. However, multiple risk factors have been identified. A few of these factors include: a family history of hypertension in at least one parent, a high-sodium diet, excessive alcohol consumption, obesity and a sedentary lifestyle. If an exact cause for hypertension is identified, the condition is termed secondary hypertension. Secondary hypertension can be brought on by disorders such as: kidney disease, obstructive sleep apnea, various endocrine disorders and even certain medications (Staessen et al, 2003).
EFFECTS ON THE ORGANS
Whether hypertension is primary or secondary in nature, it has the potential to affect many organs in the body, including (but not limited to) the heart, the brain, both kidneys and the eyes. Starting with the heart, hypertension is one of the most significant risk factors for developing early cardiovascular disease and even having a heart attack (also known as myocardial infarction). The heart is a muscle and is similar in some respects to other muscles in our body such as biceps. When we lift heavier weights, our biceps grow larger to compensate for the greater physical demand. Similarly, growth occurs with the heart muscle when it works chronically harder to pump blood to a higher level of blood pressure within the body. Typically, it is the left side of the heart that grows larger as it is the side that pumps oxygenated blood to the body; this chronic condition is called left ventricular hypertrophy. Over time, the heart can eventually tire out, resulting in heart failure. Hypertension can also lead to stroke, kidney disease, dementia and eye disease (Lorell and Carabello, 2000).
THE SILENT KILLER
Uncontrolled hypertension is sometimes referred to as the silent killer because, while often it does not cause any symptoms, it slowly damages blood vessels, which can eventually lead to organ damage. High pressure can cause stretching and injury to the inner endothelial lining of arteries (vessels that carry blood from the heart to the body). An injured inner lining attracts bad LDL cholesterol that can lead to the formation of atherosclerotic plaques. These fatty plaques can eventually rupture and attract blood cells that form a clot or blockage within the vessel and ultimately lead to heart attack, stroke, blindness, erectile dysfunction or kidney disease, among others. When arteries leading to the kidneys are subjected to chronically elevated pressures, they may become damaged, resulting in less blood flow to the kidneys. This can result in two things: an even higher blood pressure, as the kidneys are responsible for eliminating excess blood volume into urine; and waste build-up in the blood, as the kidneys are one of the body’s filtration systems (Hsu et al, 2005). Finally, uncontrolled hypertension is the most significant risk factor for stroke. Stroke occurs when a blood vessel that leads to the brain either bursts or becomes blocked by a blood clot, resulting in damage to the brain. This, in turn, can lead to damage to body function, vision, speech and memory, among other functions (Thrift et al, 1996).
To prevent excessive damage to the body, various oral medications can quickly and effectively reduce blood pressure to normal levels (Law, Morris, and Wald, 2009). That being said, everyone diagnosed with hypertension should consider lifestyle modifications as advised by a family physician. This may include reducing sodium intake to less than 1,500 mg per day, reducing alcohol intake, maintaining a healthy weight, adopting the DASH (Dietary Approaches to Stop Hypertension) diet, increasing physical activity with daily aerobic exercise, adequate potassium intake, and smoking cessation (Elmer et al, 2006). The DASH diet and weight reduction are very effective in reducing blood pressure. The DASH diet is high in fruits and vegetables and low in saturated fat.
Ask your physician about these adjunct methods of controlling blood pressure. Due to the sneaky nature of hypertension, it is important to work with your family physician on an ongoing basis to find the right treatment plan for this controllable disease.
Sharin Mithani is a resident in family medicine at the University of Ottawa and practises at The Ottawa Hospital and Elisabeth Bruyere Hospital.
Chobanian AV, Bakris GL, Black HR et al. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report. JAMA 2003; 289:2560.
Staessen JA, Wang J, Bianchi G, Birkenhäger WH. Essential hypertension. Lancet 2003; 361:1629.
Lorell BH, Carabello BA. Left ventricular hypertrophy: pathogenesis, detection, and prognosis. Circulation 2000; 102:470.
Hsu CY, McCulloch CE, Darbinian J et al. Elevated blood pressure and risk of end-stage renal disease in subjects without baseline kidney disease. Arch Intern Med 2005; 165:923.
Thrift AG, McNeil JJ, Forbes A, Donnan GA. Risk factors for cerebral hemorrhage in the era of well-controlled hypertension. Melbourne Risk Factor Study (MERFS) Group. Stroke 1996; 27:2020.
Law MR, Morris JK, Wald NJ. Use of blood pressure lowering drugs in the prevention of cardiovascular disease: meta-analysis of 147 randomised trials in the context of expectations from prospective epidemiological studies. BMJ 2009; 338:b1665.
Elmer PJ, Obarzanek E, Vollmer WM et al. Effects of comprehensive lifestyle modification on diet, weight, physical fitness, and blood pressure control: 18-month results of a randomized trial. Ann Intern Med 2006; 144:485.
Fixing the food system in Ottawa: Ottawa Food Policy Council
By Christina Marchant
The food system in Ottawa needs fixing. That’s why, for the past four years, over 300 volunteers have worked around kitchen tables, coffee shops, and boardrooms to create proposals and policy recommendations for action by the new Ottawa Food Policy Council (OFPC).
The OFPC was officially launched in October 2013. The group is working towards a food system in Ottawa that emphasizes social and economic viability and environmental sustainability through the entire food cycle. The vision is a food system in which food is celebrated and enjoyed everywhere, by everyone.
The OFPC is following the path of other local and regional municipalities in Canada, including Toronto and Vancouver. All are working to improve the food system using a mix of municipal policies, programs, and civil-society interventions. Ottawa’s Food Policy Council is a collaboration among citizens, organizations and different levels of government, with the ultimate goal of making policy recommendations on how the local food system can be improved.
The Council is independent and separate from any existing organization. Its members are volunteers, including farmers, restaurateurs, chefs, anti-poverty advocates, community gardeners, dietitians, health specialists, educators, analysts, researchers, city councillors and more.
“The vision is a food system in which food is celebrated and enjoyed everywhere, by everyone.”
For those not familiar with its development, OFPC was established as a result of the Food For All project: a collaborative, community-based food research and action project spanning the years from 2009 to 2012. Food for All was led by Just Food and the University of Ottawa and made possible by three years of funding from the Canadian Institutes of Health Research. Food for All provided the structure, supports and resources, linkages to academic researchers, community partners and organizations and a forum to explore food issues together. Overseen by a steering committee, the process included representatives from community organizations and academic institutions. Over 300 community members participated in workshops, research and policy writing teams. The teams directed their own process, set the policy priorities based on evidence from academic research and other communities’ experiences and ultimately developed a set of food action plan proposals. For many volunteers, this was the first time they had engaged in the policy process (www.ofpc.ca).
Now, the OFPC is springing into action. Here are some of the things we are working on:
- Inviting neighbourhoods and communities to name food security as an essential element of a livable community;
- Advocating to improve access to both healthy whole food and locally-produced food through supportive planning and zoning;
- Working to increase access to healthy food by people living in poverty, with particular focus on those living in “food deserts;”
- Supporting healthy school food environments;
- Supporting a breastfeeding-friendly city.
You can get involved. Come to our public meeting on March 24 at Dominion Chalmers Church, corner of O’Connor and Cooper in downtown Ottawa. Check out our website at www.ofpc-cpao.ca. Become involved in a working group. Invite someone from the council to speak to your neighbours or your community association. Community participation is key to our success!
Christina Marchant is director of the Community Health Promotion & Early Years at the Centretown Community Health Centre.
Spring into cross-training
By Neil McKinnon
Yes, it’s been a long and cold winter. For some (including this writer), the temptation to sit inside, eat chips and stream online TV shows is still overwhelming. But whether you kept active or turned into a couch potato, the Glebe Report has collected a few suggestions of enjoyable activities that will help get you moving again. You do not necessarily have to brave the winter run to get ready for more activity in spring.
Walking is the most common physical activity but, according to Statistics Canada, we don’t do enough of it. Forty-one per cent of Canadians walk less than one hour per week, but the Canadian Community Health Survey advises that to keep moderately active, one should do at least 30 minutes to an hour of walking per day. The Canadian Centre for Occupational Health and Safety recommends more walking to help improve mental health, lower blood pressure and cholesterol, ease back pain and reduce risk of heart disease and stroke. Also, adding on at least an extra 30 minutes of walking per day will help you lose about five kilograms of fat per year. (The writer of this story lost and kept off 20 pounds last year by simply walking more!)
According to Steve Papai, recreation supervisor for Brewer Pool, swimming is a great cardio workout that’s also generous on the joints. “Swimming improves fitness levels because it uses breath control. You’re more buoyant in the water so it is easy on joints,” he says. Swimming is also great for overall toning, as it works your body from neck to toe. Aside from the fitness benefits of swimming, Papai says a lot of people enjoy the social benefits of having a pool membership.
Chinese boxing is Chinese martial arts without the trendy North American name. Sinisa Gajic, owner of Practical Chinese Boxing on Fifth Avenue, says martial arts take the balanced approach to fitness over the fast one, resulting in less disappointment and injury.“ Martial arts are no boot camp. We are not looking for maximum fitness. We lead people to gradual fitness and skill development over time,” says Gajic.
Martial arts can be practised at any age or skill level. To get fit, Gajic says people should be prepared to dedicate about an hour per day toward focused exercise with proper form, no distractions and a goal in mind. The first lesson Gajic teaches his clients is how to use breath as a means of relaxing and increasing energy. “People are often already stressed. Pushing yourself to your limits all the time is counterproductive,” he says. “Many people look for activities that increase tension on their body. I think we are already tense because of all the stress in our daily lives. So you want to relax when you train.”
“Fencing is a super technical sport but people don’t often get injured while doing it,” says Paul ApSimon, fencing coach for the University of Ottawa Gee-Gees. Fencing is a dynamic sport. It’s also a plyometric exercise (jump training), with many stops and bounding directions.“Fencing has a lot of fitness benefits. One of the things people lose later in life is stability,” says ApSimon.
“Fencing is always done in seated stance, or a half squat. We also use a ton of core work, which on its own has a lot of benefits for stability and balance.” ApSimon says that before their first fight, people need to condition themselves by developing power, speed and balance. Otherwise, you’re looking at being exhausted after only a few minutes of work. “You really get into (fencing),” says ApSimon. “After a while of having someone with a weapon in front of you, you step back and realize how much work you’ve done.”
For more information about Paul ApSimon’s fencing classes, contact him at firstname.lastname@example.org or 613-852-3832.
For more information about Sinisa Gajic’s martial arts classes, contact him at practicalchineseboxing.com or 613-233-9878.
For more information about Brewer Pool and Arena, call 613-247-4938.
Neil McKinnon is a freelance contributor to the Glebe Report and an exercise enthusiast.