This month Dr. Jacques Doueck interviews Dr. Albert Matalon

Dr. Albert Matalon

Dr. Albert Matalon is an Assistant Clinical Professor of Medicine at NYU School of Medicine and an adjunct Associate Professor of Medicine at Weill Cornell Medical College. He specializes in hypertension and kidney disease.

Why is high blood pressure (hypertension) called the “silent killer?”

Hypertension, or high blood pressure, is one of the leading controllable risk factors for heart attack, congestive heart failure, stroke, kidney disease, and vascular disease. Hypertension is called the “silent killer” because there are usually no symptoms – someone will only know he has high blood pressure if he has his blood pressure checked.

What blood pressure is considered high?

Hypertension is not black and white, rather it falls upon a spectrum – the higher the blood pressure the worse the risk of dangerous outcomes. Studies show that by decreasing systolic blood pressure (the “top” number) from 150 to 140 you can decrease the risk of stroke by 50%. Decreasing systolic blood pressure from 140 to 130 lowers the risk by an additional 50%, and going down from 130 to 120 drops the risk by another 50%. The healthiest blood pressure is around 122/70.

How can I treat and prevent hypertension?

The ideal way to treat mild hypertension is via a healthy diet and regular exercise. The most important dietary modification you can implement to lower blood pressure is cutting out salt from your diet.

Why is an awareness of your salt intake so important in controlling hypertension?

High blood pressure is driven by salt. Restricting the salt in our diets to less than two grams daily can lower blood pressure by 10-15 points, and sometimes more. I have several patients who were able to discontinue all blood pressure medications by being exquisitely careful with their salt intake. This is easier said than done – the average amount of salt the American diet is greater than 5g a day, and in kosher diets heavy in Middle-Eastern foods the amount can be as high as 7g daily. Most salt in our diets does not come from the salt shaker – it comes from foods that already contain high amounts of salt, such as processed or packaged foods, canned foods, instant soups, cheese, pickles, olives, smoked foods, and snack foods. The biggest problem for us lies in restaurant cooking or catered menus (including the Mazza that we love!) All food prepared out of the house is absolutely loaded with salt, whether it tastes salty or not.

I don’t really have an extra hour a day to exercise. What can I do?

Regular exercise and weight loss are lifestyle modifications that can improve blood pressure, so it’s important to try to fit them into your life. They do not need to be excessive to have an effect – even a 20 minute walk three times a week and a weight loss of 5-10 pounds can have a favorable effect on blood pressure. Of course, the more exercise prone and weight conscious you are, the better!

When is medication needed?

When lifestyle changes are not adequate to get blood pressure into the desired range, medications must be added. It is important to take your blood pressure medications religiously and not miss doses even if you feel fine, because hypertension causes damage even when you don’t feel it occurring.

What’s the bottom line where blood pressure is concerned?

Always cook your own foods and use fresh ingredients. If you exercise several times a week and control your weight, your body will look as good inside as it will outside!