Blood pressure vigilance key in heart health efforts

Dr. David Portugal attended medical school at the University of Texas and completed his residency and interventional cardiology fellowship at Tufts Medical Center in Boston, Mass.

Portugal has been in private practice since 1998 and currently serves as committee chairman for the citywide Cardiology Clinical Program Committee for Memorial Hermann Healthcare System.
The No. 1 cause of stroke in this country is high blood pressure, or hypertension, which Portugal said is a major risk factor for heart attacks.
“If left untreated, it can lead to congestive heart failure,” he said. “So knowing what your blood pressure is and keeping it in the normal range is extremely important.”
Portugal said both the systolic and diastolic blood pressure readings are important, with diastolic hypertension, or elevation of the lower number, more common in younger individuals and isolated elevation of just the top number, or Isolated Systolic Hypertension (ISH), most common in patients over the age of 50.
“In elderly patients over the age of 70, the arteries become quite stiff, which can lead to an actual lowering of the diastolic pressure,” Portugal said. “So, they have on one hand isolated systolic hypertension, but a low diastolic pressure. This widened pulse pressure is an independent risk factor for cardiovascular events in the elderly.”
Hypertension is known as the “silent killer” due to its lack of symptoms, so Portugal recommends that everyone have a general physical with their primary care doctor at least once a year. He also said blood pressure can be taken anywhere -- local pharmacies, fire stations or even a nurse at school or work.
“I actually encourage all my patients to purchase their own blood pressure machine so they get in the habit of checking it on a regular basis. Moreover, I have them keep a blood pressure diary that they can bring to their appointment to review,” he said.
In the majority of patients, according to Portugal, heart disease is preventable.
“The most obvious place to start is to not smoke,” he said. “One should participate in a vigorous exercise program at least three or four times per week. When I say vigorous, this means getting your heart rate up and working up a sweat. I generally recommend at least an hour workout for my patients, which could include stretching and warming up 10 minutes, followed by a good cardiovascular workout like biking, swimming or walking, as well as some weight training for 15 minutes.”

NAME: David Portugal, M.D.
OCCUPATION: Cardiologist
COMMUNITY CONNECTION: Works at Memorial Hermann Medical Group Cardiology Southwest
FAST FACT: Portugal wears a red dress pin on his lab coat on each annual national Wear Red Day, a campaign developed to raise awareness among women that heart disease is actually the No. 1 killer of women.
Mark DeHaven is a freelance writer. He can be reached at neighborhoods@chron.com.