BY YOLANDA BRUNSON-SARRABO Hypertension, or "High Blood Pressure” is  a prevalent topic for myeloma patients. Some patients may feel like hypertension springs up out of the blue, but does it really? Oftentimes we may shrug off signs that something else is going on, especially when trying to maintain multiple myeloma.  The thought may be “Now what… something else to deal with”, but this something else can be a huge deal. What is High Blood Pressure? The cause of high blood pressure is not easily defined, but it‘s suggested that anyone can develop the disease. Although it’s not curable it can be managed once you’re diagnosed. Blood pressure is the force of blood pushing against blood vessel walls. High blood pressure (HBP) means that the pressure in your arteries is higher than it should be. Your pressure is defined by two numbers that include systolic and diastolic readings. A pressure reading generally of 120/70 is normal, whereas 140/90 is borderline stage 1 high pressure. Systolic pressure refers to the first and top number when reading results. It’s the amount of pressure in your arteries during contraction of your heart muscle when compressed. Diastolic refers to the bottom number when the heart rests between the beats.  High blood pressure can lead to strokes, heart attacks and seizures. Stages of High Blood Pressure

• Low Normal=90/60
• Normal=90-119/60-90
• Pre-Hypertension=120-139/80-89
• Stage 1 Hypertension=140-159/90-99
• Stage 2 Hypertension=160+/ 100+

Patients may already have a hectic myeloma maintenance schedule, but adding blood pressure meds on top of that may be more normal than not. Many of the treatment medications tend to heighten the blood pressure, such as Krypolis (Carfilzomib). Though I do have a family history of hypertension, I did not have high blood pressure until I started Kryoplis. I’m on the smallest Kyprolis dose there is, but now that I’m faced with this first hand, I see how important it is to follow the regimen for maintaining a normal blood pressure. I remember years ago I introduced my mother, who had high blood pressure, to alternative options rather meds, and one day I asked her what would happen if she stopped taking her pills. Her answer was golden… she said “I would die”. Now that I’ve had a few close calls when it comes to watching my pressure, I totally get it now. High blood pressure is nothing to play around with - period! What to Consider When Maintaining Your Pressure: Nutrition Although excessive salt (which is highly concentrated in pre-packaged and restaurant foods) can be a driver of high blood pressure, a recent study also showed that people with high blood pressure also have lower levels of potassium, calcium and magnesium. If you’ve never paid attention to the amount of sodium certain foods hold before, now is the time to take it in consideration. Limiting the amount of salt in your diet can be the right move in maintaining your blood pressure. Another good move may also be to make sure you are getting the recommended daily allowances of magnesium, calcium and potassium. The intake of water holds a huge importance, but too much water (believe it or not) can increase your pressure, which is why some patients are prescribed diuretics (water pills) along with HBP meds to balance maintenance. Including a healthy portion of vegetable and fruits are encouraged, as well as limiting your alcohol intake. Stress This is always a challenge in handling myeloma in general, but lowering the amount of stress in your life is suggested to help lower your blood pressure. If you feel like you’re heading to zone 10 with a piercing headache as well as pounding heart palpitations then that means it’s time to settle down. Some great stress relievers are yoga, exercise, sitting in a quiet dark room until you feel calmer. Exercise Wouldn't exercise actually increase my blood pressure? Well believe it or not, moderate and light exercise does the body and heart good when you achieve those goals at a pace that is sensible. Check with yoru doctor to see how you can get started with an exercise program that is right for you. Family History/ Age Well speaking from experience, family history and age do play a factor in your spike in blood pressure. As long as you’re diligent being mindful of this and making gradual improved health changes then you are heading in the right direction and can manage high blood pressure, no matter your genetics. Now I understand why things such as getting blood pressure reads multiple times during treatment is necessary. Heart disease is important to consider when facing multiple myeloma, as there are so many direct consequences to your overall health. The heart literally is our lifeline.  As long as everyone on your team is up on monitoring your condition from all aspects, you should be fine.