Tuesday, April 3, 2007

High Blood Pressure - The Silent Killer

So much has been written about hypertension (high blood pressure) that we physicians think patients already know all there is to know. We forget that of the 50 million Americans that have hypertension, 1/3 don't even know they have it. Also, it is human nature to pay attention to something only when it has a direct connection to our lives. As we age, high blood pressure becomes more of an issue. In case one of the readers of EverythingHealth has just been diagnosed or has never even had their blood pressure tested, I offer this information....and I hope it is useful.

Blood Pressure is always reported as two numbers and normal blood pressure is 120/80 or below. The top number is the systolic (blood flowing through the arteries when the heart is contracting). The bottom number is the diastolic (pressure of the arteries when the heart is resting between the beat). Hypertension is a reading of 140/90 or above. If a persons blood pressure is over 140/90 on 3 testings, it is hypertension and needs attention to bring it down to a normal range.

Why do we care? Hypertension can cause stroke, heart failure, heart attack, aneurysm and kidney failure. If you smoke, drink heavily or have high cholesterol on top of hypertension the risks increase.

Here are some myths:
* "I can feel my blood pressure when it is high" (anxiety can be felt, high blood pressure is silent)
* "My blood pressure is only high when I see you, doctor" (even episodic hypertension is dangerous and it is probably higher on other occasions)
* "I know lots of people who weigh more than I do and they don't have hypertension"
(overweight people have twice the hypertension as normal weight folks)
* "But I'm thin, I can't have hypertension" (thin people can have hypertension-it isn't always weight related)
* "But I've always had low blood pressure" (we don't know the cause of most hypertension. Blood pressure rises with age and genetics play a roll)

The good news is that most hypertension can be controlled with lifestyle changes and medication. Weight loss, regular exercise and avoiding salt may be all a person with mild hypertension needs. If that is not effective after a few months, there are many prescription medications that will bring blood pressure to the normal and safe range. The good news is that there are dozens of different medications that work so we should be able to find one that is easy to take, doesn't cause any side effects and is effective.

Control of hypertension is one of the reasons fatal heart attacks have decreased over the past few decades. It is an important risk factor and even a "little" high blood pressure should be lowered. It's fine to start with lifestyle changes but get it checked again soon and don't be afraid to start on medication if the pressure is still elevated. Don't forget, there are no symptoms but that doesn't mean it isn't there.


Judy S said...

Great new photo, Ms. Toni.

You inspired me to take my BP tonight. It's 133 over 78 on the right arm; 118 over 68 on the left arm. It's usually higher on one side. Does that makes sense?

(I realized that blog comments are not the place for official medical advice, actually)

However, I'm on Quinipril and it seems to be working very well, so I second Toni's advice.

Toni Brayer MD said...

Your blood pressure seems well controlled on your medication and it is common to get slightly different readings on either arm.

Everyone who takes blood pressure medicine should get their own BP cuff so they can monitor at home just like Judy did.

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