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Checking your blood pressure can help save your life

By Dr. Gulshan Harjee Email By Dr. Gulshan Harjee
February 2013
Checking your blood pressure can help save your life

The most commonly diagnosed condition in my office is hypertension or high blood pressure (HBP). Most of my patients had never been told they had it, nor had they felt any symptoms that made them suspect it. However, when silently lurking without treatment, it is one of the most dangerous conditions—the “silent killer.”

About 75 million people in the U.S., or about 1 in 3, have HBP. And almost another third have prehypertension— blood pressure numbers that are higher than normal, but not yet in the high blood pressure range.

More than half those with HBP do not have it under control. Some may be avoiding treatment because they don’t feel ill and are in denial, or because they worry about side effects, not understanding that the untreated condition is a bigger problem than a minor side effect that may not even happen. Others prefer natural products that may not work as well as prescriptions.

How does HBP work, and what can it do to you?
Blood pressure (BP) is the force of blood against your artery walls as it circulates in the body. BP normally rises and falls throughout the day, but it can cause health problems if it stays high for a long time: it can harden the arteries, decreasing the flow of blood and oxygen to the heart, causing:
• Chest pain (angina),
• Heart failure (when the heart can’t pump enough blood and oxygen that your body needs),
• Heart attack (when the blood supply to your heart is blocked and heart muscle cells die from a lack of oxygen).

HBP can also break or block arteries that take blood and oxygen to the brain, causing a stroke. Heart disease and stroke are leading causes of death in the U.S.

Diagnosis:
BP is measured using two numbers. The first (systolic) number represents the pressure in your blood vessels when your heart beats. The second (diastolic) number represents the pressure in your vessels when your heart rests between beats. Hypertension is defined as a BP measurement higher than 140/90. Prehypertension begins at 120/80. Normal BP is less than 120/80.

A chest x-ray and electrocardiogram (EKG) may be performed, and blood work and urinalysis should be done.

Treatment:
About 5% of HBP is called secondary, because it comes from kidney failure or congestive heart failure. Although we don’t know the reason for the other 95% (called essential HBP), we can treat it so that it doesn’t cause problems.

Monitor your pressure. Some patients feel so nervous at the doctor’s office that their BP rises there (“white coat syndrome”). Therefore, patients with HBP may bring their own BP meter and their home-recorded measurements to the doctor to compare with the office readings.

See if simple changes in lifestyle will bring the BP down.

Diet: Eat a healthy diet, low in salt, total fat, saturated fat, and cholesterol, and rich in fiber, especially from fruits and vegetables.

Exercise: Try a brisk 10-minute walk outside or on a treadmill, 3 times a day, 5 days a week. Aerobic exercise that keeps the heart rate around 155 for about 45 minutes can help. Elderly patients must walk to exercise as much as their condition allows.

Weight: Maintaining an ideal body weight is mandatory. Get to an ideal body mass index (BMI).

Quit smoking as soon as possible. Drinking should be reduced to moderate, slowly over one to two weeks. Ask your doctor about side effects of drinking with your medication.

Medication: Follow your doctor’s instructions and stay on your medications. There are many types: ARB agents and ACE inhibitors are first line these days; other options are calcium channel blockers, beta blockers, alpha blocker, and diuretics.

Remember, treating hypertension is lifesaving, to avoid congestive heart failure, coronary disease, kidney disease, and diabetes occurrence or complications.

[Gulshan Harjee, M.D., is a board certified internist in private practice with an emphasis on prevention. Please email your health and medical questions for consideration in this column to: gharjee@comcast.net. The material in this column is of a general nature, and must not be construed as specific medical advice. This column rotates monthly along with the Fitness Lifestyle column by Aarti Patel.]

 


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