Cardiologist
Juan R. Amell, M.D.
answers your questions
about High Blood Pressure...
|
|
 |
Q: I’ve always thought that high blood
pressure was just one of the consequences of getting older. What causes
it?
Dr. Amell: While the cause for this
condition can be pinpointed in some cases, the exact cause of this silent
killer that affects more than 60 million Americans remains a medical mystery.
We know that calm, collected individuals are just as susceptible to hypertension
as are highly active people. A person’s odds of having high blood pressure
are greater if one or both parents had it; Blacks are twice as likely to
have it as Caucasians; and obesity is also a major risk factor — as is
diabetes. We also know that smoking significantly reduces the benefit
of blood pressure lowering medications, and is a risk factor for heart
disease.
Q: What, exactly, is blood pressure?
Dr Amell: Let’s start with the basics. Each beat of the human heart
— 60 to 70 per minute — pumps two to three ounces of blood into the large
arteries leading to all of the body’s organs. Between beats, theheart refills
with blood. If there are no obstacles, blood will flow freely throughout
the system. Blood pressure is the force exerted against the walls of the
arteries that conduct the blood throughout the body.
Q: I know blood pressure is measured
by inflating a cuff on the upper arm, but what do those numbers mean?
Dr. Amell: In simple terms, blood
pressure readings measure the force of the blood against arterial walls
in two stages — when the heart beats to pump blood out of the heart and
when it relaxes to refill. The first is called systole, and the
second is diastole. A reading of 120 over 80, for example, indicates
a systole (beating) pressure of 120 and a (between beats or resting) diastolic
pressure of 80. Anything under 140 over 90 is considered within the normal
range. High blood pressure — hypertension — results when the blood encounters
resistance in moving throughout the body, building up pressure against
the walls of the vessels, which forces the heart to work harder. A high
systolic number may be of some concern, but doctors are usually more concerned
with the second number, especially when it is consistently over 90.
Q: How serious is hypertension? Can it be fatal?
Dr. Amell: Absolutely. High blood pressure contributes directly or indirectly
to about one million deaths each year and accounts for more doctor visits
and prescriptions than any other medical problem. If left untreated, high
blood pressure causes the walls of the small arteries to thicken (which
reduces the flow), and weaken (which increases the chance of rupture).
If this continues long enough, the result can be a heart attack, stroke,
kidney damage or a number of other potentially life-threatening problems.
Q: How do you know if you have high blood pressure?
Dr Amell: Unfortunately, in most cases, you don’t. It is called the
"silent killer" because it rarely causes any symptoms. That means that
the disease can do virtually all its damage before it is detected. Hypertension
is most often discovered during a routine physical exam or even by a screening
at a health fair, for example. It takes more testing to confirm the diagnosis,
however, and to determine the severity of the condition before appropriate
remedies can be recommended. For a diagnosis of hypertension, the blood
pressure readings must be consistently high on several different occasions.
Q: If I have all the risk factors for high blood pressure, does that
automatically mean that I will get it?
Dr Amell: No, although it certainly increases the odds. Fortunately,
there is no need for high blood pressure to be fatal or even to occur in
the first place. It certainly doesn’t have to interfere with leading a
normal, healthy lifestyle. Discovering that you have high blood pressure
gives you the chance to add years on to your life. The good news is twofold:
you may be able to prevent hypertension by making some lifestyle modifications,
and, if you are diagnosed, most cases can be kept under control.
Q: Are you saying it can actually be
prevented?
Dr. Amell: Yes, sometimes, although
it takes a strong commitment to a life-long regimen to accomplish this.
There have been lots of suggestions from researchers across the country
about things people can do to prevent high blood pressure. Before starting
on a prevention program, however, consult your physician to make sure what
you propose is consistent with your overall health. Here are some options
to ask your doctor about:
Learn to control stress; get plenty of exercise at least three times
a week; cut down on your salt intake; watch your weight and get rid of
those extra pounds sensibly; and eat plenty of fruits and vegetables to
get lots of vitamin C and minerals like potassium and calcium.
| Some researchers suggest getting a dog, because having a pet is a calming
influence. Strangely enough, study after study shows that petting or talking
to your pet brings blood pressure down and keeps it down as long as the
contact with the pet is maintained. Other remedies in the news are eating
garlic and broccoli. |
|
 |
Recent studies have shown eating tomatoes to be especially beneficial to
men, who face a slightly higher risk of high blood pressure than women.
Tomatoes are high in vitamin C which can help lower blood pressure and
the lycopenes in tomatoes have been found to lower the risk of prostate
cancer in men who eat tomatoes several times each week. That also goes
for pizza, spaghetti sauce and even catsup! But be careful not to load
them down with extra salt — which would negate all their other benefits,
and learn to read the labels on the foods you eat. And, finally, lighten
up a little. Get in a good laugh several times a day (Read
Laughter
and Stress) You’ll be amazed at how much better overall
you’ll feel.
Q: If lifestyle and diet modifications don’t correct my high blood
pressure, how else can you treat it?
Dr. Amell: Fortunately, over the past decade, there have been numerous
advances in the development of antihypertensive medications. They have
been shown to work best, however, when patients take them in concert with
a healthy diet and plenty of exercise. The important thing to remember
about blood pressure medication is that every case is unique and medications
are not interchangeable. In reaching an appropriate prescription, we have
to take into consideration drug interactions and the patient’s overall
health. The first line treatments include diuretics, which help the body
get rid of excess fluids, and beta-blockers, which reduce the workload
of the heart. Two newer types of drugs — calcium channel blockers and ACE
inhibitors — have been found to be quite effective with fewer side effects.
In many cases, it is appropriate to use ACE inhibitors — designer molecules
that attach to a target enzyme and prevent it from triggering a signal
to release a blood pressure increasing hormone — as the first line of treatment.
Again, an appropriate treatment plan is based on test results and the
patient’s overall condition, and may involve a combination of medications.
Control of high blood pressure with a minimum of side effects calls for
close cooperation between patient and physician.
The biggest obstacle to success is compliance — many people simply don’t
take their medications as directed. If problems occur with one treatment
option, there are other medications to try. The important thing is to arrive
at an effective treatment plan and stick to it.
If you fall in the high risk category for high blood pressure, or
have had several high readings in recent months, make an appointment with
your doctor as soon as possible. It is never too early to start on a hypertension
prevention plan.
|
