What you need to know about high blood pressure

Do you have high blood pressure?

If you’re an adult you have a one-in-five chance — and your lifetime risk for developing hypertension is 90 per cent. Your risk may be even higher if you have a family history of high blood pressure, heart disease, kidney failure or strokes.

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Blood pressure is the measurement of the pressure of blood inside your blood vessels, specifically, the brachial artery of the upper arm. A normal blood pressure of 120/80 (120 over 80) represents a systolic pressure of 120 mm Hg (when the heart contracts) and a diastolic pressure of 80 (when the heart relaxes).

But blood pressure is more than just a number.

High blood pressure damages the delicate inner walls of arteries throughout the body, including the kidneys, brain, heart, eyes and extremities. Over time, it contributes to atherosclerosis (narrowing of arteries), manifested as progressive kidney failure, loss of circulation to your feet and legs, dementia, loss of vision, erectile dysfunction, heart failure (weakness in the pumping of the heart) and angina (chest pain due to impaired circulation to the heart muscle).

The catastrophic end results are premature heart attacks, strokes, blindness, kidney failure requiring dialysis, amputations of toes and feet, aneurysms (the expansion and rupture of blood vessels in the chest, abdomen or brain) and end stage heart failure. 

Unless you have it measured, you won’t know your blood pressure. Most people with high blood pressure feel perfectly fine. That’s why it’s recommended that all adults have their blood pressure measured “at appropriate medical visits.” I recommend at least once a year.

High blood pressure may be caused by medical conditions such as kidney disease or an overactive thyroid, by medications including ibuprofen or an unhealthy lifestyle. However, 95 per cent of people with high blood pressure have essential hypertension that is often genetic. Blood pressure also increases with age.

White coat syndrome is a real condition, wherein a person’s blood pressure is much higher when taken by a doctor or nurse than at home. For this reason, many clinics now rely on automated office blood pressure machines. The operator sets it up, leaves the room and allows the machine to take three measurements. I ask my patients to measure and record their home blood pressures with a reliable machine, which we compare to our office equipment.

If blood pressure is never high at home or work, we don’t prescribe medications. However, some people have significant rises in their blood pressures with stressful situations, including their work. If the blood pressure is high at least eight hours a day (i.e. at work) in addition to the medical clinic, it should be treated.

I coined the term “White Collar Syndrome” when I discovered that my patient — an accountant — had the highest pressures when he was at work.

As a physician, I want my patients to maintain safe blood pressure levels and avoid long-term complications. Medications have a potent effect in lowering blood pressure, but they are not addictive and don’t make the body dependent any more than before they’re started.

I have many patients who have been able to reduce the doses and numbers of medications they take through major lifestyle changes. Some now have normal blood pressures without any drugs.

These potent lifestyle changes include quitting smoking, limiting or stopping alcohol, increased physical activity, weight loss (if overweight), eating more fruits and vegetables and less red meat, and limiting sodium (salt) in the diet.

On Monday, August 21st at 7 pm, I’m presenting, “What You Need to Know About High Blood Pressure” at the Tommy Douglas Metrotown Library in Burnaby. This free presentation is sponsored by the Burnaby Division of Family Practice and the Burnaby Public Library. Because seating is limited, please register by phone at 604-436-5400, in person at any branch or onlineat bpl.bc.ca/events/what-you-should-know-about-high-blood-pressure-0.

Dr. Davidicus Wong is a family physician. To learn more about upcoming health education events, see the BDFP website at divisionsbc.ca/burnaby. For more on achieving your positive potential in health: davidicuswong.wordpress.com.

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