High blood pressure a silent killer

Posted on Wed., March 12, 2008
By Oliver Graham, MD

NOT LONG AGO, a patient of mine, a seemingly healthy, vibrant woman in her mid-70s, had a massive, incapacitating stroke and died four months later in a nursing home. Before her stroke, she would come to the office feeling fine, but her blood pressure ranged around 180/100.

Both she and her daughter didn't believe her blood pressure needed treatment because "she felt fine."

She didn't have any headaches. She didn't feel "pressure" anywhere. She wasn't dizzy or light-headed. "How could something be wrong if I feel so good?" she would ask.

She simply refused to treat her high blood pressure since she "felt just fine."

High blood pressure, also known as hypertension, is called "the silent killer" because you don't know you have it or that it's damaging you, until it affects your body in serious, permanent and often disabling ways.

In addition, it is often difficult to stay motivated to take medicines on a daily basis because reducing your blood pressure probably won't make you feel better day-to-day.

But there are long-term benefits to reducing blood pressure; the main one is that you stand a better chance of living a long life.

Taking medicine, reducing your salt intake, becoming aware of "target numbers" for your blood pressure and measuring it yourself at home, can help you live a long, healthy life.

Research shows that lowering blood pressure brings 40 percent fewer strokes, 50 percent less heart failure and 25 percent fewer heart attacks.

People with hypertension should look at blood pressure like diabetics look at blood sugar levels: Check it at home periodically, especially if you are not at the right target numbers in your doctor's office.

Writing down the blood pressure numbers, along with the date and time, and bringing them to your doctor's appointment, along with all your medicine containers, can help your doctor adjust your medicines appropriately.

I recommend buying a good-fitting upper arm blood pressure cuff to test your blood pressure at home. They cost about $50 and can be purchased at most pharmacies. Bring it to your appointment to compare its readings to your doctor's.

It is important for those with high blood pressure to know their target numbers. In most people, the target for the top (systolic) number should be less than 140. The bottom (diastolic) number should be less than 90.

People with diabetes, kidney, heart or blood vessel disease should have numbers less than 130/80.

Regular physical activity such as walking briskly for 30 minutes a day can reduce the systolic pressure by 5 to 10 points. Losing weight is another effective way to get your blood pressure down. For every two pounds you lose, you can expect one-to-two points off the systolic pressure.

Other methods include moderating alcohol consumption to two drinks or less per day, reducing salt intake and eating more fruits and vegetables. If you have sleep apnea, wearing a nightly CPAP mask may help get your blood pressure down.

Don't be fooled by how good you might feel when your blood pressure is high. Treating blood pressure may not make you feel better right away, but it will help prevent a stroke, heart attack and kidney failure which can lead to kidney dialysis.

Graham is an internal medicine specialist practicing mostly at Contra Costa Health Services' Pittsburg Health Center, where he co-directs the chronic kidney disease clinic.