High blood pressure
A silent and dangerous killer
Karen Miller | 12/9/2015, 4:30 p.m.
Many people have trouble taking medicine when they feel fine and have no symptoms. That’s the problem with high blood pressure.
For the most part, high blood pressure is a silent assailant — even when it’s dangerously high. That’s one of the reasons that adherence to a medication regimen for the disorder is low. Roughly half of Americans treated for HBP adhere to their long-term therapy, noted the Centers for Disease Control and Prevention.
That’s a mistake. The disorder wreaks havoc — under the cover of silence. Lack of control of HBP can cause heart failure, heart attack, blindness, kidney failure, stroke and even dementia. That’s a hefty price to pay for a disease that for the most part can be easily controlled with medication and healthy lifestyles.
High blood pressure, also known as hypertension, is one of the most common medical conditions in this country. The American Heart Association estimates that 80 million, or one-third of the U.S. adult population is afflicted.
Blood pressure is the force exerted against the walls of the arteries when the heart contracts or beats. Arteries are the blood vessels that carry oxygen and nutrients to muscles and organs. The upper number, or systole, measures the pressure when the heart beats. The bottom number, or diastole, measures the pressure when the heart relaxes between beats.
Both numbers are important. “Both are associated with heart disease, stroke and heart failure,” explained Dr. Myechia Minter-Jordan, the CEO and president of The Dimock Center in Roxbury. “We look at them equally and treat if even just one is high.”
Normal blood pressure is less than 120/80; high blood pressure is 140/90 or more. In between the two is pre-hypertension — 121/80 to 139/89 — which is typically not treated. Recent research, however, suggests that even pre-hypertension can cause complications down the line.
Treatment for HBP is not cookie-cutter. “It varies by the individual,” Minter-Jordan explained. Severity, age and even race are considered. For instance, according to the Mayo Clinic, older people and African Americans can often control their pressure more effectively with calcium channel blockers than with other medications. Additionally, regardless of the type of medication, black people can often more successfully control their pressure with two medications, one of which is a diuretic to help rid the body of excess fluid, Minter-Jordan explained.
There are two types of HBP. Primary or essential — the most common type of HBP — has no identifiable cause, and tends to develop gradually over many years. Secondary HBP, on the other hand, is due to an underlying, identifiable condition, such as tumors and thyroid conditions.
In some cases, HBP occurs beyond one’s control. Age, race and family history play significant roles. Certain chronic conditions, such as kidney disease, diabetes and sleep apnea can increase the risk of HBP, as do some medications, including birth control pills and some over-the-counter medications.
More often than not, however, we bring it on ourselves. We are our own worst enemies. Unhealthy lifestyles contribute to the disorder. Overweight and obesity, lack of physical activity, tobacco use, excessive alcohol use and diet are all controllable factors. Stress can also increase the pressure, but is typically temporary. Pressure can return to normal when the stress subsides.