By Dr. Paul Martiquet. You know you have high blood pressure when… Actually, the only right answer is: when it is measured. The implications of having high blood pressure, or hypertension, include many life-threatening complications and problems. Thus, the “silent killer” moniker. Of the millions of Canadians that have hypertension, only about one in four knows it. The rest go on about their lives with, in effect, a ticking time bomb inside them.
When you have high blood pressure, the force of the blood against your artery walls is too strong. This can lead to damage to arteries, heart and kidneys, and may lead to atherosclerosis and stroke. Hypertension develops slowly and can cause serious organ damage, usually with no warning symptoms.
Only direct measurement can identify hypertension. Most people have seen the pressure cuff strapped onto the upper arm of a patient, the doctor cradling his or her arm and listening with a stethoscope. But what is going on?
First, the bladder inside the cuff is inflated sufficiently to cut off blood flow. Then, that pressure is released until the doctor hears blood begin to flow. This is the systolic pressure, or the pressure of blood against artery walls when the heart has just finished pumping (contracting). This is the first or top number of a blood pressure reading.
Then, pressure in the cuff is reduced further until there is no compression of the artery and blood flows normally. This gives the diastolic pressure, or that of blood against artery walls between heartbeats, when the heart is relaxed and filling with blood. It is the second or bottom number in a blood pressure reading. Together, the blood pressure reading is given in the form of systolic over diastolic, for example, 125/85 (125 over 85).
The risk level associated with blood pressure readings varies on a continuum, but there are generally agreed-upon ranges of danger. What is considered the “normal range” is less than 120 over less than 80 (<120/<80). Pre-hypertension is 120-139 over 80-89. Stage 1 hypertension is in the range of 140-159 over 90-99; and Stage 2 is more than 160 over more than 100. The exact causes of high blood pressure are rarely identified, but several factors are known to increase it: obesity, a family history, heavy alcohol use, high salt intake, and aging. A sedentary lifestyle, stress, low potassium intake, low calcium intake, and resistance to insulin may also cause your blood pressure to rise. Now for the good news. Hypertension, once diagnosed, can be managed. Yes, there are medications that will reduce blood pressure (if the situation has become that bad), but the best answer is in the choice of self-management. Healthy food, exercise, less salt, losing weight, and less alcohol can all be part of the plan. On average, doing any one of these can reduce blood pressure by as much as 10 or more points, systolic and/or diastolic. Specifically: Change to healthy diet -11.4 / -5.5 5 kg weight loss -7.2 / -5.9 2-3 fewer drinks per day -4.6 / -2.3 More exercise -10.3 / -7.5 Less or no salt added to food -5.8 / -2.5 Having your blood pressure taken is simple and painless, and could mean early diagnosis of a life-threatening situation. Avoid becoming a victim of this silent killer — have your blood pressure checked tomorrow. Dr. Paul Martiquet is the Medical Health Officer for Powell River/the Sunshine Coast/Sea-to-Sky/Central Coast.Paul can be reached at: paul.martiquet@cgh.bc.ca
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