Blood pressure - we ALL have it !

[Doc Alan]

The heart is a pump, and blood pressure is measured as systolic ( force of heart contraction ) / diastolic ( heart relaxation as it takes up blood) in mmHg ( millimetres of mercury). In a normal adult it should be around 120/80. It has a "skewed normal distribution", meaning there is a continuous range. Risks of increased blood pressure ( hypertension) thus gradually increase, with investigation and treatment becoming more important.

In most cases there are no symptoms and no cause, such as kidney / endocrine disease, can be found ( essential hypertension). At least 1/5 of the population in UK, Philippines, and elsewhere in the world have hypertension.

It's so easy, and vital, for your doctor to check your blood pressure ! There are also machines which can be used at home (www.bhsoc.org/how_to_measure_blood_pressure.stm).

Why bother ? . Hypertension increases risk of stroke, heart attack / failure, eye, kidney and artery disease. There may be a treatable cause (5%), especially in young people. Drug treatment is effective, as also are lifestyle changes ( stopping smoking, reducing weight, exercise, healthy diet ).

Whom to treat ? All with moderate hypertension ( 160/100 + ). Some with mildly raised blood pressure (140/90 +), depending on other factors like diabetes. All with severe hypertension (180/130) - only these are likely to have any symptoms.

Visiting your doctor can raise your blood pressure ( "white coat effect") by up to 15 mm . That's why it's best to have it measured at least twice and as relaxed as possible ! Only your doctor can decide whether or not treatment is needed, depending on individual circumstances. But a 5 minute blood pressure check up every 2 or 3 years is worthwhile !

[joebloggs]

thanks Doc Alan

funny you post this now, i was asking my misses the cause of my high blood presure (190/110) , i'm on meds now its down to 130-140 / 80-90

she said doesn't really know

another cause .

http://www.webmd.com/stroke/news/201...er-stroke-risk

[Terpe]

thanks Doc Alan

funny you post this now, i was asking my misses the cause of my high blood presure (190/110) , i'm on meds now its down to 130-140 / 80-90

she said doesn't really know

another cause .

http://www.webmd.com/stroke/news/201...er-stroke-risk

Sounds same as me joe.
I take 3 meds every day:-
Amlodipine
Atenolol
Perindopril

I had no idea I had High Blood Pressure until I applied to join a gym when we came to live in UK.

I put it down to the 33 years as a business traveller enjoying too much alcohol, too many ciggies, too much rich foods and not enough exercise.

I wonder if being married is attributable

[joebloggs]

Sounds same as me joe.
I take 3 meds every day:-
Amlodipine
Atenolol
Perindopril

I had no idea I had High Blood Pressure until I applied to join a gym when we came to live in UK.

I put it down to the 33 years as a business traveller enjoying too much alcohol, too many ciggies, too much rich foods and not enough exercise.

I wonder if being married is attributable

i take lisinopril 20mg a day

i didn't know either til i woke up and thought my wife and kids were sat on my chest and misses rushed me to hospital

dont drink or smoke, what do i do

i put it down to been married to

[Doc Alan]

I estimate 1/ 5 members and / or their relatives have blood pressure high enough to need treating . I posted the thread in response to a question about a relative in Les_taxi's "Fitness" thread .
It's true in 95 % of cases there isn't a single treatable cause, but a huge amount is known about high blood pressure / hypertension. The drugs listed by joebloggs and Terpe all act in different ways on the heart and body's blood pressure to achieve the desired blood pressure level.
What we know about "essential hypertension" applies to the 95% without one cause - but the factors below don't apply to everyone .
* Genes : several identified ( "polygenic" ). Use is made of this knowledge in drugs used for treatment.
* Environment :
1. Stress - whatever the cause ! City dwellers have higher blood pressure than rural populations.
2. Other lifestyle factors - stop smoking ; lose weight ; reduce excess alcohol intake ; reduce salt and fat, and increase fruit and vegetables in diet; increase exercise ; treat other conditions like diabetes. All of these affect blood pressure in addition to general health .

[fred]

My bro inlaw says it runs in his family and that meds are far too expensive too consider,considering he has never felt ill effects!! (probably since the early 1980`s and beyond)
I`d like to get him to see a Doctor but I must also consider the long term costs of any drugs prescribed as it will be me paying for them during any such long term commitment..
I dont want to go on and on at him about it as I have no intention of causing the guy stress while he is so laid back about his condition (and just about everything else).. He works like a horse every day in our veg garden..He`s a non smoker and drinks a bottle of Red horse about twice a week. Diet is mainly fish,veg and rice but will eat Pork fat as would any Filipino should it be presented..(In our house not very often)
His Mother has has always had high blood pressure and now well in to her 70`s... She is bringing up 3 of her grand children on her own (between 5 and 10 years old) runs 2 Sari sari stores and a piggery and doesn't seem to know what the word "stress" means!
Onli in di Pilipins eh!!

[Doc Alan]

Fred - your 58 years old brother-in-law has ( if the readings are accurate and consistent ) severe hypertension - over 180/110. Clearly it's in his genes ( hypertension is twice as common if one or more parents are hypertensive ). At these levels it's unusual not to have symptoms, you have identified no other possible causes, and his mother is still alive in her 70's.
I'm not a GP, but in the UK expert advice is to treat if these values are sustained - thus preventing complications like heart and kidney disease. For most people the risks increase with higher levels of blood pressure, but there are always exceptions !
I can fully understand your dilemma - he feels well ( but most hypertensives don't have symptoms ), his mother is a good age ( you don't mention his father ? ), and unlike the UK with our NHS ... you have to consider cost. He may not even wish to be treated !
To my knowledge filipinos are no different to caucasians with respect to blood pressure ( although we know black people, for example, are more susceptible to hypertension ). Your brother-in-law is lucky - just like some smokers don't get cancer. You could possibly ask him one more time to have a medical check up ? However, if you - and he - decide to "leave well alone", that's understandable .

[fred]

Doc..Thanks for the information.
Its hard for me to identify other possible causes as his Father died due to liver failure (from memory) which Im sure was due to years of alcohol abuse.. I`ll ask in the morning about any blood pressure issues he may of had tomorrow as they are all sleeping as I speak..
His sister and some other siblings also have high blood pressure issues.. You may remember me telling you about the eldest sister that had a brain tumour? Anyway..She was successfully operated on,tumours removed and recovering well..
My wife however has low blood pressure readings sometimes in the mornings and yet perfectly normal the following evening!!
What a strange lot they are!
My Mother in the UK badly needs a knee replacement but due to blood pressure issues cant have it done at present,, She takes all kinds of meds to get it down to an acceptable level often successfully but one trip to the Dr`s and it rises back up again.. I assume thats the white coat syndrome you referred to which also makes me think twice about asking the Bro in law about seeing a Doctor after all these years!!
Damn!! Im secretly wishing my guest had kept that damned thing in her suitcase now.
Thanks again.

PS.. I was about to hit the sack but I suppose I`d better Google "Severe hypertension" first..

[Doc Alan]

My wife however has low blood pressure readings sometimes in the mornings and yet perfectly normal the following evening!!

Damn!! Im secretly wishing my guest had kept that damned thing in her suitcase now.
Thanks again.

PS.. I was about to hit the sack but I suppose I`d better Google "Severe hypertension" first..

Thanks for the update !
Chronic/ persisting low blood pressure ( less than 90/60), with no symptoms, is almost never serious. Mine was 115/55 last week . It can be more serious with increasing age, diabetes, or as a side effect of drugs - when there's insufficient blood flow to vital organs. This causes confusion, blurred vision, dizziness or fainting.

Blood pressure machines are not necessary for most people - a check up at the doctor's every 2-3 years is usually sufficient. My doctor checked mine only because I was having a booster typhoid jab, and GP's are encouraged to take such opportunities to check blood pressure.

As for searching the internet, you will be swamped . For the forum, where "Health Issues" are just one section, I try to summarise what is known about a topic in as few words as possible . My sources ? Up to date textbooks with selected internet sites, and experience to "interpret" them .

[Arthur Little]

Once again, Alan ... we're indebted to you for sharing your professional knowledge and expertise with us. With an estimated 20 percent of the population worldwide being prone to hypertension - the "silent" killer - it's vitally important that those people likely to be predisposed towards developing high blood pressure ... whether through genetic or other factors ... present themselves for regular checkups at their GP's surgery.

Oddly enough, though, my mother was diagnosed with this ailment during the late 1950s ... when she was prescribed appropriate medication in tablet form of one kind or another - which she continued to take on a daily basis for upwards [excuse pun] of 40 years - until her death from a massive cardiac infarction at the ripe old age of 84. Yet my own blood pressure was recorded as being at a "very safe" level at the time I underwent carotid arterial surgery nearly three and a half years ago ... and has remained static ever since ... despite my having had a series of Transient Ischaemic Attacks - or mini-strokes - leading up to the operation.

Around the same time, my son's father-in-law [then aged 58 - and a non-smoker to boot!] experienced symptoms similar to mine. Unlike MY condition (brought about by elevated cholesterol levels) HIS had been caused by raised blood pressure that had gone unchecked; he then went on to develop an actual full-blown stroke that affected both his speech and the left side of his body for a while afterwards. Thankfully he has since more or less fully recovered ... albeit not without a lengthy period of rehabilitation!

[Doc Alan]

... my own blood pressure was recorded as being at a "very safe" level at the time I underwent carotid arterial surgery nearly three and a half years ago ... and has remained static ever since ... despite my having had a series of [B]Transient Ischaemic Attacks ...

... my son's father-in-law [then aged 58 - and a non-smoker to boot!] experienced symptoms similar to mine. Unlike MY condition (brought about by elevated cholesterol levels) HIS had been caused by raised blood pressure that had gone unchecked...

Thank you for your comments Arthur .
Your blood pressure was safe for you , because to lower it too much when your arteries are already narrowed would have risked a "completed stroke", not your "TIA's" which last under 24 hours and are reversible.
Completed strokes are mostly caused by arteries narrowed by atheroma ( fatty deposits ) or blocked by a "clot" - resulting in brain damage ( infarct ). Hypertension is only one of the risk factors involved. 1/5 strokes are due to bleeding ( haemorrhage ) which may also be caused by hypertension ( but there are other causes ). From what you say, that was the main cause of your son-in-law's father's stroke.

Because circumstances of members and their relatives are all different, only your own doctor can advise on possible treatment. Lifestyle changes may be sufficient. The "white coat effect" or even "receptionist effect" does mean that unless your blood pressure is clearly normal, it's good practice to repeat the measurement ( or get you to do it at home ). Even if hypertension does affect a large number of people with no symptoms, in 4/5 of the population blood pressure will be at a safe level .

[Arthur Little]

So ... ladies and gentlemen ... regardless of age or ethnicity ... if you EVER have even the slightest reason to suspect your blood pressure might be higher than it SHOULD be ... then heed the good doctor's advice and have it checked out - sooner rather than later!