Blood Pressure Up?

High blood pressure is a silent killer. Let’s face it. In today’s world there are a lot of things that make our blood pressure jack up.

The idiot driver that cuts you off so they can slam on their breaks and whip into Starbucks – ahead of you! The guy in the cubicle next to yours who hums Lady Gaga all day – dude we can here you even if you can’t hear us… What about waiting for the cable guy – “we will be there between 12 AM and 11:59 PM ma’am.”?  During the day our blood pressure fluctuates in a beautiful balance to keep us from being dizzy,  bringing oxygen to our organs, and increasing blood flow during exercise.

As we mature (I refuse to use the term aging, getting older or long in the tooth, so….) as we mature,our blood pressure increases. In fact, the most common type of high blood pressure is called Primary Hypertension, and science still hasn’t discovered what causes it. We know it happens in those with a family history of hypertension, who are overweight, have diabetes, smokers, and folks with high cholesterol, but the reason why is still elusive.

What is a high blood pressure?  Hypertension is a systolic blood pressure (SBP is the top number) ≥ 140 or a diastolic blood pressure(DBP is the bottom number) of ≥ 90 mm Hg. High blood pressure is divided into three categories (in mm Hg): Prehypertension is a SBP of 120-139 or DBP between 80-89. Prehypertension means you are on your way to hypertension and is not a good sign – while most doctors won't treat “prehypertension”, it is a wakeup call for you to begin exercising regularly, lower salt intake,lose weight, and stop smoking;Stage 1 hypertension is SBP of 140-159 or DBP between 90-99 and  Stage 2 hypertension SBP ≥ 160 or DBP ≥ 100.

What is different about hypertension in men and women?  There is a lot ofscience and research in this area, but I’ll stick with some basics. Men have a higher blood pressure than women, and boys have a higher blood pressure than girls beginning in puberty – younger boys and girls ages 6-11 have no significant difference in blood pressure levels. In some studies, after the 5th or 6th decade, high blood pressure in women equals or exceeds men.  We theorize that hormones havesomething to do with this difference.  Not so good news for men is that cardiovascular disease (heart attacks, strokes, death) events occur at higher rates in men than women across the lifespan.

Women are more likely to suffer from “white coat hypertension”. This is when your blood pressure goes up when you are at the  doctor’s office. Women often try to talk me out of treating their blood pressure stating that theirblood pressure is only high in the office. To confirm this I have them check their blood pressure 2-3 times a week and call me with the values. Statistically speaking if a woman is in her 60s or 70s it is probably high blood pressure.

Properlychecking your blood pressure is important – arm at heart level not hanging down, no caffeine or nicotine for 30 min, rest for 5 minutes and use the proper size blood pressure cuff – if you can barely get in around your arm go up a size if you wrap in around 2-3 times get a smaller size. To get really specific, check blood pressure in both arms at least once to see if there is a large difference.

High blood pressure is bad for both sexes. One billion people worldwide have hypertension, and sixty five million inhabitants in the United States alone require treatment for their hypertension. Over half of high blood pressure in the US is untreated or poorly treated. In fact, suboptimal blood pressure (SBP > 120 mm Hg) is the number one risk factor for death throughout the world, and it is responsible for more than 50-60% of heart disease events.

One thing about guys, they don’t like to go to the doctor, and, in fact, research shows that they use doctors more for acute (emergent) reasons. In other words, something has to be wrong and make the guy feel bad for them to see a doctor. Women on the other hand get annual physicals, see healthcare providers and nurses during pregnancy, and are the major consumers ofhealthcare. Women are more likely to have a blood pressure check.

Remember, high blood pressure is silent until it’s not - undiagnosed or untreated high blood pressure lead to strokes, heart attack, kidney failure, blindness and a host of other things. So get a blood pressure check annually especially after age 35 or earlier if you have a family history of high blood pressure, are pregnant, have a history of heart or kidney disease, are overweight, don’t exercise, have diabetes or highcholesterol, or smoke.

Your blood pressure will come down after the rude driver, hearing Lady Gaga’s Poker Face hummed off key for the hundredth time and when the cable guy has come and gone, but primary hypertension won’t suddenly become normal just because you ignore it!

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