BEATING THE BLOOD PRESSURE BLUES FOR A HEALTHY HEART: THE INVISIBLE NEMESIS
How's your blood pressure today? Unless you had it checked, you can't be sure. That's because there are no symptoms of high blood pressure, also known as hypertension. But we do know that it's one of the Big Three risk factors in heart disease along with cigarette smoking and elevated cholesterol levels, and it's the Number One risk factor for strokes. We also know that we can completely control blood pressure in almost every case.
You're not alone. It's estimated that nearly 60 million men and women in the United States have an elevated pressure. To a large extent the condition is another part of your genetic heritage, and your blood pressure has probably been slowly but surely increasing since you were much younger, perhaps even back to your childhood.
On its most basic level, blood pressure is quite easy to understand. It refers to the pressure required to pump blood from the heart through the arteries to all parts of the body. Through a complex system of checks and balances, blood pressure is regulated and adjusted. During exercise pressures goes up, and at rest it comes back down. Different pressures may be needed in different parts of the body at different times.
Blood pressure is something we just don't think much about since we can't feel it. Even when one is completely calm and relaxed, blood pressure may be elevated. Over a period of time, hypertension leads to a thickening or hardening of the arteries, which ate also weakened in the process.
There are two important blood pressure measurements. The first is the systolic pressure, the pressure of the blood pushing against the artery wall as the heart beats. The second is the diastolic pressure, a measurement between beats when the heart tests. A reading of 120/80 is stated as "120 over 80" with the systolic being 120 and the diastolic 80. That reading, by the way, is completely normal, and the patient would be termed normotensive.
For years there was controversy as to what would be considered high blood pressure. Then in 1972 the US National High Blood Pressure Education Program was launched by the US National Heart, Lung, and Blood Institute in conjunction with the nation's major medical organisations. This program has initiated efforts to educate both patients and physicians as to the seriousness of hypertension and methods of controlling it. Today there is virtual consensus as to the classification of blood pressure in adults 18 years or older.
The risk of cardiovascular problems related to blood pressure increases with greater levels of both systolic and diastolic pressure. Diastolic pressure is normally of greatest concern, but systolic pressure is also considered. You'll note in the following breakdown that the term "mild hypertension" is used. That's somewhat deceptive and should not be construed to mean that such an elevation is of no consequence. All elevations of blood pressure should be treated and controlled.
You've had your blood pressure measured many times, but you may not know exactly how the measurement is made. The apparatus used is called a sphygmomanometer ("sfig-mo-ma-na-meh-ter"). It consists of a cloth or rubber cuff to wrap around the arm, a rubber air bulb to pump air into the cuff, and a manometer, which measures pressure in millimetres of mercury in a glass tube similar to a thermometer. As air enters the cuff, mercury rises in the manometer. The cuff temporarily cuts off blood flow in the forearm.
As air is gradually let out of the cuff, blood begins to flow again and the mercury in the glass tube drops. The doctor or nurse (or other trained person) listens to the blood flow through a stethoscope placed on the artery just below the cuff. One first hears a thudding or tapping sound as the blood spurts out. It occurs when the air pressure in the cuff is a bit lower than the pressure in the artery. The reading on the glass tube at the time of that first sound is your systolic pressure.
Mercury continues to fall as more air is released from the cuff. When the tapping sound stops, blood is smoothly flowing between heartbeats. The moment the sound stops a reading is taken from the manometer tube. This is your diastolic pressure.
Your blood pressure varies from day to day, situation to situation, and even minute to minute. That's why to get an accurate assessment the doctor will take two, three or even more readings. He may also take both sitting and standing pressures. And to be absolutely certain of your condition, at least two examinations on different days are needed.
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Cardio & Blood/ Cholesterol
