Hypertension - A 21st Century epidemic

Hypertension (high blood pressure)

Some time ago an article written by Sheryl Ubelacker, a health reporter for the Canadian Press, indicated that obese children appear to have a blood vessel abnormality similar to that which doctors see in much older adults with high blood pressure and cardiovascular disease.   The obese children studied already had stiff blood vessels, aortic stiffness is an early indicator of cardiovascular disease.  Aortic stiffness in adults is associated with heart attacks and stroke that can result in premature death, and this is the reason that many, many of us are on hypertensive medication.

While the obese children studied had normal cholesterol levels, their blood pressure was marginally elevated and ultrasounds of the heart showed arterial health was already compromised.

We know there is an association between unhealthy lifestyles and heart disease.  Poor nutrition and inactivity are threatening their health and well-being. It is obvious that we must rethink the lifestyle standards we have accepted as a society to protect the future health of our children.

This is a very sobering message.  As adults living in the Western world many of us are more or less resigned to the fact that at some point we will have to be on medication for high blood pressure, high cholesterol or both.

On the other hand an article in JAMA in 1997 reports that drugs for high blood pressure may be over prescribed, based on the results of a review of measuring hypertension.  Researchers found that patients, whose blood pressure was measured by ambulatory monitoring where levels are recorded throughout the normal working day with a device strapped to the patient, needed fewer drugs than people whose blood pressure is monitored in the surgery.

Ambulatory monitoring avoids the "white coat effect", when blood pressure is raised unnaturally when a patient gets to the hospital or clinic. It is also more accurate than the standard testing, and is not open to interpretation from the operator.  This is very true and indeed my own experience, having bought a blood pressure machine for use at home is that I really don’t have a blood pressure problem!   The readings throughout the day when I took my blood pressure were much lower than in the surgery.  I had not thought that I was a nervous patient, in fact having worked around medicine and medical people all my life; I felt I was quite happy in a doctor’s surgery but maybe my subconscious knew different! 

There is no doubt that high blood pressure can lead to heart attack and stroke and that we should do all in our power to keep it low.  But it is interesting that without trying very hard one can find many different perspectives on the subject.    I think that if we are to be concerned about any aspect of this it should be the over-prescription of anti-hypertensive medication. 

There are obvious things that we can do to keep ourselves healthy and free of hypertension.  They are the old chestnuts, keep weight under control, don’t smoke and don’t drink.  But also it is important to check that you know what you are dealing with.  Get yourself a home blood pressure measuring kit so that you can find out what your blood pressure is at various times of the day. You can actually have the machine compared to the machines at your doctors surgery so that they are also satisfied that the readings you are getting are the same as they would be in the surgery.

There is no doubt that it is very important to control blood pressure for all sorts of reasons.  Just do your best to make sure that your blood pressure is recorded as accurately as possible so that any treatment you have is accurate too!

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Amanda Thomas

UK Health Radio