September 11, 2019 // Perspective
Still the silent killer
I recently was asked to be a guest on the “Doctor, Doctor” show that airs on Redeemer Radio at 1 p.m. Fridays and again at 11 a.m. Saturdays. The topic of discussion was high blood pressure. I thought I would share some of the important points made during that discussion.
I am very proud of my colleagues who host this show; Drs. Tom McGovern, Christopher Stroud and Andrew Mullally. We work together as members of the local Catholic Medical Association chapter, the Dr. Jerome Lejeune Catholic Medical Guild of Northeast Indiana, to uphold the principles of the Catholic faith in the practice of medicine. They have just recently taken their weekly presentation national on Eternal Word Television Network.
In 1943, President Franklin D. Roosevelt was given a clean bill of health by his physician even though his blood pressure was 220/120. Just a few years later he died of a fatal hemorrhagic stroke. His death brought hypertension into the limelight. It was not till the 1950s that life insurance companies figured out how harmful high blood pressure was and began to insist on accurate blood pressure measurements before a life insurance policy was approved.
Here are some key statistics. One in three Americans has hypertension. Hypertension contributes to 1,000 deaths per day in this country. People with high blood pressure are four times more likely to die from stroke and three times more likely to die from heart disease. At age 35-44 one in four men have hypertension, and in women it’s one in five. By age 70 women surpass men as having more hypertension.
Most people with hypertension do not have any symptoms, and that’s why it’s called the silent killer. I strongly recommend investing in an automated blood pressure cuff for home use to track blood pressures. If your blood pressure is higher than 130/80 by current guidelines you have hypertension. The new goal for blood pressure is 120/80 or a little lower. Over the years, many prospective controlled studies have proven that targeting a systolic blood pressure of 120 reduced morbidity and mortality.
Controlling blood pressure is particularly important in people who have diabetes, kidney disease and congestive heart failure. Uncontrolled hypertension is a major contributing cause of congestive heart failure. As a cardiologist, my goal in my patients with cardiomyopathies is to try to keep their blood pressure around 110 systolic. The heart’s left ventricle is a lot happier pumping blood against a lower resistance.
There are many lifestyle changes that can be initiated to lower blood pressure. If you are overweight, weight loss would be a good first place to start.
Overzealous use of salt will also raise blood pressure, and one of the first dietary changes you should make is reducing salt intake. Some cultures use lots of salt, and epidemiologic studies show that those countries have a higher incidence of hypertension.
Limiting caffeinated and high-calorie beverages like soda pop will not only lower blood pressure but also weight, for a win-win.
When talking about natural ways to lower blood pressure, it also must be pointed out that exercise is a must. As a person exercises the normal physiologic response is for the blood pressure to rise. But after exercise blood pressure actually falls, and with regular exercise blood pressure will be much better controlled on a daily basis.
If you make lifestyle changes and your blood pressure remains high, it’s time for a doctor to prescribe medication. The good news is that there are many low-cost and effective medications available. Most of the meds people use have gone generic and paying as little as $4 a month is quite common.
One mistake I see all the time by physicians is that they start a blood pressure agent: If they don’t get acceptable blood pressure control, they stop that agent and prescribe another one. Then, that medication may not get the blood pressure to goal so it is stopped and a third one is started.
Studies show that many patients need two or three medications for optimal control. In my practice, if the medication I start is tolerated and lowers the blood pressure some, I will add another medication, and even a third or fourth agent, until I get the blood pressure to where I want it.
Remember, we are made of body and soul. If you take care of your body and strive to stay healthy you will be more capable of doing the work of God as you serve Him here on earth.
To catch the “Doctor, Doctor” show on the radio, tune in to 95.7 FM in Michiana and 106.3 FM in northeast Indiana, or listen anytime on the podcast “Doctor, Doctor.”
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