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High blood pressure: A real silent killer

Why you need to know if you have it, and how to treat it.

I recently learned that I have what my doctor describes as “elevated blood pressure” – that is, blood pressure that routinely exceeds the 120/80 mmHg that is considered the top of the normal range, but doesn’t quite hit the 140/90 mmHg that indicates true high blood pressure.

This discovery has alarmed me, because having high blood pressure is a Very Bad Thing. It’s a major risk factor for heart attack and stroke, it can damage the blood vessels in your kidneys and and cause kidney failure, and it can damage fine blood vessels in your brain and cause trouble with memory and cognitive processing. If left untreated, as it far too often is, high blood pressure reduces both longevity and quality of life.

It also alarmed me because I’m not supposed to have high blood pressure. High blood pressure or hypertension, is more likely to affect older people, the obese or inactive, smokers, or people with diabetes, and I am none of these things. I’m only 33, for a start, and I don’t smoke or have diabetes. I’m 1.7m tall and weigh 55 kilograms, giving me a BMI of 19 – right at the bottom of the normal range – so I’m not obese or overweight. And I’m physically active; I do yoga twice a week, I bike and walk about 30km a week, I eat reasonably well, and I only drink and carouse in moderation. In short, I’m doing pretty much everything right, habitwise, yet despite all my efforts my blood pressure is stubbornly stuck at about 130/85.

According to my doctor, my major mistake was in selecting my parents; there is a history of hypertension on both sides of my family tree, and all the good habits in the world are apparently not enough to overcome the power of hereditary. In addition, she accused me of being overly stressed and anxious, which is true, and of eating too much salt, which may also be true (hey, no one’s perfect). 

At any rate, despite my grumbling, I’m actually very lucky that my doctor caught the problem. Hypertension seldom has any noticeable symptoms (I certainly didn’t have any), and so many people walk around for years with undiagnosed high blood pressure, which makes it much more likely that they will suffer some of the long-term consequences of the condition – this is why the condition is so often called the silent killer. The lack of symptoms means that it’s important for you to take responsibility for getting your blood pressure measured regularly, even if you’re a paragon of good health, because hereditary can mean hypertension even for the healthy.

In addition, many people know that they have high blood pressure but fail to take measures to manage it because they don’t realise how serious it is. Thanks to my doctor, that’s not going to be a problem for me – she made the dangers abundantly clear. Since my blood pressure is in the elevated range, rather than in the high range, I’m not going to take any medication, but I will take the doctor’s advice and make some lifestyle changes like reducing my salt intake, managing my stress better, and limiting my alcohol intake to one drink a day (men can have two). For others with elevated or high blood pressure, lifestyle changes may include losing weight, making a point of exercising for at least 30 minutes a day, quitting smoking, and following the DASH diet, which is specially designed for people with hypertension.

On top of all this, some doctors recommend that anyone who has a high blood pressure reading at the doctor’s office should purchase a home blood pressure monitor – there are reasonably priced and reliable digital home models available these days – and make a point of measuring his or her blood pressure at least once a week and keeping track of the readings. Monitoring your blood pressure is essential for managing it, especially as you make lifestyle changes or, if necessary, start taking blood pressure medications. Having a record of how your blood pressure changes in response to exercise or new drugs can help your doctor design the right regime for you.

With sensible lifestyle changes and careful attention, hypertension can be managed. The key steps are making an effort to monitor your blood pressure so hypertension can be diagnosed, and taking the condition seriously. 

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