What’s Yours At?
Although we’ve been measuring blood pressure for about 2 centuries, which is even longer than the Liberals have been running Canada as their fiefdom (young ones won’t believe this, but there really was a time before Sheila Copps), there is still lots we don’t know about blood pressure.
To start, it was always vigorously maintained that the lower or diastolic pressure was much more important in determining the risks of complications attributed to high blood pressure (HBP) than was the upper or systolic pressure. Studies over the last few years have shown, however, that not only is an elevated systolic pressure also a major risk factor for HBP-related complications, but for some people, particularly middle-aged men (a group that for some reason really captures my attention), a high systolic pressure may be even more dangerous than a raised diastolic pressure in leading to future negative health consequences such as strokes and perhaps dementia.
As well, a “normal” blood pressure has long been held to be anything below 140/90, but an update from the famous Framingham study found that even blood pressure readings in the “high normal” range, that is, 130-140/85-90 were related to a higher risk of complications than were lower blood pressures.
In other words, with blood pressure, as with auction bids and the amount of boyfriends your teenage daughter brings home to do “homework” with in her locked room – you may want to aim for the lowest numbers you can get away with.
Finally, a study published in the American Journal of Hypertension found that only 13% of Canadians suffering from HBP are getting adequately treated for it, which is scary indeed, not only for those who will get strokes and heart attacks as a result of not keeping their blood pressure down, but for the rest of us, too, given how much HBP-related complications cost the medical system.
So let me state this as strongly as I possibly can: no matter your age or gender, get your blood pressure checked regularly (at least once a year, more often if it’s borderline or high), and if you have HBP, even that oxymoron of a “high normal” blood pressure, you need to act on it ASAP.
As always, start with lifestyle modification: don’t smoke, limit your alcohol intake, exercise regularly, and try some form of the Mediterranean or DASH diets – lots of fruits, veggies, beans, fish, nuts, low-fat dairy products, and less saturated fat. (As for salt, the current but ever-changing consensus is that in “salt-sensitive” people, blood pressure rises with excess salt intake, while others tolerate salt and need not limit their salt intake; this opinion is, of course, subject to change at a moment’s notice, so take it with a grain of salt – you knew that was coming, I’m sure).
If lifestyle modification doesn’t do it, though, you should start on some sort of blood pressure-lowering medication, remembering that whichever meds you opt for, you must make sure to take them regularly and for as long as your blood pressure stays up, which often means for the rest of your life.
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