Under Pressure

Nothing may be scarier than to be told you have high blood pressure. Images of griping one’s chest in the midst of a heart attack  or suddenly losing speech, vision or motor function immediately rush into our minds. We think our goose is cooked, or at least is on its way to being cooked. It’s natural then to become fixated on the numbers—systolic, the top number flashing on the monitor and the diastolic, the bottom number that frequently makes our physician frown. We’re told by the committee that knows these things that the “normal” number should be 120/80 or less. Going slightly above those numbers places us in the ‘prehypertension’ (meaning, start doing something different NOW) range. If we make it into the big leagues, i.e., blood pressures consistently above 140/90, then we’re considered ‘hypertensive’ and the fear sets in (and life insurance sales agents run the other way).  Studies have shown even small reductions in that top number (less than 5 mm Hg) can reduce the risk of stroke, heart disease or death by anywhere from seven to 14 percent.

For the physician it’s easy to reach for the prescription pad (or in our case the computer mouse) and prescribe one of literally dozens of medications intended to lower our pressure to more manageable levels. It may be a medication that costs only pennies a day, or a brand-name medication that causes us to rethink retirement or possible taking out a second mortgage just to pay for the little pill. Even then, experience has shown that only one third of patients with hypertension ever achieve the goal of getting below the 140/90 goalpost. Many of us don’t relish the thought of taking any pill for that matter, especially for the rest of our lives. We can always pretend the numbers don’t apply to us (they frequently do), or our pressure is usually better when we’re not stressed (that doesn’t seem to happen too often anymore). But there comes a time when we have to look the numbers in the eye for what they are and see if we can avoid having that stroke, heart attack or worse.

Before we cash that prescription in, is there anything we can do first to keep from having to pop that pill? As empowered patients, we know there is always something we can do to help take charge of improving our health. If your blood pressure numbers are very high, you may be wise to take the medication while working on what follows. We’ve touched upon the importance of weight loss before in terms of getting down into our normal Body Mass Index (BMI). But when it comes to lowering the blood pressure, a little goes a long way. Numerous studies have shown that for individuals that are overweight (a BMI greater then 25) that losing 10 pounds of weight can reduce blood pressure or even prevent the development of hypertension. Besides losing the weight the committee suggests we get at least 30 minutes of aerobic (i.e., get that blood a pumping) exercise at least four days a week. For men, they suggest no more than two alcoholic drinks per day; for women, no more than one per day. They also suggest we give up the fast food salt lick and reduce our sodium intake to less than 100 mEq per day (if you think that’s easy remember that one Arby’s large roast beef sandwich has 81 mEq of sodium). We should all DASH to the table for what is considered the healthy diet of our generation.

Lastly, we should all at least try to lower our stress levels. Perhaps there is something to closing our eyes and meditating (preferably not while driving). Possibly avoiding the medication hit to our pocketbook may induce some sense of calm and give us a sense of control of our own health.  Just maybe we can avoid that pill and look our numbers in the eye and send them down into the normal range where they belong.

About Steve P. Sanders

A general internist writing and sharing ideas and art.

One Response to “Under Pressure”

  1. Hi Steve

    I can empathize with people suffering from hypertension. I used to have hypertension not long ago and then started a strict regime of less-everything(salt, sugar, fat, fried) food plus regular exercises.
    My blood pressure is now within normal range (120/80) or so.
    Though it is important for people with hypertension to monitor their blood pressure regularly, the existing way of doing so may not be accurate and may give you a false sense of security.
    There is now a new innovative watch-like device, that monitors the blood pressure round the clock in a non-invasive manner. And this has clinically proven to be accurate and help prevent and also predict potential heart attack and stroke.
    For more details, read my article at the following link:


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