Last week, I discussed the definition of hypertension; what the numbers are and what the readings should be; ‘white coat’ hypertension; and blood pressure readings in office and home.
Let’s look more closely at why men develop this prevalent killer and what to do about it.
“Why did this happen to me?” A common question, and a fair one. Hypertension can be inherited. In fact, a man whose parents both have hypertension is TWICE AS LIKELY TO DEVELOP HYPERTENSION themselves. Family history is a big one.
Other RISK FACTORS include: Age (the older you get, the more likely the genetic ‘tripwire’ will activate; existing hypertension can also worsen as a man ages); Obesity; Tobacco use; Caffeine or other stimulant intake (over the counter diet pills, energy drinks, decongestants for upper respiratory symptoms or allergies); African American descent (unfortunately, African Americans can have more severe cases, get it earlier in life, and have worse results from it) Other risk factors include kidney disease; excess alcohol consumption; physical inactivity; medications; street drugs (especially stimulant type drugs); and other systemic diseases. There are some who feel excess salt intake can be a contributing factor. There are rare conditions as well that should be addressed with the doctor and treated appropriately.
Hypertension can sometimes be diagnosed with an elevated home reading that is verified by an office reading. Typically, I like to see patients have a pressure check once a week for three weeks, since sometimes blood pressure can be high because of something stressful going on at the time it was checked.
After that, I encourage my patients to get a reading occasionally when they are away from the office, and keep a log of the reading, day and time, and if exceptionally high, what is going on at that time (car trouble? Argument?). This can artificially elevate the pressure, and does not always mean changes are needed.
COMPLICATIONS OF HYPERTENSION include: increased left sided heart size, called LVH (left ventricular hypertrophy); heart failure; stroke; bleeding in the brain; other heart disease INCLUDING HEART ATTACK; kidney failure and many other systemic diseases. In other words, UNTREATED HYPERTENSION IS TERRIBLE FOR YOU.
So, the big question: HOW DO YOU TREAT HYPERTENSION?
Obviously, you need to see your doctor. We will decide if medication is right for you.
Things you can do to help include:
PHYSICAL ACTIVITY: it is recommended that aerobic exercise 3-4 times weekly for 40 minutes at a time. HOWEVER, MY OWN OPINION is that ANY exercise is better than none, and not all patients are capable of the recommended amount of activity. Bottom line: do your best. More and more evidence is coming out that lifting weights is beneficial as well. Come in and talk to me if you have questions about weightlifting or exercise in general.
SMOKING CESSATION: you know you need to quit, and I’m not here to preach at you. If you need help, ask for it. We have medication and other programs that can really help.
WEIGHT LOSS: of course, this involves diet. My personal opinion is that a low carb type diet is the most effective at losing weight and lowering your blood pressure. Other doctors may have different opinions on this topic; feel free to discuss it with me.
SALT RESTRICTION: it is said that salt decrease can lower your pressure around 4.8/2.5.
Many medications are available when your lifestyle changes do not control blood pressure. Depending on which one you take, you may experience temporary fatigue or lack of energy. This usually will pass after your body gets used to the lower pressure (remember, this did not happen overnight, and your body has a lot of adjusting to do; be patient).
Unfortunately, most hypertensive patients require lifelong medication, although some patients can bring their pressure into normal range by lifestyle changes. If caught early and controlled, people with hypertension CAN LIVE A COMPLETELY NORMAL LIFE. However, you do need have routine blood work and doctor visits to make sure it is controlled.
I am here if you have any questions. Hope to see you soon (but not too soon)!
James T. Cail III, DO