Why Do You Argue

May 30, 2017

It’s a quirky thing. It has been my experience that when people learn they have high cholesterol, they will usually accept the diagnosis and attempt to lower it with diet, medication, exercise or a combination. But when people are told that their blood pressure is high, quite often they will argue that it is not high, has never been high and is just an aberration of the moment. Some things worth arguing about and some things are not! High blood pressure is nothing to argue about! Blood pressures measurement is an important standard for assessing health status, just as a complete blood count is to how your body is functioning.  Left uncontrolled, high blood pressure (hypertension) places you at great risk for a stroke or heart attack.  According to the 2014 Evidence-Based Guidelines for the Management of High Blood Pressure in Adults, (JAMA 02/05/2014) “Hypertension is one of the most important preventable contributors to disease and death.”

Your blood pressure can be “perfect” for years and can change almost overnight. It can be fine when you are home and at rest, but high when you are out and about. Perhaps you really do have the infamous “white coat syndrome” where you get nervous when your blood pressure is taken by a health care provider in an office setting. But you need to assess if that is really the case. Some people argue that their blood pressure can’t be high because they feel fine, have no symptoms and they are very calm people.  Here are some important facts about high blood pressure:

FACTS: There are generally no symptoms with high blood pressure. Any person or personality type can develop high blood pressure.  

FACT: Blood pressure can change and become elevated at any time.

FACT: For most high blood pressure, the cause is unknown. 

FACT: High blood pressure is usually not curable, but it can be controlled.

FACT: If blood pressure medication is prescribed by your doctor, you usually take

 it for life, although it may be adjusted.

MOST IMPORTANT FACT: Controlling high blood pressure can prevent strokes and heart attacks.

            Rather than argue with someone about whether or not your reading was high, try to understand what is happening when you blood pressure is elevated.  Simply stated: if your blood pressure is high, your heart is working harder than it needs to work.  Blood pressure readings represent the force of blood pulsing against the side of the blood vessels as it flows through your body.  Readings are always reported in two numbers: systolic pressure/diastolic pressure.  Systolic blood pressure (the top number) is when you heart squeezes to pump your blood to your body.  Diastolic blood pressure (the bottom number) is when your heart is relaxed and filling with blood.  A desirable blood pressure reading for all persons is less than 140/90. Recent guidelines have been put forth for specific groups of people, but do not change the desirable level. You should work with your health care provider to determine your target blood pressure.

Everyone’s blood pressure will go up and down during the day with normal activities of living, so one high (elevated) blood pressure reading does not mean that you have hypertension.  When the number stays high over a few measurements, it is defined a as high blood pressure.  At very high levels, a single reading can be an urgent threat to health (readings in the 200/100 ranges.) 

            For blood pressure over 140/90, there are several actions that can be taken to reduce the numbers.  Lifestyle changes are often prescribed as a first step.  They include increasing exercise, losing weight, not smoking, avoiding salt and fat, and decreasing alcohol.  If these actions fail to bring blood pressure under control, physicians have many different types of drug that can be used.  If a doctor does prescribe a medicine, it is very important to take the medicine as directed.  You should never stop taking high blood pressure medicines unless you are working with your doctor during this process. 

            Don’t bother to argue about high blood pressure.  Do what you need to bring it down!  For written information on high blood pressure, Quinnipiack Valley Health District residents (Bethany, Hamden, North Haven and Woodbridge) can call QVHD, 203 248-4528. Visit the QVHD website, www.qvhd.org, like us on Facebook and follow us on Twitter.