In his monthly column, Dr. Kent Herbert answers your questions related to health care matters. Simply submit your question to stefaniw@newfalconherald.com. It’s your chance to ask the doc.Question: What is high blood pressure and why should I be concerned?Answer: Studies show that one out of every three adults in the United States has high blood pressure, and, of these, one in three doesn’t know it because high blood pressure typically has no symptoms. Blood pressure is made up of two parts: the systolic blood pressure (the top number) and the diastolic blood pressure (the bottom number). The systolic blood pressure is the pressure in the blood vessels when the heart beats, and the diastolic blood pressure is the pressure when the heart is at rest, between heart beats. At different times it was thought that either the systolic or the diastolic was more important than the other, but now we know that if either is high, it can be a serious problem.Doctors used to think that any blood pressure under 140/90 was good enough, but now we know that the ideal blood pressure, and what should be considered “normal,” is 120/80. People with blood pressures between 120-139 systolic and 80-89 diastolic are considered to have prehypertension. As blood pressure usually increases with age, these individuals will likely develop hypertension if measures are not taken to lower the blood pressure. Think of this as the zone where one has the opportunity to improve blood pressure without medications; once the blood pressure gets above 140/90, most people will require medication to bring it down.Ninety to 95 percent of people with high blood pressure have “essential hypertension,” meaning that the cause is not known. In the other five to 10 percent, kidney disease or a narrowing of certain arteries may be the cause. This is called “secondary hypertension” and is more commonly seen in young people with high blood pressure or those whose high blood pressure can’t be controlled with medications.High blood pressure is harmful because it can cause the heart and circulatory system to work too hard. Over time, this can lead to heart attacks, strokes, kidney disease and heart failure. Untreated high blood pressure is the No.1 risk factor for stroke, and the risk of stroke increases as blood pressure increases over 115/75. For every 20-point increase in systolic blood pressure and 10-point increase in diastolic blood pressure, the risk of stroke doubles. Therefore, a person with a blood pressure of 135/85, although it is technically normal, can cut their risk of stroke in half by decreasing their blood pressure to 115/75. In addition, such a blood pressure reduction would cut a person’s risk of having a heart attack by 20 to 25 percent and developing heart failure by 50 percent.The first step in controlling your blood pressure is to have it checked. Your doctor should check it at most visits, or you can check it yourself at the grocery or drug store or with a home blood pressure cuff. If it is elevated, check it again and keep track of your numbers, or have your doctor check it. If it is consistently high, the first step in treatment is dietary and exercise changes. Weight reduction, a low-fat diet and regular exercise will lower the blood pressure, as will decreasing alcohol use and quitting smoking. Reducing salt can also lower the blood pressure, and it is recommended that adults consume no more than 2300 mg of salt daily, which is equal to about one teaspoon. It is important to recognize this includes the salt that is already in foods, not just what is added. If your blood pressure comes down with these changes, it is important to continue them indefinitely.If these measures don’t work, your doctor can prescribe medication for high blood pressure. There are many safe and simple medications available, but it is important to continue with dietary and exercise changes to help the medications work. Also, blood pressure medications are designed to control, but not cure, high blood pressure, so they need to be taken consistently.High blood pressure is called the “silent disease” because it generally has no symptoms and often goes undetected. The time to treat it is early, before it takes its toll on the body. Treatment most often consists of dietary and exercise changes, with medications used as needed. Many people avoid checking their blood pressure because they don’t feel it’s important or because they are afraid that it may be high. Other people feel healthy so they assume their blood pressure will be good. As with most medical issues, it is better to know your blood pressure and take action to reduce it than to suffer the consequences later in life.Dr. Kent HerbertBoard-Certified Family PhysicianFalcon Family Medicine7641 McLaughlin Rd.Falcon, CO 80831(719) 494-2006(719) 494-8448 faxwww.FalconFamilyMedicine.com
