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Fighting a silent killer

Dr. Drew Werner

“It’s always that high.” “It’s up because I had too much coffee this morning.” “Whenever I come to the doctor’s office it’s too high; it’s fine when I am home.” “No one ever told me it was too high before.” “I feel fine.”What is it? Blood pressure, of course!Dear Doc: I have to have some surgery, and I’ve been told my blood pressure is a little bit high. My doctor said I may need medication, but I hate taking pills. Is there anything else I can do? Is it really that bad?- I Feel Fine (in Eagle)Dear Fine: Something happened to me while I was living in upstate New York, which has always made me think of blood pressure. My family and I lived in a small house not far from my medical practice. Despite living through more rain than anyone could want, I still needed to water the side lawn where the occasional sun turned it brown. Watering wasn’t a problem because the plumber had connected all of our outside faucets to the line coming in from the street, bypassing the pressure regulator. That meant we had street pressure to water the lawn. It was pretty amazing. With just a single oscillating sprinkler, I could water nearly a half-acre from our garden hose! Well, one day I turned the sprinkler on and set an automatic shutoff at the sprinkler head. I went to bed knowing the water would surely shut itself off. The next morning, however, I awoke to a river of water flooding downhill into our neighbor’s lawn! The hose that was attached to the sprinkler head finally succumbed to the high pressure and burst wide open. The rest, as they say, is history.Every time I think of that burst hose, I think of people with high blood pressure and wonder when their disaster will come.High blood pressure, or more specifically hypertension, is a medical condition defined by the two numbers you are probably familiar with. It is expressed as a number over another number. Ideally it should be 120/80 or less. The top, or systolic, number refers to the pressure of the blood in our arteries while the heart is beating. The lower, or diastolic, number refers to the pressure when the heart is resting or between contractions. Both are important and tell us about the health of our vascular system. Like a flexible but not floppy hose, it is ideal if our arteries have some compliance or ability to absorb the sudden increase in pressure while the heart beats. At the same time, those arteries should relax when the heart does. They don’t become floppy but just allow the pressure in them to drop about 35 percent to 45 percent. However, people with high blood pressure typically have stiff vessels with less give. Their vessels don’t deal as well with the rapid pressure changes from a beating heart and over time become damaged. This damage can lead to heart attacks, stroke, kidney failure and other really unpleasant things.Is our blood pressure important? You bet it is. Doctors often refer to hypertension as the “silent killer.” Generally, it is impossible to tell when it is too high. Some people, though, are very attuned to such things and may feel when it is indeed high at times. However, feeling OK doesn’t guarantee your blood pressure is.What can you do? The first thing is to periodically have your blood pressure checked. Your doctor’s office is a good place to start. Many of the community screenings like the 9 Health Fair are excellent, too. City Market has do-it-yourself machines, which also help give you a basic idea. Like the temperature outside, fluctuations are normal, within a range. If your pressure is outside of that range, it is unhealthy, even if it happens only once in a while. While stress, pain, injury and other factors were once considered reasonable excuses for a rise in blood pressure, that is no longer the case. If it is high, it is high! Now, one high reading doesn’t mean you need to get your affairs in order, but it is something that needs checking. If two out of three readings are high, it is time to get serious about bringing it down!What readings are good and bad? What can you do? Want to know more about the medications you have heard about? Stay tuned next week.Vail, Colorado


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