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The Pressures of Blood Pressure
and Tension

By Dr. Peter W. Kujtan, B.Sc., M.D., Ph.D.

Article printed on page 24 in the July 10, 2013 issue of
The Mississauga News under the feature: Health & Beauty, Medicine Matters.
Portrait of Dr. Peter W. Kujtan, supplied 2005
Dr. Peter W. Kujtan

Hypertension is a condition that for the most part has no ongoing symptoms, except in the rare emergency situation. It takes years to develop heart, kidney, eye and circulatory problems. Controlling hypertension is an intervention that produces the greatest reduction in stroke and heart attack risk. The only other intervention with greater impact on your risk is to quit smoking.

It usually takes about six months of repeated measurements and observing trends to make the diagnosis. After hypertension is diagnosed, we usually begin by looking at and trying to modify risk factors. I challenge patients to start simple by adding a brief activity to their day such as parking futher away, climbing stairs, or doing a brisk reconnaissance loop of the supermarket before you start shopping. At some point, I might consider advising patients to commence the use of medication. Starting blood pressure medication is difficult to do and maintain since there is no obvious gains readily seen by the patient.

The goal of treatment is to lower the resting systolic-diastolic pressures to below 140-90, or more ideally, below 130-75. Trouble is that you don't feel much different with the treatment, and sometimes even experience unwanted effects.

Prevention and decrease of risk is a difficult concept to accept, and this leads to non-compliance. Blood pressure changes with the needs of the body. When we refer to blood pressure, we assume the measurement is made at rest in a relaxed atmosphere. Most patients refuse to apply that definition to my exam room, particularly with latex gloves, scales and pap slides lying about.

Starting medication is a difficult choice. At last count, there are over 200 different brand names and variations of blood pressure formulations available. This fact alone points to the conclusion that no ideal agent has yet been discovered, and secondly, relying solely on medication without addressing other modifiable risk factors is foolish. The answer to the question seems to be that for some people medication can be withdrawn when they successfully change lifestyle factors.

Drinking less alcohol, exercising regularly, attaining an ideal weight, quitting smoking, decreasing salt intake, controlling blood sugar and cholesterol can all combine to eliminate the need for medications. Your doctor may try a short period of careful monitoring while temporarily suspending a medication. I would strongly dissuade anyone from attempting discontinuation of their medication without appropriate medical advice.

Related resources:
17 Effective Ways to Lower Your Blood Pressure from Healthline. High blood pressure, or hypertension, is called the "silent killer" for good reason. It often has no symptoms, but is a major risk for heart disease and stroke. And these diseases are among the leading causes of death in the United States ... The good news about elevated blood pressure is that lifestyle changes can significantly reduce your numbers and lower your risk - without requiring medications. Here are 17 effective ways to lower your blood pressure levels.
An Overview of High Blood Pressure Treatment from WebMD.
Hypertension from Wikipedia.
Blood Pressure Readings Explained from Healthline. The top number refers to the amount of pressure in your arteries during the contraction of your heart muscle. This is called systolic pressure. The bottom number refers to your blood pressure when your heart muscle is between beats. This is called diastolic pressure. Numbers greater than the ideal range indicate that your heart is working too hard to pump blood to the rest of your body.
Blood pressure from Wikipedia.
What is normal blood pressure? From Blood Pressure UK. Ideally, we should all have a blood pressure below 120 over 80 (120/80). This is the ideal blood pressure for people wishing to have good health. At this level, we have a much lower risk of heart disease or stroke.
Blood Pressure Chart from Blood Pressure UK.
High Blood Pressure. Also known as Hypertension from National Heart, Lung, and Blood Institute (NHLBI).
Heart-Healthy Living. Ways to adopt a heart-healthy lifestyle. You can do a lot to protect your heart and stay healthy. Heart-healthy living involves understanding your risk, making choices, and taking steps to reduce your chances of getting heart disease, including coronary heart disease, the most common type.
High Blood Pressure: When to Seek Medical Care
Treatment from eMedicine Consumer Health
Types of Blood Pressure Medications from American Heart Association
Why is high blood pressure a 'silent killer'? CNN video, 1:29 min. Elizabeth Cohen explains why it's important to check and maintain a healthy blood pressure.
Diabetes and High Blood Pressure from Johns Hopkins Medicine.
How to Prevent Hypertension by eHow Contributor.

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