New Insights Into High Blood Pressure

DANBURY –– It used to be thought that a systolic blood pressure (the top number) under 140 was in the normal range. Today, however, doctors have a better understanding of blood pressure, and strive to have their patients well under 140.

“High blood pressure isn’t a normal concept,” said Howard Garfinkel, MD, chief of nephrology/hypertension at Danbury Hospital. It is a misconception that blood pressure should naturally increase with age. “Your blood pressure should be what it was when you were in high school.” Even slight variations in blood pressure can put one at risk for problems later on, he added.

Dr Garfinkel spoke at a recent Medical Town Meeting sponsored by the hospital, “Off the Cuff: New Insights on High Blood Pressure.” He helped to clear up some misunderstandings about hypertension, helping people to better grasp what the two numbers in a blood pressure reading mean. Blood pressure is recorded as two numbers, he said, one when the heart is contracting and one when the heart is relaxed.

The most important number is the top number, according to Dr Garfinkel, and the lower the better. Having a high systolic number puts one at risk for cardiovascular problems. The top number is so important, he said, that some experts in the field think that it should be the only number measured. In some cases of high blood pressure, especially in the elderly, the top number is the only elevated number. This condition, called isolated systolic hypertension, accounts for 70 percent of all high blood pressure in the elderly.

In cases of high blood pressure, doctors first try to determine if something is causing it, such as a blockage in the renal artery or a tumor in the adrenal gland. Just like in a cardiovascular blockage, an artery to the kidney could be blocked and cause the hypertension. Treating the blocked renal artery can help ease blood pressure problems.

Another problem of high blood pressure is that it puts one at increased risk for hardening of the arteries, or arteriosclerosis. “We have to understand high blood pressure as a risk factor for vascular disease. The higher your systolic blood pressure, the worse the outlook is for a cardiovascular problem. The lower, the better your outlook.”

Why is blood pressure so important? Because it affects all the body’s organs, according to Dr Garfinkel. And diabetics are especially at risk.

Dr Garfinkel recommends several ways to keep blood pressure in check:

Weight reduction –– Obesity seems to turn on genes that cause high blood pressure, diabetes, and other conditions

Sodium restriction –– Many prepared foods are filled with salt. Strive to eat a more natural diet.

Stop cigarette smoking

Limit alcohol intake –– Up to two bottles of beer or two glasses of wine is OK, but anything more can raise blood pressure.

Exercise regularly –– Aerobic exercise, like walking, is better than isometrics. Dr Garfinkel also cautions that patients with high blood pressure should not life weights.

Dr Garfinkel suggests that patients make sure their blood pressure is taken the proper way, by sitting with your legs touching the floor and having your arm resting on a table or supported by someone.

He also suggests that people find out what their doctor’s blood pressure goal is for them.

While blood pressure can be managed with medications, doctors are finding that it takes more and more drugs to keep it in check, he said.

For more information, ask a doctor, or visit the Danbury Hospital website, www.danburyhospital.org.