Detecting the Silent Killer

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Do you know why the nurse takes your blood pressure (BP) every time you come for a consultation? Simple reason – because high blood pressure (Hypertension) can lead to many severe illnesses, not just heart problems. So how do you keep your blood pressure under control?

As part of the routine in most good hospitals and clinics is the measurement of your blood pressure. You should get this done at least twice a year. Rising or elevated readings do mean you should get medical advice.

I get my own BP checked regularly and the other day I was in the clinics and got the nurse to take my BP. It was 158/87. Too high. However, about 30 minutes later I had my BP checked again. This time 147/76. Much better, but still marginally up. How could this be? To complicate the matters even more, I had my BP checked this week. Result 120/65. Now, were all the machines wrong? Or were the nurses recording the pressure incorrectly? Simple answer – Just as one swallow doesn’t make a summer, one elevated reading does not necessarily mean hypertension.

So why is BP important? Because if you don’t you don’t have any BP you are definitely dead! However, if your BP is too high, it can mean you could be claiming early on your life insurance policy – or your relatives will, on your behalf.

High BP is otherwise known as the “silent killer” as there are very few symptoms of the increase in blood pressure, until a vessel bursts somewhere, generally catastrophically! The good thing is you are dead within minutes, so you won’t linger.

Why is it important? Blood is needed to keep all the organs of the body supplied with oxygen. This is done by the red blood cells which carry the oxygen, with the pump to drive the system being the heart. The tubes from the heart heading outbound are the arteries, and those returning the blood to the heart are the veins.

This heart-arteries-veins-heart system is a “closed” circuit. In other words, no leaks, otherwise you would be continually losing the life-preserving blood, but to make it go around, there has to be a pumping pressure.

The heart squeezes the blood inside itself and pumps it out into the arteries. This squeezing pressure is called the Systolic, and is the upper number quoted when we measure your blood pressure. For example systolic 120 over 70.

After the squeeze, the heart relaxes to allow the blood to fill the chamber, ready for the next squeeze. The pressure does not return to zero, because there has to be some pressure to refill the chamber. This resting or ambient pressure is the lower number quoted and is called the Diastolic. BP is then typically quoted as 120/70, being 120 (systolic) over 70 (diastolic). The actual pressure number is measured in a millimeters of mercury scale.

So what is the correct BP? The following table shows the categories of BP measurements.

Optimal: less than 120/80

Normal: less than 130/80

High-normal: 130–139/85–89

High blood pressure (true hypertension):

Stage 1: 140–159/90–99

Stage 2: 160–179/100–109

Stage 3: 180 or higher/110 or higher

The problem with running at high pressure is that the heart is having to work harder, and therefore may be subject to premature heart failure. The arteries are also subjected to higher pressures than they were designed to cope with and can burst, making the risk of stroke so much higher. Other organs don’t like working at the high pressures either, and kidneys in particular, can go into failure mode.

No, if you really have hypertension, get it treated – but remember to have repeated measurements done, and don’t let a doctor classify you as being “hypertensive” on one BP reading, until repeated measurements confirm the high level to show that your BP is too high.

There is a good reason for this as well as the straight out medical one. If your BP is (consistently) too high, your friendly insurance man will decline insuring you because you are “hypertensive”. Don’t let them do that on one reading outside their “limits”.