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Pressures of Blood Pressure
(Hypertension)

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

Article printed on page 19 in the November 15-16, 2008 issue of The Mississauga News under the feature: Health, Wellness & 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 factors 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 further, 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 when we do start the treatment, and sometimes you 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 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 The answer to the question seems to be that for some people medication can be withdrawn when they successfully change their lifestyle. 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 for a short period to monitor carefully while temporarily suspending a medication. I would strongly dissuade anyone from attempting discontinuation of their medication without appropriate medical advice.

I would like to recognize a special couple who have inspired many of us to love life as much as we cherish our health. One is the icon, and the other is the solid base without whom the icon could not glow. The legendary hockey hero Johnny Bower and his wife Nancy are celebrating their 60th Wedding Anniversary today. I thank them for their guidance, support and friendship over the years. This column and this town would not be the same without them. May God Bless them!


Related resources:

Hypertension from Wikipedia, the free encyclopedia.

Hypertension / High Blood Pressure from WebMD.com.

High Blood Pressure from eMedicineHealth. Overview, Causes, Symptoms, Exams and Tests, High Blood Pressure Treatment, Medications, Surgery, Other Therapy, Prevention.

Grapes may help fight high blood pressure from intheNews.co.uk.

Johnny Bower from Wikipedia, the free encyclopedia.

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