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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 The answer to the question seems to be that for some people medication can be withdrawn when they successfully change lifestyle factors.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:
An Overview of High Blood Pressure Treatment from WebMD.
Hypertension from Wikipedia.
Ideal Blood Pressure includes video by Dr. Tytus. Ideal blood pressure is 120/80; you have hypertension if it's consistently above 130/90. Two values are usually given when you measure your blood pressure. The first is a systolic reading, given when the heart contracts, and a diastolic reading, given when the heart relaxes.
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.
Treatment of High Blood Pressure
Types of Blood Pressure Medications from National Heart, Lung, and Blood Institute (NHLBI)
High Blood Pressure: When to Seek Medical Care
Treatment from eMedicine Consumer Health
Types of Blood Pressure Medications from American Heart Association
Adopting a treatment strategy: Choosing high blood pressure medications from MayoClinic.com
High Blood Pressure, Medications Increase Diabetes Risk.
How to Prevent Hypertension by eHow Contributor.

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