8 replies to this topic

[maineman]

Around 1950 the connection between rising blood pressure ond premature death (stroke, heart attack, kidney damage, retinal damage) was unkown. What was known is that as we age the blood pressure goes up. Just like we get gray hair, wrinkles, etc. In other words, it was felt to be a "normal" part of ageing. When the connection was made and intense effort was made to influence blood pressure. Studies on diet, exercise, stress, etc. were undertaken and continue to this day. A "manhattan project" type of zeal led to insights into metabolism that led to most of the discoveries of the late 20th century. From the moment we added blood pressure pills and screening into the population the incidence of stroke world wide has crashed, the population is living much, much longer. In fact, the treatment of BP has saved more lives than polio vaccines and penicillin. The last frontier on the blood pressure battle is a more precise definition of "what is high". The latest study in London on very old people and pressure was just stopped prematurely this week because the treatment group did so much better on medication than the control group it was unethical to continue. At 80 years old with elevated blood pressure the group was split in two. The treatment group got a teeny tiny dose of non-fancy old blood pressure meds, the control group was essentially told to do what they had been doing for the past 80 years. The results were startling. (see HYVET -Hypertension and the Very Elderly Trial - Imperial College, London) Anyway, just sharing. Amazing to this day that there are some who disregard blood pressure data. By 40 years old you should be checking this once a year. Keep it in the 120/70 range as best as you can through proper weight. If not, add a lousy old blood pressure pill and live a long a healthy life. As the study once again shows, its never too late to take care of yourself. BTW, there are only 2 ways to properly control blood pressure. Weight loss and/or blood pressure pills. mm

[stocks]

Around 1950 the connection between rising blood pressure ond premature death (stroke, heart attack, kidney damage, retinal damage) was unkown. What was known is that as we age the blood pressure goes up. Just like we get gray hair, wrinkles, etc. In other words, it was felt to be a "normal" part of ageing.

When the connection was made and intense effort was made to influence blood pressure. Studies on diet, exercise, stress, etc. were undertaken and continue to this day. A "manhattan project" type of zeal led to insights into metabolism that led to most of the discoveries of the late 20th century. From the moment we added blood pressure pills and screening into the population the incidence of stroke world wide has crashed, the population is living much, much longer. In fact, the treatment of BP has saved more lives than polio vaccines and penicillin.

The last frontier on the blood pressure battle is a more precise definition of "what is high".

The latest study in London on very old people and pressure was just stopped prematurely this week because the treatment group did so much better on medication than the control group it was unethical to continue.

At 80 years old with elevated blood pressure the group was split in two. The treatment group got a teeny tiny dose of non-fancy old blood pressure meds, the control group was essentially told to do what they had been doing for the past 80 years. The results were startling. (see HYVET -Hypertension and the Very Elderly Trial - Imperial College, London)

Anyway, just sharing. Amazing to this day that there are some who disregard blood pressure data.

By 40 years old you should be checking this once a year. Keep it in the 120/70 range as best as you can through proper weight. If not, add a lousy old blood pressure pill and live a long a healthy life. As the study once again shows, its never too late to take care of yourself.

BTW, there are only 2 ways to properly control blood pressure. Weight loss and/or blood pressure pills.

mm

MM,
Does blood pressure vary over the course of the day? Might you see a 10 mm increase
later in the day from stress or exercise?
That would make a single reading suspect.

[Rogerdodger]

Relatives also raise blood pressure.

[gman]

MM, I apologize for busting into your high blood pressure thread, but I have a friend that was recently diagnosed with a disease/syndrome that I have never heard of. Would you mind giving me direction (or a dependable internet link) as to what this disease is. She has been receiving platelet transfusions that have helped. Thank you. Metatlasti Fibrosis Myelofibrosis and Myelatys Plastic Syndrome --John

[maineman]

Around 1950 the connection between rising blood pressure ond premature death (stroke, heart attack, kidney damage, retinal damage) was unkown. What was known is that as we age the blood pressure goes up. Just like we get gray hair, wrinkles, etc. In other words, it was felt to be a "normal" part of ageing.

When the connection was made and intense effort was made to influence blood pressure. Studies on diet, exercise, stress, etc. were undertaken and continue to this day. A "manhattan project" type of zeal led to insights into metabolism that led to most of the discoveries of the late 20th century. From the moment we added blood pressure pills and screening into the population the incidence of stroke world wide has crashed, the population is living much, much longer. In fact, the treatment of BP has saved more lives than polio vaccines and penicillin.

The last frontier on the blood pressure battle is a more precise definition of "what is high".

The latest study in London on very old people and pressure was just stopped prematurely this week because the treatment group did so much better on medication than the control group it was unethical to continue.

At 80 years old with elevated blood pressure the group was split in two. The treatment group got a teeny tiny dose of non-fancy old blood pressure meds, the control group was essentially told to do what they had been doing for the past 80 years. The results were startling. (see HYVET -Hypertension and the Very Elderly Trial - Imperial College, London)

Anyway, just sharing. Amazing to this day that there are some who disregard blood pressure data.

By 40 years old you should be checking this once a year. Keep it in the 120/70 range as best as you can through proper weight. If not, add a lousy old blood pressure pill and live a long a healthy life. As the study once again shows, its never too late to take care of yourself.

BTW, there are only 2 ways to properly control blood pressure. Weight loss and/or blood pressure pills.

mm

MM,
Does blood pressure vary over the course of the day? Might you see a 10 mm increase
later in the day from stress or exercise?
That would make a single reading suspect.

Stocks,

Blood pressure varies with every heart beat. It can vary by much more that 10 mm, just between the waiting room and the exam table. Or AM to PM and left arm to right arm. I never "diagnose" HBP based on a single reading. Usually a person with HBP has consistently high readings. But you are right: you need to interpret a single reading with suspicion. If there is any doubt, you can take readings at home throughout the day. Ambulatory Blood Pressure monitoring is still too expensive for routine use, but you can get close with frequent intermittent readings.

mm

[maineman]

MM,

I apologize for busting into your high blood pressure thread, but I have a friend that was recently diagnosed with a disease/syndrome that I have never heard of. Would you mind giving me direction (or a dependable internet link) as to what this disease is. She has been receiving platelet transfusions that have helped. Thank you.

Metatlasti Fibrosis Myelofibrosis and Myelatys Plastic Syndrome

--John

John, I think you are referring to Myelofibrosis or Myelodysplastic syndrome. This usually occurs in older folks whose bone marrows are on the fritz and not making enough blood products, like red blood cells, platelets or white blood cells. See if you can find out exactly what she has, that would be a help. Reliable sources on the web include Medscape.com

Other than that commonly found in the older folks, younger people can get it, possibly linked to toxic exposures (unleaded gas, possibly, some pesticides, and some herbicides. In most cases the cause is unknown. Let me know if I can be more helpful.

mm

[PorkLoin]

Stocks, blood pressure can vary a LOT. This spring I had osteomyelitis - two vertebrae in my back, and twice a day I went to the hospital for intravenous infusion of antibiotics. BP was taken before and after every session (117 in all), so I had many readings for a goodly sample size. I've read that BP often "spikes" when you first get out of bed. Heard from other people that even mild exercise can really make it go up, too (likely dependent on the individual). My own experience is some days the first reading would be perhaps 145 for the top number. Pretty high, and unusually high for me. Maybe it was just getting out of my truck, walking across the parking lot, going into the hospital (many people have some sort of "fear" response when going into hospitals, doctor's offices, etc.). Heck, even just having the BP taken makes some people's BP go up.... I think one is supposed to be still for about five minutes, then have BP taken with the arm at the level of the heart. No smoking or caffeine for awhile before the measurement - that stuff makes BP go up too. Lots of times people don't get that five minute still period before BP measurement. Slam bam you sit down and the nurse does it. Anyway, I'd sit there, sometimes purposefully trying to meditate, envisioning blood vessels dilating, etc. The next reading would be lower, usually in the 120s or between 115 and 120. Best, Doug

[Echo]

There are hundreds of influences on any one blood pressure reading and so averaging several readings as MM mentioned is best. Even then there can be a "white coat" influence where readings in a doctors office or medical setting can be higher due to patient anxiety. Also, there is a biological diurnal variation in blood pressure in humans due to hormonal and neuronal activity that raises blood pressure in the morning hours, staying high during the day and falling in the evening hours. Adrenal/cortisol levels rise for example. Centuries ago this surge facilitated our ability to go out and hunt/scavenge for food and defend ourselves. It persists even now as we wake up to go to work and watch futures/market openings and deal with the world. Many things can effect a single BP reading: size of the cuff, position of the patient(sitting, laying, standing), temperature, anxiety, pain, talking during the reading, when you took you last BP med, alcohol, tobacco, caffiene, psuedophed, motrin/advil/aleve, etc., steroids, etc etc etc. The list is truly long. The bottom line is that multiple readings done correctly give you a general idea of the BP in any one person. Every mmHg drop in BP will lead to a drop in risk of dying, stroke, cardiovascular events until you get the BP down below 120/80. Just do it. echo

[stocks]

Great comments. I would conclude that a certain fraction of the population has consistently high b/p and should take steps to reduce it (there are several ways). A certain fraction of the population has low b/p and need not take action. For the rest in the middle, finding the 'true' b/p can be difficult and the course of action is not easy to determine. But lower is better. Also, a prescription made on the basis of a single measurement should be challanged.

Edited by stocks, 13 August 2007 - 11:38 AM.