Question of the Week

February 2, 2009


Most people have had their blood pressure checked at some point. Whether at a routine visit to the doctor, a visit to the dentist, when donating blood, or when being checked by a doctor or nurse who monitors athletes at school, checking a person's blood pressure is a routine, non-invasive test that can give doctors insight into what is happening inside a patient's body.

"Danny Thrall had always taken his abilities for granted. He was good at swimming. ... The college sophomore called his mother in September. 'Mom,' he said, 'my blood pressure's high, and they're not letting me practice.' ... A routine physical turned up slightly, but consistently, high blood pressure. The team doctor hoped it wasn't serious, but it was enough to keep Thrall out of the pool. He went to a cardiologist for tests, who sent him to more specialists for even more tests. 'At first, this just seemed like a major inconvenience to me. I was just being impatient about it and getting edgy,' he says. 'I thought this was some routine thing where they were going to go through everything and say, "Oh, you were fine."' But he wasn't. The tests showed that his aorta was greatly enlarged because it was overcompensating for a leaky valve. Surgery, his doctors said, would have to happen quickly... Had he been allowed to practice, they said, he very well could have died. At the very least, he would have done irreparable damage to his heart."

High blood pressure is much more common in adults than in children and teens. A healthy, athletic teen with consistently high blood pressure was a warning sign that caused doctors to look further.

"Blood pressure is the force of blood against the walls of arteries. Blood pressure rises and falls during the day. When blood pressure stays elevated over time, it is called high blood pressure. The medical term for high blood pressure is hypertension. High blood pressure is dangerous because it makes the heart work too hard and contributes to atherosclerosis (hardening of the arteries). It increases the risk of heart disease and stroke, which are the first- and third-leading causes of death among Americans. High blood pressure also can result in other conditions, such as congestive heart failure, kidney disease, and blindness. A blood pressure level of 140/90 mmHg or higher is considered high. About two-thirds of people over age 65 have high blood pressure. If your blood pressure is between 120/80 mmHg and 139/89 mmHg, then you have prehypertension. This means that you don't have high blood pressure now but are likely to develop it in the future."

While adults are more likely to be aware of their blood pressure, the instances of hypertension among teens and children are increasing.

"Although it is far more common among grownups, high blood pressure is on the rise among kids as the childhood obesity epidemic grows. And, according to a new study, hypertension is a serious problem that's often undiagnosed in kids. Looking at the blood pressure levels of more than 14,000 children and teens (from ages 3 to 18), researchers discovered that nearly three quarters of the 500-plus kids who had hypertension hadn't been diagnosed with high blood pressure in any of their three previous routine checkups. Kids with high blood pressure often don't have any symptoms at all, so the condition can be tough to catch. Diagnosing hypertension is also 'complicated because normal and abnormal blood pressure values vary with age, sex, and height, and are therefore difficult to remember,' says the study. That's why it's crucial for doctors — and parents — to keep track of kids' blood pressure levels as they grow and address any abnormalities."

Abnormalities in blood pressure levels can be red flags for doctors who can then look further into what might be causing the hypertension. In cases where lifestyle changes (losing weight, increasing exercise levels, eating healthier foods, etc.) can help reduce the blood pressure levels, doctors and patients can work together and create goals and strategies for healthier living. In cases where the cause is unknown, doctors can run further tests to investigate what might be an underlying cause.

"In 90 to 95 percent of high blood pressure cases in adults, there's no identifiable cause. This type of high blood pressure, called essential hypertension or primary hypertension, tends to develop gradually over many years. The other 5 to 10 percent of high blood pressure cases are caused by an underlying condition. This type of high blood pressure, called secondary hypertension, tends to appear suddenly and cause higher blood pressure than does primary hypertension. Various conditions and medications can lead to secondary hypertension, including: Kidney abnormalities; Tumors of the adrenal gland, Certain congenital heart defects; Certain medications, such as birth control pills, cold remedies, decongestants, over-the-counter pain relievers and some prescription drugs; Illegal drugs, such as cocaine and amphetamines."

Even when there is not one specific cause that can be identified, an assessment of daily health habits can raise red flags and signal possible contributing factors. Whether someone is trying to reduce the risk of developing high blood pressure (HBP) or control/reduce HBP that has already been diagnosed, it is key to establish healthy habits.

"Healthy habits can help you control HBP. Healthy habits include:

  • Following a healthy eating plan
  • Doing enough physical activity
  • Maintaining a healthy weight
  • Quitting smoking
  • Managing your stress and learning to cope with stress
If you combine these measures, you can achieve even better results than taking single steps. Making lifestyle changes can be hard. Start by making one healthy lifestyle change and then adopt others. Some people can control their blood pressures with lifestyle changes alone, but many people can't. Keep in mind that the main goal is blood pressure control. If your doctor prescribes medicines as a part of your treatment plan, keep up your healthy habits. This will help you better control your blood pressure."

With HBP rates on the rise in children and teens, many are becoming more aware that the healthy (or unhealthy) habits that are established at a young age can affect a people's health for the rest of their lives.

"Problems with high blood pressure that start in childhood may last a lifetime. ... Researchers analyzed blood pressure levels at various ages during childhood and compared them with follow-up measurements taken in the same individuals up to 47 years later. The results showed a consistent relationship between the children's blood pressure levels and blood pressure levels as adults. In particular, blood pressure levels among older children appeared to have a stronger link to blood pressure levels in later adulthood. Researchers say an estimated 73 million adults have high blood pressure, which is a major contributor to heart disease, heart failure, stroke, kidney failure, and other health problems. They say targeting children with high blood pressure with lifestyle modification techniques such as a healthy diet and regular exercise may help reduce their risk of high blood pressure and its related health consequences as adults."
Web MD

Questions of the Week:
What do you, your friends, and your family members need to understand about what blood pressure is, and what high blood pressure might indicate? How often should you have your blood pressure checked? Why might some people need to have their blood pressure checked more frequently than others? If your blood pressure is currently in the "healthy" range, what can/ should you be doing to reduce your risk of developing high blood pressure in the future? If your blood pressure is currently considered borderline or high, what can/ should you be doing to lower your blood pressure and reduce your risk of long term damage?

Please email me with any ideas or suggestions.
Note: Due to increasing amounts of SPAM sent to this account, please include "QOW" in the subject line when sending me email.

I look forward to reading what you have to say.

Health Community Coordinator
Access Excellence @ the National Health Museum

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