How much do you know about hypertension?
Hypertension, widely known as high blood pressure is one of the most common chronic conditions treated around the world.
The chances of developing this condition increase with advancing age.
Almost 50% of the individuals aged 60-69 and approximately 75% of the individuals older than 70 have hypertension.
One of the most widely known studies called the Framingham Heart Study has estimated that almost 90% of women and men who didn’t have high blood pressure at 55 or 65 years of age will have the disease by age 80-85.
It is no secret that the number of medications prescribed to individuals increase with advancing age and many of these prescribed medications are related to hypertension.
These statistics sound very negative and depressing. It seems that we have no choice other than to get older (at least for now until somebody is able to invent a rejuvenating elixir) and ending up with high blood pressure and the need to take a large number of medications.
Are there ways to prevent hypertension or at least reduce its damage to the body?
I would like to discuss a case with you that is unfortunately too common in our society.
You may find that your behavior might be a little similar to the following patient.
It is the case of a 46 year old patient who considers himself to be one of the healthiest people in the world. He exercises regularly and denies smoking or using “street drugs”. He is very successful at his job. He has never had any medical examination or blood work done. He says that he does not need these things and hates going to a doctor.
His father lived to be 78 years old and never had any issues either. He makes fun of people who take medications and go to their doctors on a regular basis. One day his brother, who had bought a new blood pressure machine, asked him to check his blood pressure.
Our patient was reluctant and didn’t want to do it until he finally agreed. His first blood pressure reading was 190/110 mm/Hg which is much higher than the normal blood pressure of 120/80 mm/Hg. His brother insisted on having a second measurement that was 186/110 mm/Hg.
The patient smiled and downplayed the results of these measurements. His brother who was very concerned said, “You need to take care of this blood pressure, you need to go to a doctor and discuss a treatment”. Our patient repeated that he is young and healthy and emphasized again that his father lived to be 78 years without any medical issues.
Before going any further, let me explain what high blood pressure or hypertension actually means.
What is hypertension?
Hypertension is when the pressure inside our vascular system including the heart, brain, kidneys, liver and all other organs increases dramatically.
Having some pressure is always good. Imagine the following example, you’re living in the 10th floor of a New York City apartment and intending to take a shower. You probably wish to have good water pressure that could assure you a successful shower otherwise your shower will turn to a nightmare.
The same thing is true with our body, brain, heart and kidneys that require good blood flow and this blood flow is maintained by a certain blood pressure.
Like everything else, too much of anything is bad. That is why high blood pressure will increase the pressure to much higher levels that will damage the walls of the vessels and make them irritated and traumatized.
Therefore, long term high and uncontrolled high blood pressure will result in hardening of the blood vessels and consequently worsening of pressure. Patients who have long-term and uncontrolled high blood pressure may end up with heart attack and stroke.
Now, let us analyze this case together.
Mistake 1: Counting too much on youth
It’s a common perception that youth can protect us from illness and aging, brings us pain and disease. This belief leads to many misconceptions and misunderstandings. You seldom get problems with a new car.
However, if you don’t treat your new car well, the damage and destruction will happen sooner than later. Youth hides the problems with its better flexibility and partial ignorance but it can’t make the problems to disappear. Youth doesn’t provide a total safety wall around us. This reality needs to be understood and appreciated.
We can build good health in the early phases of our life and at the same time we can also destroy our health very early. Imagine a house that is built with high quality material and by well qualified people. The chance that this house lasts longer and causes fewer headaches to the owners is much greater than a house that is built poorly.
It is clear that we can’t live as long as a house can last but, you get the point…
Mistake 2: Seeing Hypertension as an accident
Developing hypertension is not an accident. You don’t win high blood pressure at one of the lottery drawings on Saturdays. It’s a process that starts many years before manifestation of the high blood pressure. Our belief that things happens suddenly and at once is based on false beliefs and it’s simply naive. Pre-hypertension is the stage before hypertension and most of the time it’s ignored.
Look at our news reports. People talk about how a bridge has collapsed and killed many innocent individuals. But how many people are interested in finding out what the exact reason for this collapse was.
I am not suggesting that starting tomorrow we should stop our job and start functioning as a general inspector and inspect all the bridges and roads for problems and deficiencies. What I am trying to say is that almost nothing— except a few accidents—happens suddenly, and without prior warning.
This is important information that if appreciated, can save you a huge amount of suffering and unnecessary troubles.
Mistake 3: Underestimating your enemy
The next obvious mistake of this individual has cost many people their victory, lives and success. Underestimating the enemy is one of the greatest mistakes that one can do and unfortunately, it happens more often than you may believe. It happens in every sector of life, such as in sports, politics, the economy and certainly in health related matters.
This individual with high blood pressure is underestimating his condition and is not recognizing this matter as a danger to his livelihood. There can be many reasons for the underestimation of this condition. They can include lack of knowledge and/or anxiety in facing the reality. Whatever the reason, the outcome can be lethal to this person. He needs somebody who is candid and blunt with him and who can tell him the truth.
But as we all know, telling the truth can only go so far…..
Mistake 4: Gambling with your health
This younger man is clearly gambling with his health. He is ignoring reality as if, this ignorance would make the problem disappear. This behavior is like a typical Russian roulette. It could go well for a while but it can also go wrong very fast. However, it will go wrong eventually. He is not willing to understand the danger and to get help.
Mistake 5: Misunderstanding family history
I hear very often that younger people try to justify why they don’t want to take care of themselves. They want to make themselves believe that their genes are great and their father, mother or brother would have lived a longer life if they only weren’t a smoker or obese or…etc.
In my experience, relying too much on family history can be very dicey.
Most of the information that we remember and have heard from our family is inaccurate or incomplete. We don’t know the context of the problem and condition and naturally, we try to build our own interpretation around the existing information. Our general knowledge about our first degree family members’ health conditions is poor and about second degree family members almost non-existent.
You should not rely too much on the notion that because your father didn’t die from a heart attack you will also be safe. It is clear that a reliable family history can help us in classifying one’s risk profile but I usually focus on positive events to intensify the treatment and less on negative events to rule things out.
Let me explain what I mean.
If you tell me that your father had a heart attack, I would classify your risk of having heart attack as high and intensify your management. But if you deny any heart attack in your first degree family members, I would still consider you as a possible candidate of having a heart attack—not as high as somebody with a positive family history—and help you to minimize your risk factors accordingly.
An accurate family history is important but not enough to justify ignoring the reality.
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