It's called the silent killer. Some people seem to find out that they have high blood pressure by accident - when they walk into the doctor's office or emergency room for a bad cold or a sore throat. And then, some people never get a chance to discover that they have had blood pressure problems - until it is too late. This is all because of the fact that the symptoms of high blood pressure are so diverse that many can not tell whether or not their blood pressure is high; and sometimes the symptoms are masked by other details, such as weight. Nevertheless, high blood pressure continues to be a problem in the American society, in spite of all of the high tech equipment, and advancements made in medical pharmacology.

Some of my patients still ask me - "what is a normal blood pressure?" Well, that's a good question, because it really depends on the age (and sometimes gender) of the patient. Most of us know that a blood pressure of 120/80 is considered normal; but that "normalcy" is for the younger patient (ages 18-50). For the majority of young people (from infant to young teenager), the blood pressure usually hovers around 90-110/70 or 80. That's normal for them....and then some women seem to handle a blood pressure of 90/60 for the rest of their lives. Normal is what the body is used to "seeing and experiencing". Go above that "mark" for an extended period of time and there will surely be damage done to organs in the body, including the heart and brain, just to name (perhaps) the two important ones.

So, where do we stand in the fight to control America's blood pressure? The answer to that question can be seen in the hospitals. Yes, we have come a long way in dealing with many of the problems associated with blood pressure. New medicines are available which can do a better job in controlling the heart rate, or help "dilate" the blood vessels, thus lowering the pressure. The ultimate goal (in most situations) is to reduce the pressure upon which the heart must pump in order to get the blood out into the circulation. It is not always that easy. For many people with a long standing history of high blood pressure, the heart has become enlarged due to this high pressure. Increase the heart size - without adding more "energy" or muscle to the organ - and you have a "failed heart". The result can be devastating. Strokes occur due to heart not being able to pump enough "oxygen-rich" blood to the brain. Heart attacks develop because the heart is "overloaded" and cannot work with what oxygen it has available. This is known as "ischemia" - or a lack of oxygen to the heart or brain.

Doctors are now able to do more with blood pressure problems than perhaps ever before in the history of modern medicine. It still, however, boils down to the patient - the one with the problem. The tools can be given to the patient, but the patient must make use of them. For example, there are some "risk factors" of high blood pressure which can be changed by the patient. Some of these are smoking cigarettes, weight control, diet, exercise, employment (in terms of stress factors) and drinking alcohol. Other risk factors, such as a family history of high blood pressure, diabetes, a history of previous heart attacks, etc., cannot be controlled or "changed" by the patient; but there are medicines which can be used to help minimize these risks and prevent other, more serious problems in the future. For the patient, there must be a cognizant effort made to reduce those risk factors which can be changed - and also to follow the prescribed drug treatment plan devised by him/her and the physician. Again, for an example, your physician might advise you to stop smoking and lose a few pounds, while also placing you on blood pressure medicines. He or she is telling you that because there might be evidence of an "enlarging heart", clogging of the arteries or vessels which supply blood to the heart (coronary arteries) - or you could just have high blood pressure with no evidence of any noticeable damage - yet. Those are your "tools". If they are not used properly, the treatment program will eventually fail, and there might be an increased risk of an impending stroke, heart attack, or the development of congestive heart failure. All of these are tragic and could be deadly.

The American Heart Association has made it clear to America that we are at war - with our diets, the way we live, what we eat, and how "we go about our business" - all because it affects our heart. If you think that you might have high blood pressure (some "early signs" might be dizziness, lightheadedness, a headache, etc.), go see your doctor. It might be time for your annual check up anyway. And bring the tools back home. Your heart depends on them.

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