Dear Doc:
I am a 55-year-old and recently went to the doctor after many years for a physical. I was told that I have high blood pressure. My BP was 155/95. I was given some information on exercise, diet and the risks of high blood pressure. I am to return in a few weeks. Do you think I will need medication for my high BP?

Dear Reader:
May is the awareness month for ALS, brain tumors, celiac disease, skin cancer, and national burger month among others. Clearly, we need more months, less diseases, and less lobbying for burgers! May is also National High Blood Pressure Education Month.

Blood pressure has two numbers, the top number or the systolic pressure number, and the lower diastolic pressure number. Systolic BP is the force on the blood vessel walls as the heart contracts and pumps blood out to the arteries. The diastolic BP is the pressure on the arteries when the heart is relaxed between beats.

If your systolic BP is 120 or less and your diastolic BP is less than 80 your BP is considered “normal.” BP between 120 and 139 systolic, or diastolic BP between 80 and 89 is considered pre-hypertensive. BP greater than 140 systolic or greater than 90 diastolic is considered high blood pressure (hypertension).

In some things in life less is more. Your golf score, number of ex-wives (allows you to keep more of your stuff), and having a lower BP may allow you to add more years to your life!

The treatment of high blood pressure is the most common reason for outpatient doctor visits in the United States (excluding visits for pregnancy/prenatal care). Seventy million Americans or one in three adults have high blood pressure and another 70 million may have pre-hypertension. More alarming are the facts that only about half of those with known hypertension have their BP under control. In addition, only about 20 percent of adults who have high BP don’t even know they have it! It is estimated that high blood pressure costs the nation $46 billion each year. This total includes the cost of health care services, medications to treat high blood pressure and missed days of work.

High BP is like that silent flatus (fancy medical term for fart) from your dog, or that disapproving stare from your new wife, all can be silent but deadly. In fact, hypertension is often given the name “silent killer” as high blood pressure may be causing your body damage for years before symptoms are felt or recognized. High BP contributes to 360,000 deaths per year or almost 1,000 deaths per day in the United States!

Rapid rises in BP or very high BP may cause headaches, neurologic symptoms, chest pains, shortness of breath or heart failure. If these symptoms occur medical attention should be sought immediately. More commonly, high BP silently damages the arteries of the eyes, kidneys, brain and heart over time. Like the pipes in your house, your arteries can be damaged if they are under too much pressure, leading to kidney disease, strokes, vision problems and heart failure.

In most cases, the cause of high BP is not known, but it is clear that genetics, diet, lack of exercise, smoking, alcohol consumption, older age and some medications contribute to developing high BP. In five to ten percent of the population, another disease process such as thyroid, adrenal or kidney disease may be the cause of high BP.

Healthy diet including lower salt intake, regular exercise, smoking cessation, limiting alcohol, and weight loss may significantly lower your BP. If despite these efforts your BP remains elevated, your health care provider may prescribe medication to lower your BP.

Follow your doctor’s diet and exercise advice. The important thing is to return to your doctor for another BP reading, medication treatment of high BP (unless very high or symptomatic), should not be based on just one reading. Your doctor may also measure your BP in both arms and while sitting and standing. If there are variations in these readings your doctor may choose a different medical treatment or order further testing. Losing weight, less salt, less alcohol, and less sitting on the couch may be all you need to lower your BP and add years to your life. If not, there are many different medications that have been proven to be effective in controlling high BP.

Stay healthy, and smile at the 1880s tombstone of one Lester Moore who died in a gunfight. “Here lies Lester Moore, four slugs from a .44, no Les no more.”

Dr. Nagpaul is a medical doctor and is board certified in Internal Medicine. He currently is the Medical Director at Newark-Wayne Community Hospital, DeMay Living Center and Wayne County Public Health. This column is meant to be educational and not intended to be used to make individual treatment decisions. Prior to starting or stopping any treatment, please confer with your own health care provider. To send questions to our medical providers, please email Dr. Nagpaul at Arun.Nagpaul@rochesterregional.org and put “Ask a Doc” in the subject.