PRESCRIPTIONS
High blood pressure takes its toll silently
By Landis Lum
Q. I just got diagnosed with mild hypertension, but feel fine — no tiredness, headaches, or anything! Do I really need to be concerned? Can I avoid drugs?
A. The alarming thing about high blood pressure is that it is silent — you feel normal. And then you wake up one morning permanently paralyzed and unable to speak — victim of a stroke.
Or you get shortness of breath from heart failure. These complications start occurring above a blood pressure of only 115 over 75, and will double if the top number — the systolic pressure — gets to only 135, or the bottom number gets to only 85, with even further increases in complications with higher numbers.
Above age 55, nine out of 10 of us will develop hypertension. Above age 50, a systolic pressure of more than 140 becomes a much more important predictor of risk than the lower number. If your doctor agrees, then try getting your pressure down through natural means first before resorting to drugs.
Lose weight if you're overweight. Increase your daily physical activity, like walking an extra 10 minutes twice a day. Eat less pizza, Spam, ramen, hot dogs, and other salty foods. Watch your alcohol intake.
Eat foods that will lower your blood pressure — namely, four to five servings of vegetables and another four to five servings of fruits a day, along with two servings of low-fat (1 percent or skim) dairy products a day (milk, yogurt, or cheese).
This is called the DASH diet — to find out what this stands for and see sample menus and recipes (like turkey meatloaf), go on the Internet to www.medlineplus.gov, find "high blood pressure" under "health topics" and look under "nutrition."
You should also eat less meat.
Which drugs are best? I remember when we were all using expensive drugs like Norvasc, Plendil or Diltiazem because these so-called calcium channel blockers supposedly caused less problems with blood sugar and cholesterol than standard drugs like water pills (diuretics).
Well, on May 21 the Journal of the American Medical Association published the latest Joint National Committee report on hypertension treatment, along with a meta-analysis showing that calcium channel blockers actually led to more heart failure and other cardiac events than diuretics.
Most patients should be started on diuretics based on the latest scientific studies — look up the acronym "ALLHAT" on the Web site above.
And ... I know you didn't want to hear this, but most people will need two or more drugs to get to the goal of 140/90 (or 130/80 if you have diabetes or kidney disease).
