Diplomate, Board Certification of Emergency Medicine
Chairman, Department of Emergency Medicine Ma'ayenei
Hayeshua Hospital
Blood pressure is our subject today. Admittedly, it isn't
the most interesting subject, and it is an affliction that
most people don't even know when they have it. Yet it is the
cause of many maladies that can be lethal, and there are
exciting things happening in this field.
Blood pressure is the pressure, or the force, the blood has
when it leaves the heart. It is expressed in two numbers,
the first is the pressure from the heart when it is
contracting (that is, when it is actively pumping), and the
second is when the heart is resting. Obviously, these
pressures must be enough to get to all the far away places
in the body, as well as make it through valves and various
debris that may clog the blood vessels.
Blood pressure is usually measured with a syphyngometer, a
simple device that squeezes your arm. While blood pressure
varies with age, let's just say that an adult's blood
pressure should not fall under 80 (first number) or be
higher than 190 (first number) acutely, and chronically not
higher than 140.
Blood pressure can rise for many reasons, including:
diabetes, because the vessels become diseased; high
cholesterol, because the vessels become full of debris;
valve problems, because the blood must overcome the
obstruction; kidney disease, because the body may hold on to
extra fluids; obesity, because there is higher force needed
to circulate the blood; or, most commonly, it is due to
reasons we don't know.
We do know that walking around with uncontrolled blood
pressure can cause heart attack, blindness and stroke. The
heart becomes big and more prone to heart attacks because it
thinks it must maintain a high blood pressure, whereas in
stroke, the vessels in the brain can literally burst due to
the higher pressure.
Let me say again that elevated blood pressure usually
presents with few or no symptoms. People who feel as "fit as
a fiddle" may be setting themselves up for a debilitating
stroke by ignoring their blood pressure. Not that you should
overdo this either; there are times high blood pressure is
necessary, and we usually don't have to reduce it
emergently. It is best for your doctor to make this
decision; but you must take the initiative. If you are over
the age of thirty, you should no allow a year to go by
without having your blood pressure checked at least once.
We'll speak about treatment for high blood pressure and what
is low blood pressure next week; but just to reinforce --
the best way to prevent high blood pressure is exercise and
stopping to smoke. I bet you thought I'd say that! Write me
in care of the Yated.
Special note to Mrs. R. in Manchester: Thanks for your
letter. I have contacted Dr. D. and he has agreed to write
an article on advances in macular degeneration for me. Keep
reading this column!
A message from Glaxo, the sponsor of this column. I'm
surprised about the amount of migraine headache sufferers
who do not know about Imitrex and Naramig for migraines.
These medications are geared for the treatment of migraines,
as opposed to general pain relievers. Naramig and Imitrex --
from Glaxo.
