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The Scenario:
Edgar is a baseball player with a AAA team from the south. While in college he dominated second base and helped his team rack up an impressive 24 - 3 record. In fact, early on he was recruited to play minor league ball, but decided to join after graduation. As part of the process at the time, he underwent a routine physical examination.
Everything checked out fine, except for one thing -- his blood pressure. While at the doctor's, his blood pressure was 150/100. So he was asked to get it checked again over the next couple of weeks. Although he discovered that it went up and down, his pressure on the whole continued to run high. Hypertension runs strong in the male side of his family, so he wasn't shocked; But his grandfather died of a stroke, thought to be caused by hypertension, which left him feeling concerned.
Edgar felt fine, and saw no reason why he shouldn't be able to play ball. Eventually, he was allowed to play, but only on the condition that his pressure get treated.
Questions:
Answer:
Last things first. What's so bad about hypertension?
Most people know that high blood pressure puts a strain on the circulatory system. And it's pretty simple to see how problems result from this strain. When the heart is pumping against higher pressures, day in and day out, for years at a time, it simply has more work to do and therefore is more likely to weaken and fail. And blood vessels, after years of straining to contain the high pressures within, may deteriorate and rupture causing a stroke (damage to the brain), or will plug up from accelerated atherosclerosis (hardening of the arteries). The kidneys, which filter blood continuously in a system that is normally under high pressure, will suffer damage to the filters as they plug up and scar.
People don't do so well without their heart, their brain, or their kidneys. So what can Edgar do?
Well, he can't do anything about the fact that he's male, African-American, or that he seems to be predisposed to hypertension by his family history. Those risks are in his genes.
What he can do, however, is lose that extra 20 lbs. deposited in his paunch over last winter. Cutting down on salt intake will help about half the time and is always worth a try. Exercise helps, but it won't work unless done regularly (say several times a week) and maintained over time -- hard to do for many people, but helpful for lots of other health problems too.
If he averages more than about two drinks of alcohol a day, cutting down is apt to improve his pressure. It may be that taking in extra amounts of potassium, calcium, or magnesium will lower his pressure, but the evidence isn't strong enough to make it a routine recommendation. And let's not forget about the effects of stress. Meditation, biofeedback, and any number of techniques for handling stress better clearly helps some people.
Tripod member Gillespie noted that, "Perhaps the problem is 'white coat hypertension' -- i.e. his blood pressure goes up at the sight of a tool-wielding doctor or nurse." Good thought. If Edgar gets his pressure checked on a day outside of the office, or on a day when he is not actually seeing the doctor, it might be significantly lower.
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