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Blood Pressure Article

Editor's note: This story was originally published in the My Blood Pressure Newsletter. If you are interested in having your blood pressure story told, please email Kellie or Steve at support@my-blood-pressure.com.

Blood Pressure Article - by Dr. Tom Floyd

The topic of blood-pressure has been undergoing change in the last few years.  We used to say that a person's blood-pressure should be approximately 100 plus your age.  A 65-year-old would have an acceptable blood-pressure of 165 using this criteria.  That is the old way of looking at things, but we now have a new way of looking at things.

We no longer think that rising blood-pressure is a normal consequence of aging. In the spring of 2003 new blood-pressure guidelines were issued.  Using the old guidelines, anything over 140/90 is considered high blood-pressure. This figure has not changed with the new guidelines; anything over 140/90 is still high blood-pressure. Blood-pressure is between 120/75 and 140/90 is now classified as "Pre-Hypertension".

The new target is for your blood-pressure to be below 120/75.  (A large medical study that was concluded in early 2003 actually showed that a blood-pressure that is greater than 115/70 is causing damage to the inside of the arteries, however the authors of the study set 120/75 to be their new target.)

You might wonder, what kind of damage is being done to the inside of the arteries? Using a garden hose for an analogy, we have all seen how the hose will plump up when you turn the water on.  That swelling is actually stretching the garden hose.  High blood-pressure is doing the same thing to your arteries. On the inside of the arteries, the stretching gives way to microscopic cracks in the inner lining (this lining is known as the endothelium).  This is significant because it is at these damaged sites that cholesterol gets a toehold, and can then grow to become an artery clogging plaque.  This plaque buildup is called atherosclerosis.

Many people have had blood-pressure's in the 130's/ 80's for several decades, and their doctors said everything is fine.  We now know that damage was occurring inside the arteries, and the doctors never knew it.

In my own life, I am one of these people.  I used to have a blood-pressure of about 135/85; I was happy that I did not have high blood-pressure.  Then, in the spring of 2003, I found out that I should have my blood-pressure below 120/75.  I do not like to take medicine, but I started using blood-pressure pills at that time.

I have been using the blood-pressure tracking software that was developed by the editor of this newsletter.  It is a very good program; it does everything that I want.  I can see that my blood-pressure now ranges from 105/60 to 115/70.  I am relieved that I have stopped damaging the endothelium of my arteries.

But, I know that damage has occurred, and I want to repair the damage.  (We cannot see the early stages of atherosclerosis unless we perform surgery and fillet the artery open like it was a trout.) When I was in medical school, we were taught that atherosclerosis was irreversible. The first person to prove us wrong was Dean Ornish, MD in the mid-1990s.  Dr. Ornish showed that a low-fat diet, when combined with moderate exercise and stress reduction (usually he promoted meditation), would actually cause the atherosclerosis to regress.

I like this approach, because it is natural and does not use any medicines.  However, many Americans (editors note: and Australians!) cannot adhere to a lowfat diet, and their lifestyle does not permit them to exercise or meditate.  If these folks want to repair the atherosclerotic damage caused by high blood-pressure, they need to reach for a medicine.  The best medicines for damage control are called the "Statins", these are cholesterol lowering medicines.  Some of the most popular Statins are Lipitor, Crestor, and Zocor.

It does not make any sense to attempt to repair damage, if you continue to have high blood-pressure.  The Statins would help to repair damage, but the high blood-pressure would continue to cause damage, so you would not make any progress.  To get the blood-pressure down, there are over 50 different blood-pressure medicines.  They are grouped according to class, and there are six main classes.  Trying to figure out which medicine is for you is a complicated task.  I advise working closely with your doctor to figure out what is right for you.  Since it is a common condition to have a need for both a Statin and a blood-pressure medicine, pharmaceutical companies are coming up with new formulas that actually have two medicines rolled into one pill.  The only one out at this time is called Caduet; it combines Lipitor with Norvasc (a "Calcium Channel Blocker" blood-pressure pill.)

Lastly, is there any such thing as having a blood-pressure that is too low? If a person stands up from a chair, or from a horizontal position, and they get dizzy, then their blood-pressure is too low.  That is called orthostatic hypotension.

You're not supposed get dizzy when you stand up from a chair. Aside from that, I do not think that your blood-pressure can be too low.  In fact, it is my opinion that the lower the better, provided that you do not experience orthostatic hypotension.

By Tom Floyd D.O. -- a Family Practice doctor in Howell, Michigan. Dr. Floyd can be contacted via his website: TomFloydDO.com or by email at: .