Thursday, March 30, 2006
Early treatment keeps hypertension from being 'silent killer'

By Dr. Anthony Policastro
Nanticoke Memorial Hospital,
Medical director

Every now and then I pull out an old article because it seems time to refresh every one's memory. This is one that I published five years ago and thought it worthwhile to do again. High blood pressure has often been called "the silent killer." That is because it causes few symptoms in the early stages. The only way to find that it exists is to take a blood pressure. Every adult should have his/her blood pressure checked from time to time. It does not matter whether they have symptoms or not. The medical term for high blood pressure is hypertension. Many people think that the primary reason for it is stress and being constantly upset. That is not true. While getting upset raises your blood pressure temporarily, it does not usually keep the blood pressure high. Exercise helps keep blood pressure down. Staying away from large amounts of salt on food keeps blood pressure from going up. Maintaining a reasonable body weight helps keep blood pressure down. Genetics plays a big role in determining who will develop high blood pressure. Both of my parents had high blood pressure. Therefore, it is not a surprise that I have developed it to some degree. The main effect of high blood pressure is on the blood vessels in the body. It depends on which blood vessels are affected as to which problems develop. Most of the changes are silent until problems occur. Blood vessels in the eyes can be affected. The result is a change in the blood vessels of the retina. This can sometimes be seen in the examination of the eyes. Therefore, a patient may find out that high blood pressure is present on a visit for an eye exam. The changes in some cases can cause vision problems.

Blood vessels in the brain can be affected. This can involve small blood vessels so that there are small areas of damage. The damage adds up over time. Therefore, it may affect a variety of brain functions depending upon the area that is involved. It can also involve larger blood vessels. The result can be signs of a stroke that come and go. These are called transient ischemic attacks (TIA). TIAs suggest that the patient may have a full stroke at a later time. They should be taken seriously. Blood pressure should be checked. If it is high it should be treated. In some cases the pressure on the blood vessels in the brain is so high that they may burst. This causes a brain hemorrhage. The result is a stroke that may kill the person. It might be the first sign of high blood pressure. Hypertension can also affect the blood vessels in the kidneys. This can cause kidney function to slowly deteriorate over time if the blood pressure is not treated. When the heart has to pump against very high pressures, it interferes with the heart's ability to keep that up for long periods of time. Once the heart can no longer do that, it fails. The result is congestive heart failure. This is another reason to treat high blood pressure. Of course, many people think that if they take blood pressure medicine for a while, it will make their blood pressure better forever. Then they can stop the medicine. That is also not true. Blood pressure medicine works similar to pain relievers. When the medicine wears off, the pain comes back. When you stop blood pressure medicine, the pressure usually goes up. That is true even if the pressure has been normal for years on medicine. It may not happen right away. It may take a few days or a few weeks, but it will likely happen again. That means that the medicine is usually a long-term requirement. Every time it is stopped and the blood pressure goes up, the damage from the blood pressure on the parts of the body begins again. There is a good reason for high blood pressure being called the silent killer. Make sure you get yours checked regularly by someone trained to do it. Do not rely on inaccurate machines in your local department store. Do not become one of the victims that will help it continue its name as the silent killer.