FAMILY MEDICINE® COLUMN
By John C. Wolf, D.O.
Associate Professor of Family Medicine®
Ohio University College of Osteopathic Medicine

UNTREATED HYPERTENSION MAY LEAD TO HEART ATTACK OR STROKE

Question: During a physical for work, they found my blood pressure was a little high. I've been to my family doctor a few times since, and he has now started me on medication. I feel fine, as I did before I started the drug. I know my doctor told me to take my medication every day, but it is expensive. What would happen if I didn't take it all the time?

Answer: High blood pressure, or hypertension in medical jargon, is a very common condition. There are about 60 million Americans with it. Wow! That is a problem of staggering proportion, isn't it? And just like you, most of those who suffer with the condition have no symptoms at all. That is part of the problem. The absence of pain or obvious symptoms from high blood pressure doesn't mean that there is no danger.

Compounding the issue is that of those 60 million people with high blood pressure, only half are actually aware they have the disorder. Further, only one third of those who know they have it are getting appropriate high blood pressure treatment.

High blood pressure increases in frequency with advancing age. It does occur, though, in the young and relatively young ñ but at a much lower rate. Young and middle aged men are also afflicted with it more commonly than women. After middle age, however, women lose their "advantage" in this situation and are stricken with hypertension at an equal or slightly higher rate than men.

African-Americans of all socio-economic levels as well as economically disadvantaged Americans of every racial and ethnic background have a higher frequency of hypertension. And as for the risks of untreated high blood pressure, it is the leading cause of heart disease and stroke. We all know how common these problems are and how devastating they can be.

Blood pressure is classified as normal when it is less than 130 over 85. High normal pressures are values between 130 to 139 for the top number and between 85 to 89 for the bottom number. Individuals in this high normal range have an increased risk for heart disease and stroke, but the amount of increase is modest. The best treatment for individuals in this category does not involve medication. Instead, weight reduction to the ideal range is very important as is avoiding excess salt, sugar and caffeine. Regular daily exercise and adequate amounts of dietary calcium also play a role for some.

Readings of 140 over 90 or more constitute high blood pressure. Individuals with high blood pressure usually benefit from non-drug treatment, but may also require medicine to keep their pressure in the safe range. You apparently fall into this very common category.

The specific medicine your doctor recommends to treat your hypertension depends upon the cause of the condition. Ninety percent of those with high blood pressure have no specific underlying cause that medical science can identify. These folks, with so-called "essential hypertension," benefit from any of the many medications that bring pressure into the normal range. The remaining 10 percent have specific causes of their hypertension and benefit from very specific drugs. Figuring out the best choice for you is a job for which your doctor is trained.

So what would happen if you quit taking you medication? Your blood pressure would shoot back up, and in a few years you'd undoubtedly have a heart attack or stroke! Important business this treatment of hypertension.

Talk to your doctor if you are having a problem with your medication. Common concerns are that the drugs are expensive, hard to remember to take regularly, or are causing undesirable side effects. Alternatives that minimize or eliminate these problems are usually available, but your doctor won't know to prescribe them if you don't explain your problems first.

Family Medicine® is a weekly column. To submit questions, write to John C. Wolf, D.O., Ohio University College of Osteopathic Medicine, Grosvenor Hall, Athens, Ohio 45701.