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AHA: What’s the deal with blood pressure?

Written By M. Ryan Odom, MD

AHA: What’s the deal with blood pressure?

March 23, 2022

Good morning North Idaho DPC family,

As I discussed last week, the American Heart Associations: Life’s Simple 7. Today I am going to discuss blood pressure. Big picture – it’s the Goldilocks of medicine. Too high or too low is dangerous.

https://www.heart.org/en/healthy-living/healthy-lifestyle/my-life-check–lifes-simple-7/ls7-blood-pressure-infographic

A question that I see often in the clinic is “what is hypertension and what do we do about it?” To help explain this topic I often refer back to our high school classes of physics and shop.

First, what is hypertension? Hypertension is elevated blood pressure >130/80. Blood pressure is the running pressure through your blood vessels. The top number (systolic) is how much pressure your heart squeezes to push the blood around, and the bottom number (diastolic) is how much pressure is in the system when your heart is resting/refilling in between beats.

Second, why do we care? Now is the time I bring in shop class. I consider the blood pressure as the RPMs of your car engine. If your car is running at 4000 RPMs, it is not going to break right now. At least we hope not. However, it is going to start causing wear and tear on the entire engine. When I compare this to the human body, when the heart is strained from the RPM/Blood pressure being elevated for a prolonged time, it starts suffering from atrial fibrillation, congestive heart failure, and heart attacks. The blood vessels are equivalent to the hoses in the engine. As a hose may rupture from too much pressure; a blood vessel rupturing is a stroke. Finally, the kidneys, eyes, and all small vessels start to have small damage from too much pressure. No, I don’t have a direct comparison to a car for the small vessels.

Finally, how do we fix it? Always lifestyle is an important component. Regular exercise lowers blood pressure, avoiding tobacco, loosing 10% of body weight, and decreasing salt in the diet are the best ways to impact your blood pressure without medications. Sometimes, this is all that’s needed. If this is not adequate, physics gets involved with our pharmacology. Without going into the specifics, blood pressure medications will either decrease how hard the heart is running (decrease RPMS), decrease the volume of the blood in your vessels, or increase the diameter of your blood vessels. By acting in these ways, we can significantly impact your blood pressure and help get it to goal.

Are blood pressure meds forever? Sometimes. Lifestyle modifications are ideal to help get your blood pressure in a safe range but sometimes we need medications to bridge the gap between identification and lifestyle taking affect. That may be all that’s required, but even with the best interventions, there are times we need medications to help long term. So if you are struggling with hypertension and would like to discuss how you can continue to impact your blood pressure at home, call the clinic and lets get scheduled to discuss it more in depth.

Cheers,

Dr. Odom

North Idaho Direct Primary Care

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