Blood pressure update

Blood pressure update – includes related article on blood pressure drugs

A leading cause of heart attacks and strokes, hypertension or high blood pressure afflicts one tenth of Canada’s population. It may be linked to obesity, faulty diet and lack of exercise but often arises for unknown reasons. High blood pressure weakens the walls of small arteries, which can lead to strokes, heart attacks, kidney damage and vision loss (due to injured blood vessels in the eyes). Because it is a “silent killer,” usually symptomless until the blood vessels have suffered considerable damage, people often don’t take their prescribed medication. It’s a dangerous mistake, increasing the risk of unexpected death from stroke or heart attack.

The numbers used to express blood pressure (e.g., 120/80 mm/Hg) refer to the maximum and minimum pressures recorded in millimetres of mercury (Hg). Normal readings generally range from 100/60 to 130/80. The World Health Organization designates a blood pressure of 140/90 mmHg as the upper limit of normal. However, one high blood pressure reading alone doesn’t necessarily mean hypertension: diagnosis depends on consistently high values found on several different occasions. As high blood pressure can start quite early in life, everyone aged 20 and up should have regular blood pressure checks. This is the one medical test that can really save lives, provided that those with unacceptably high readings take steps to redress the problem. To lower blood pressure:

* keep weight down to a desirable level. The overweight are at extra risk;

* exercise regularly (20 to 30 minutes at least thrice weekly). Regular exercise can lower blood pressure; . limit alcohol intake to three daily drinks (men), two (women). Alcohol raises blood pressure;

* do not smoke. Nicotine narrows blood vessels and raises blood pressure;

* moderate salt (sodium) intake. Excess salt may raise blood pressure;

* eat a varied low-fat diet, rich in magnesium, potassium and calcium (which may prevent or lower high blood pressure);

* continue taking prescribed blood pressure medication(s);

* get regular check-ups.

The development of new drugs and increased efforts to off set the early morning “surge” blood pressure usually peaks in the morning) have considerably improved blood pressure management. Many drugs now come in sustained-release, once-daily preparations that are preferable to swallowing tablets several times a day. This is a major advance, given that the main aim of today’s blood pressure management is to ensure that those who need it keep on taking-their prescribed medication.

The choice of blood pressure drugs depends on the type and causes of hypertension and the person’s individual health profile. Diuretics, that flush fluid out of the body are still widely used, but being overtaken by newer beta-blockers (that mute the heart’s pumping action), calcium antagonists (that dilate blood vessels) and angiotensin converting enzyme (ACE) agents (that block the pressure-raising impact of the hormone, angiotensin). However, those who already successfully control blood pressure with their current medications should probably maintain their regimen or get a medical re-assessment.

Recognize the ABCDs of melanoma

Asymmetry; Border irregularity; Colour change; Diameter.

* Asymmetry: an irregularly shaped brown spot or mole with tails and jagged edges may be cancerous; or a skin patch that changes in surface texture – that scales or oozes. A scab that keeps coming off, bleeds incessantly or becomes velvety” may denote skin cancer and should be investigated.

* Border irregularity: scalloped, sprayed, perhaps notched edges of a pigmented (brown) spot may be danger signals.

* Colour variation: uneven colour is a distinct feature of melanoma. Moles may become lighter or darker or acquire black flecks or various shades of grey or pink, or pigment may spread from the mole into skin that looks normal, with colour patches next to, but not a direct part of the mole “satellite pigmentation”).

* Diameter: most melanomas exceed six millimetres across (bigger than a pencil eraser) while ordinary, benign moles are generally smaller.

COPYRIGHT 1992 Strategic Inc. Communications Ltd.

COPYRIGHT 2004 Gale Group