It was on a routine visit to the doctor that my GP uttered the phrase every middle-aged man dreads: "Your blood pressure is a little raised." In fact my BP was 150/95mm Hg, well above the current "risk" threshold that the National Institute for Clinical Excellence (Nice) deems acceptable.
My elevated reading came as a shock, not least because I had always assumed I was in a low-risk group for stroke and heart disease: I don't smoke, I'm not overweight, I exercise regularly, and I eat plenty of green vegetables. Indeed, until my mid-40s my BP had always hovered around 120/80, which used to be considered perfect (about which more later). Now, all of a sudden at the age of 47, I was being diagnosed with stage one hypertension and being assessed for a course of blood pressure reducing medications (see box, below).
According to Professor Graham MacGregor, the chairman of the Blood Pressure Association and professor of cardiovascular medicine at Barts and the London School of Medicine, I'm one of the "lucky" ones. Hypertension affects a quarter of the British adult population and accounts for 60% of all strokes in the UK and half of all heart attacks, but because the condition is usually symptomless most people have no idea they are at risk until it is too late. "Hypertension is a silent killer," says MacGregor. "You're bloody lucky to have discovered it at an early age and been given the opportunity to do something about it."
MacGregor is probably right but I do not feel lucky. Having always enjoyed rude health, I did not wish to be admitted to the "kingdom of the sick". Nor did I relish the prospect of having to take two, three, or however many pills every day for the rest of my life. My dilemma was not helped by the fact that defining hypertension is far from straightforward. Fifteen years ago, a BP reading of 150/95 would not have been a cause of particular concern (the threshold then was 160/100). But in the UK the bar is now set at 140/90 while in the United States the American Medical Association recently introduced a new category of "pre-hypertensive" for patients whose BP ranges between 120/80 and 140/90.
Then there are claims and counterclaims about the role of salt in elevating blood pressure, and the suspicion that a new hypertension polypill, Sevikar HCT, now available on the NHS, could be prescribed to everyone over the age of 55 as a matter of course, making blood pressure treatment as common as the fluoridation of water.
Nor is the picture made any clearer by the recent identification of 16 new genes for blood pressure. When I first heard about the discovery in September, I assumed a genetic test could not be far off. Led by researchers at Barts and the London, the study involved a survey of 200,000 people of European descent and 75,000 people of non-European descent, and brings to 28 the total number of blood pressure gene pathways identified to date. However, while the Barts team found that 5% of the gene variants were common to all population groups, collectively the genes had a very modest effect on blood pressure, accounting for less than 1mm Hg of the reduction in systolic readings and 0.5mm Hg of the reduction in diastolic reading across populations (The first number refers to blood pressure when the heart is pumping; the second number refers to blood pressure between beats.)
Indeed, the lead authors of the study, Mark Caulfield and Patricia Munroe, now suspect there may be hundreds of genes responsible for the regulation of blood pressure, each one with very small effects, meaning that a useful genetic test lies some way in the future.
Like many people for whom diet and weight do not appear to be significant factors, I have long suspected my hypertension has both a genetic and an emotional component. My mother, who is 79, developed stage two hypertension, defined as 160/100mm Hg or higher, in her 60s, and scientists now estimate that 30% of the observed variations in blood pressure are the result of genetic predisposition. Furthermore, although my father's blood pressure was always well within the normal range, he was prone to mood swings of the "blood-boiling" variety and, like his father before him and his father before him, died of a heart-related condition in his 70s. While it is difficult to say whether I have "inherited" a similar disposition, I am certainly prone to sudden, irrational rushes of anger. Moreover, in a recent study Peter Rothwell, professor of clinical neurology at the John Radcliffe hospital, Oxford, found that blood pressure varies far more widely than is commonly assumed and can swing wildly throughout the day and over the course of the working week. "It's the peaks in blood pressure that are most closely correlated with stroke risk, not mean blood pressure," says Rothwell. "The key to controlling blood pressure is consistency – ironing out those swings."
Then there is the intriguing question of the extent to which blood pressure is conditioned by environmental stresses and one's temperament. For instance, it has long been known that the kidneys play a key role both in the regulation of blood pressure and the "fight or flight" response, a relationship that suggests a deeper evolutionary connection between blood pressure and our various emotional and psychological states. As the phenomenon known as "white coat syndrome" attests, the mere fact of having one's blood pressure taken by a medical professional is sufficient to send some people's readings soaring, while meditation and acupuncture have been shown to lower BP, albeit temporarily. Moreover, it is well known that people who report higher levels of stress at home or work, or have suffered a recent "life" blow, such as the death of a spouse, are more likely to suffer stroke or heart attack (in one study of work-related stressors, for instance, approaching deadlines were associated with a sixfold increase in myocardial infarction). Frequent anger and hostility have also been shown to predict coronary events. Thus in one community study patients with normal blood pressure but high anger temperament scores (as characterised by frequent or long-lasting anger reactions with little or no provocation) were shown to have an odds ratio of 2:3 for fatal or non-fatal cardiac events. While expert opinion differs over the extent to which blood pressure may be a factor, Rothwell points out that it is well known that stress raises BP and that people who are exposed to stressful situations experience greater blood pressure volatility. "I know that when I have to chair an important meeting or give a series of lectures my systolic reading can be as high as 180. That's almost certainly due to stress," says Rothwell. But while the bond between blood and emotion is embedded in everyday language – we talk of people being "sanguine" or "hot-blooded" – the average GP tends to have little time for such insights.
When we are young our bodies can more easily accommodate sudden fluctuations in blood pressure, but as we get older our blood vessels become stiffer and less flexible.
This is particularly a problem in the west and in Asian societies such as Japan. The question is why? Many experts believe the answer is salt.
For instance, the Yanomami tribe of Brazil, who eat a diet low in salt and saturated fat and high in fruit, have the lowest mean blood pressure of any population on earth – 95/61. Nor does their blood pressure increase with age. By contrast, in the west, where people eat an average of 10-12 grams of salt per day, blood pressure rises with age by an average of 0.5mm Hg a year. That may not sound a lot, but over the average lifespan that is a difference of between 35 and 44mm Hg systolic. Moreover, the most recent meta-analysis of trials involving more than 6,000 people from around the world, found that a reduction in salt intake of just 2mm a day reduced the risk of cardiovascular events by 20%. According to Professor MacGregor, who also chairs Consensus Action on Salt and Health (Cash), in serious scientific circles the connection between salt and higher blood pressure is no longer disputed. Yet for all the scientific consensus, salt-denial stories continue to enjoy wide currency in the media.
"The salt industry is trying to create the belief that there's a controversy out there, and if the experts can't agree how on earth can the man in the street make an informed decision," says MacGregor. "But the fact is we have seven or eight different types of evidence that all point to the role of salt and I know that if I cut your salt intake by half it reduces blood pressure."
To the coalition government's credit, Britain now leads the way in salt reduction, with more than 40 food manufacturers having agreed to reduce the salt content of supermarket foods by 40% by 2012, followed by a further 15% cut thereafter. At the same time, Nice has called for the acceleration of national salt reduction targets, with the aim of reducing the average British adult's intake to 6g a day by 2015, and 3g by 2025.
For all the publicity about the dangers of hypertension, however, most people remain blissfully unaware they are at risk. One of the biggest surprises for me was the discovery that my diet was not nearly as good as I thought it was: indeed, on some days I was consuming as much as 10g of salt, nearly twice the recommended amount (this is a particular problem at Christmas: a turkey dinner adds up to around 15g).
In the weeks and months that followed my diagnosis, I cut out processed foods and bread (one slice of bread contains an average of 0.5g, so if you eat six slices a day, that's half your daily allowance) and upped my consumption of fruit and vegetables.
I also cut out coffee and experimented with acupuncture, which appeared to reduce my blood pressure but only for short periods. Mindful of my father's sudden mood swings, I also made an effort to keep "irritations" in proportion and to check my temper – not always successfully. Finally, having read about the health benefits of dog ownership (dogs are thought to act as "stress buffers"), I acquired a fluffy white goldendoodle. Murphy certainly gets me out more, which may in itself be healthier.
On the other hand, he also has a tendency to steal children's balls and hare into the road after stray cats, which has its own stresses.
In the end, I came to the conclusion that I had little choice but to sign up for a course of medication and now take two pills every day– a diuretic and an ACE inhibitor.
The good news is that, four years later, my mean blood pressure now averages 130/85 – far from perfect but well within the normal range for a 51-year-old. The bad news is that I will probably have to take the drugs for the rest of my life. Unless, of course, Nice revises its definition of hypertension upwards again and I miraculously find myself back in the "safe" zone.
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8 January 2012 12:40AM
Apparently, the real cause of the rise in hypertension and associated heart disease over the last 30+ years in the UK and US (and also in other countries in Western Europe) is to do with the increasing amounts of sugar that we are eating.
Sugar: the white stuff you put in your coffee, chemically is called sucrose and consists of two molecules bonded together, one fructose and one glucose molecule.
Glucose metabolism: it´s not great to take in a lot of glucose because it affects insulin levels and can contribute towards Type II Diabetes Mellitus, but at least your body can use it. 80% of the glucose you eat is absorbed along the digestive tract; 20% reaches the liver where it is broken down and mainly stored as glycogen (a starch) for energy use in the future. Glucose is like the petroleum of life, it is the body´s energy currency and keeps everything working.
Fructose metabolism: fructose in nature is present along with a lot of fibre (in fruit, sugar cane, etc), so it should be quite hard to eat a lot of it. Also, the fibre means that most of it won´t even be absorbed by the body and won´t get to the liver. Fructose is not like glucose - it can only be metabolized in the liver, where it is broken down into a lot of really, really bad things (unlike glucose, which in its original state can be and is absorbed by any cell in the body directly for energy synthesis). In terms of high blood pressure, it interferes with nitric oxide production. This is the body´s main way of maintaining blood pressure low. If you eat a diet high in sugar, then you are eating a diet which cause hypertension.
Also, fructose metabolism produces a big quantity (30% of the total fructose calorie intake, if I remember correctly) of bad fat - vLDL (very low density lypoprotein). The small molecules of this LDL fat are what leads to athersclerosis (the build-up of plaque in the arteries and veins) and causes cardiovascular disease. Therefore, a diet high in sugar is also a diet high in fat.
I highly recommend you all go to Youtube and look for a one and a half hour talk by an American endocrinologist who treats obese children who explains all of this in greater detail. It´s called Sugar: The Bitter Truth.
8 January 2012 12:57AM
Does anyone know if the anger temprament mentioned is aggravated by salt? Can we make ourselves more tranquil by reducing salt intatke?
8 January 2012 1:12AM
@ SenoritaTarzan
Thanks for that information.....
'will read it again.....
8 January 2012 2:15AM
Interesting informative article.
But please can I ask: Get your units right! What is "a reduction in salt intake of just 2mm a day", please?
What does "Thus in one community study patients with normal blood pressure but high anger temperament scores (as characterised by frequent or long-lasting anger reactions with little or no provocation) were shown to have an odds ratio of 2:3 for fatal or non-fatal cardiac events. " mean? does that mean they have a 2 to 3 times greater chance? But 2:3 sounds like a ratio - has something has gone down by - or to maybe - 2/3? Unlcear.
Still thats not as bad as many graphs in other articles which dont have the axes labelled - so we have no idea what they are measuring. Or odds of 100:1 being desccribed as very unlikely (I'd have though that made it very likely). Suggests a lack of numeracy among either journalists or copy editors. Basic part of scientific training: get your units right, and label your axes. Should be drummed in from the earliest ages. Thanks.
8 January 2012 2:18AM
Correction: My use of "unlcear" above reminds me of an award by my previous employer, of a prize to a physics professor for "unclear" research.
8 January 2012 2:54AM
Well worth getting a blood pressure monitor from your local chemist for a few quid. They aren’t terribly accurate but you can monitor in the comfort of your own home rather than the doctors surgery which in some cases can inflate your reading because of the stress of the situation.
There is a good chart here that will show you where you are on the scale at a glance.
8 January 2012 3:28AM
I meditate to control anxiety which probably increases my blood pressure. In the short term it may only slightly reduce blood pressure but practiced enough will lead to a calmer more grounded life. Try it if you have a problem, it's got to be better than pills
8 January 2012 3:56AM
This is actually a typo! It was meant to read 2.3. The finding indicates that among people with normal bp, the risk of having an acute mycardial infarction (heart attack) or fatal coronary heart disease was 2.3 times greater in those who reported a strong, angry temperament vis a vis people who reported low tendency to become quickly angered. This was adjusted for age, race, alcohol intake, smoking, diabetes, weight and body measurements among other factors.
If you would like to read more the paper can be found at: http://aje.oxfordjournals.org/content/154/3/230.full#T3
There is now very good scientific evidence for the stress-reducing benefits of mindfulness meditation if you're concerned and want proactive ways to control anger and stress. The Guardian and Observer have included mindfulness training for weight loss in this weekend's editions. These include mindfulness CDs I think as well. Search google youtube for jon kabat zin or mark williams and mindfulness based stress reduction if you would like to find out more.
8 January 2012 5:00AM
Could you provide the reference for this statement please?
A recent metaanalysis of nine randomised controlled trials that a significant reduction in blood pressure was found of between 5 and 3 mm Hg. Article here:
http://www.nature.com/ajh/journal/v21/n3/full/ajh200765a.html
The point about meditation is that this is a lifestyle change so that over 8-12 weeks of training one has the basic skills of the technique to continue throughout your life.
So I have a number of questions about the study you cite, here a just a few:
1) what type of trial was this? Was it sufficiently blinded and randomised for example?
2) Those who were not meditating, had they undergone the same meditation techniques as those who were meditating? And if so was there a measure of pre-training bp and post-training bp for meditators and non-meditators? If the meditators and non-meditators had undergone the same training and shown a decline in bp over the training period, that may make sustained reductions in bp over 24 hours among people who had already shown overall declines in bp, less likely to achieve significance.
3) what type of meditation are you talking about (transcendental? MBSR? MBCT?)?!
Left as it is, I feel that your comment about meditation suggests to the reader that it is unlikely to work.
I think this is slightly disingenuous to leave this statement unsubstantiated as there are many articles on the benefits of mindfulness meditation for physical and psychological health in trials, systematic reviews and meta-analyses.
8 January 2012 6:43AM
Pycnogenol can help.
ACE inhibitors can do long-term harm. Watch out for what they do to the rest of your body and read "What Doctors Dont Tell You (with a constructively critical mind) for exactly that.
I'm 65 and have the heart and arteries of a healthy teenager, and really good health. I put that down to wise use of alternatives, homeopathy, meditation and breathwork.
And, for your information, both parents died young, under 60.
good luck
8 January 2012 8:05AM
Hi Mark
There is a complete approach that looks at all the lifestyle factors. It uses CBT and Hypnotherapy techniques to address and resolve these lifestyle factors as well as helping you achieve things like salt reduction, stopping smoking and exercise which I know is not an issue in your case. It is call Hypnotension.
The Hypnotension programme has only just been released. However it is based on all the existing research and has been devised after 10 years worth of work in this field. Take a look it could be right up your street.
8 January 2012 8:38AM
I bought a blood pressure meter for home use about eight years ago and have since made hundreds of measurements. The most surprising thing is that they vary with season, i.e. the average winter figures (both systolic and diastolic) are about 20% higher than the summer ones. I have no idea why, and couldn't find any explanations by Googling.
8 January 2012 8:42AM
Mark Honigsbaum
I cut out processed foods and bread (one slice of bread contains an average of 0.5g)
So, you've moved to a diet consisting of raw materials only – processing=cooking
You must be eating very salty bread
I also cut out coffee
Don't they sell decaff where you live?
LakeandMountain
I'm 65 and have the heart and arteries of a healthy teenager, and really good health. I put that down to wise use of alternatives, homeopathy,
I wondered how long it would be before homeopathy reared its ugly head.There is no clinical evidence to support the contention that homeopathy works – end of story
8 January 2012 8:44AM
LakeandMountain
Congratulations on your bold decision. I'm 480 and on my eighth set. Fine once you get over the initial mild discomfort.
Vlad Dracul XIVth
8 January 2012 8:53AM
I too was shocked to find I had hypertension and the fact that I had to take a tablet everyday for the rest of my life.
My work takes me all over Europe, and find I am often away from home 45 weeks of the year , returning home for a long week end, every 6/8. Obviously a stressful lifestyle.
This year I had the opportunity to take three months off work and just relax at home, lunching with friends and family, discussing openly problems and topics of various forms, sleeping 8 hours with a regular relaxed lifestyle. Within 4 weeks my Bp dropped dramatically 115/65 sometimes lower , while still taking the inhibitor.
Now I am back in the working lifestyle, and the BP has returned to 135/ 70........a sign of the Western lifestyle, pressure of work and the fact that its not possible to talk and smile openly with close friends and family!.
8 January 2012 8:57AM
Might be a dumb question, but would atmospheric pressure have any bearing on the readings obtained when measuring blood pressure
8 January 2012 9:14AM
I'm still lucky enough to have a resting blood pressure as low as 90/60 but even so, I do try my best to avoid salt as much as possible; which I appreciate can be increasingly difficult when you see the sodium content of most products. The recommended daily amount is about 2g and possibly could actually be as little as 1g, which can be easily exceeded by one portion of many foods even without adding anything.
8 January 2012 9:20AM
I have a BP monitor to use at home, when I go to my GP I take it and we check it against hers to be sure it hasn't lost calibration. Cheap ones are known to be inaccurate, sometimes dangerously so, and even good ones need checking. Be careful if you use one at home.
If you are a hot-blooded type, attempting to 'keep' your temper can be far more stressful than losing it, so be careful with that approach. I find cutting annoying peope and situations out of my life works better where that's possible. And I'm sure I remember other 'studies' in the past identifiying (contrary to expectations) that passive types actually have an elevated risk of heart attacks compared to irritable types, so I'd want to see a lot more evidence on that one.
I found cycling excellent for reducing my blood pressure, but mine has never been above the normal range anyway when tested at home, so it might not work as well for those with higher BPs.
8 January 2012 9:34AM
I guess that I too am one of the lucky ones.
I've long been a keen cyclist.
In my 40's when I was knocking up a couple of hundred miles each week, and with a resting pulse rate of 40, I was found - during a pre-operation check - to have high blood pressure. I was normal weight, lean as a bean, maintained a healthy diet, and even found time to do a bit of running.
An X-ray showed that my aorta was raised like an inflated hose-pipe, but tests revealed that the hypertension was not linked to my active lifestyle. My GP explained that I had what is referred to as Essential Hypertension, because, Essentially, there is no known specific cause.
20+ years later my hypertension is controlled via medication that I shall be on for the rest of my days. An unexpected spin-off was that I no longer suffer from Migraine.
I'm still cycling (though not quite so far or fast), and still have a decently low resting pulse rate. Occasionally - e.g. if I sit in a chair for too long - I experience swollen ankles as a consequence of the medication, but accept that the alternatives for my family and I could be far worse.
I'm now an advocate of routine blood-pressure screening for all, regardless of outward physical condition.
8 January 2012 10:10AM
I really do not understand this hang-up that so many people have with medication. I have a genetic kidney disease and have been on BP medication for 35 years (I am now 55). My father had the same condition but unfortunately, in those days there were very few treatments available and those that were had some pretty unpleasant side effects. As as a result he had a stroke at 45, was severely paralyzed and died at 49 after a dreadful 5 years completely incapacitated.
I will happily take my daily medication for the rest of my life!
8 January 2012 10:19AM
Could it be that you sweat out the salt during the hot months? If you reduce salt intake even further during the winter months, that might help?
8 January 2012 10:21AM
I don't smoke, take added salt or sugar, never have done. I very rarely eat processed food. I drink about 15 units of alcohol a week, I eat what is commonly regarded as a healthy diet, lots of greens and fruit. I have very stressful work but being out of work is more stressful. My average BP is about 150 over 50. My doctor says this is borderline OK. Help!
8 January 2012 10:21AM
A good, informative article.
If I have one criticism, it's the lack of a mention of 'Framingham heart risk calculators'.
http://cvrisk.mvm.ed.ac.uk/calculator/calc.asp?framingham
You need a blood test. Ask for a LRP - Lipid Risk Profile. You need to have the value for Cholesterol and HDL - High density Lipids.
Using these values, and other risk factors such as smoking, you will be able to generate a measure of risk, with respect to developing cardiac disease over the next 10 years. You will need to input your blood pressure into this calculator.
Obviously, as you get older, your risk of developing heart disease increases. That's just a natural consequence of age, but having a measure of risk will enable you to make life style changes if appropriate.
As a point of interest - my blood pressure is sometimes a bit high - 140 / 85. I'm 53. But, using the calculator my risk factors come out at around 3% - I have a 3% chance of developing heart disease in the next 10 years. This is almost insignificant - so I just relax and enjoy life.
8 January 2012 10:27AM
An excellent question - and something that's never been considered before no doubt.
I think it's very logical that atmospheric pressure might well have an effect - we experience High and Low presssure, which effects mood. But it might also exert an effect on our circulatory system
I think you might well have the makings of a PhD here!
8 January 2012 10:28AM
I'm deeply skeptical of the recommended BP figures dropping. This seems like a scam to me: the pharmaceutical industry wishing to get more money out of the NHS by claiming that more of us need their products. I call bullshit.
I do take 2 tablets for high BP, and have recently noticed dizzy spells. They're probably working too well, but my doctor says I have to keep taking them, can't stop now. Oh well, when I crash the car cos I've collapsed due to low BP, no doubt the insurers will sue the GP...
8 January 2012 10:39AM
Good information, but I think you missed out the crucial point about fructose in regards to today's typical diet of processed foods.
Not many people know that a *lot* of processed foods today contain high fructose corn syrup. It is sweeter than sucrose, and a little bit cheaper, which is why food manufacturers started inserting it into soft drinks, cordial, bread, pastry, etc.
Some scientists, like Dr. Lustig, the American endocrinologist you mentioned, believe that this high consumption of fructose is more damaging to the body, and is the real cause of today's high levels of obesity, diabetes, and high blood pressure.
8 January 2012 10:47AM
There is far too much diagnosing and measuring these days and I have developed a healthy distrust of the health industry.Are we meant to be in the same condition at 93 as we were at 23?
8 January 2012 10:51AM
The most important information was that the Yanomami tribe of Brazil did not suffer from hypertension. An experiment was conducted where the long suffering laboratory rat was fed on diets of different peoples, around the world, and the rats developed the same disease, and health patterns, as the humans on the same diet.
The rats fed on the diet of the Hunza people, lived to a ripe old age, and remained vigorous, and healthy to the end.
Medical science, in the West, has made the fundamental error of studying disease instead of health. (Cynically, one could say there is more money in disease than health).
The "Alternative" medical solution is not Acupuncture or meditation, as cited, but revision of the diet to an optimum healthy diet. By "healthy", I do not mean what people think of as a "healthy" diet, but a diet which, by experiments such as the one mentioned, actually is shown to maintain health.
8 January 2012 11:17AM
At the age of 40, I used to have high BP, around 150-90 when taken by medical staff. At home, it was always better, 140-80, so there was some of "white coat syndrome". Then three years ago I quit smoking, and now, with 45, my BP is perfectly normal, always around 120-70, without taking any sort of medication.
8 January 2012 11:22AM
On a recent visit to England (I live in Italy) I was amazed how salty English bread is (Tuscan bread traditionally is made without salt). Even 'home-baked', whole meal. The bakers would claim that that is what the public demands, but in reality it is to prolong shelf life, very convenient for the bakers. Another great source of salt is of course cheese, which is also stuffed full of saturated fats. One can do oneself, and the planet, a favour by cutting out the stuff (animal husbandry accounts for c. 20% of greanhouse gas emissions)
8 January 2012 11:28AM
According to a 2009 Cochrane review: 'at present there is no evidence to support aiming for a blood pressure target lower than 140/90 mmHg in any hypertensive patient.'
http://summaries.cochrane.org/CD004349/aiming-for-blood-pressure-targets-lower-than-14090-mmhg-is-not-beneficial
8 January 2012 11:57AM
What's the bloody point of that picture if the text is too small to read? Christ, some things this paper does really get on my nerves.
8 January 2012 12:09PM
What do you mean by 'better'?
8 January 2012 12:12PM
Homeopathy? Then age clearly hasn't brought wisdom in your case.
8 January 2012 12:14PM
Christ some people are quick to blame others when they think things don't work properly. Click on the picture and it opens in a new window. You can increase the font size once the window opens and voila text is now readable.
8 January 2012 12:14PM
Huh?
8 January 2012 12:17PM
I have been diagnosed with Essential Hypertension since my early 30's and have been on medication since then. However, I have always been on the lookout for alternatives. Recently I read about a machine called Resperate, which claimed to reduce BP naturally by controlled breathing exercises.
I can tell you it does work, but to get lasting effects you need to use it regularly.
I know in the USA it is recommended by the Mayo clinic and there have been some trials on its effectiveness.
You can get it at Boots and it costs about £150.
8 January 2012 12:24PM
Since being on 10mg of Amlodipine a day, I have never suffered from a hangover. I believe it is something to do with enlarging the arteries.
8 January 2012 12:24PM
You posit the 'heritability' of sudden rushes of temper, but I believe recent neuroscience suggests that anger management is a question of brain pathways that become hardwired in baby and early childhood as a direct result of childrearing techniques. It's interesting that if your father had sudden flashes of temper then he may have been unable to teach you how to manage your temper as a toddler and a child and as a result that toddler-like sudden fury may have persisted into adulthood.
8 January 2012 12:28PM
Actually there's massive disagreement about what is a healthy/unhealthy amount of salt. Like the 'five-a-day' recommendations and the units-per-week guidelines it's a figure the government proposes without any real evidence. Anyone who's curious about salt could not do better than read Mark Kurlansky's book about it.
8 January 2012 12:37PM
Perhaps if you were'nt so obsessively anxious about the state of your health you might relax a bit and your BP might fall.
8 January 2012 12:40PM
My (US) doctor pointed out to me that the US health authorities have been regularly lowering the 'at risk' measurements for blood pressure, so that my formerly 'perfect' 120/80 is now seen as pre-hypertensive. I refused to take any medication for this, knowing that the lowering of the recommended numbers has been heavily influenced by so-called advice from the same drug companies peddling the pill to lower blood pressure.
See also: Statins
8 January 2012 12:50PM
Yeah, but check out their lifestyle too. They do very few hours of what we call 'work', only as much as they need to, and spend the rest of their time at leisure.
8 January 2012 1:18PM
It happened to me at about your age: after a lifetime of solid 120/80 a routine visit to the docs stunned me with a startling 160/98. The doc wanted me on drugs immediately but I refused. I could not accept that such a shocking and unfamiliar increase couldn't be dealt with - at least partly - by lifestyle changes.
I have always enjoyed my food and eaten perhaps a little more than I should, but I have never been overweight (well, not by more than a few pounds, anyway). I really enjoy alcohol and drink almost daily. I love coffee. I did not suspect salt since I have never been fond of it and had virtually cut it out of my diet many years previously (I never sprinkle it on food and I add only tiny amounts to my cooking. I rarely eat pre-packaged food.) At the time I was going to the gym several times a week, and have always been fairly good about exercising.
What I did know was that at I was having a thoroughly miserable time at work: a miserable commute from London to Glasgow every week, working on a miserable death-march of a project in a miserable office with miserable people I did not like and who did not like miserable me. I was also dealing with the depression of having returned to this grinding existence after six wonderful years in New York. There were relationship problems too. I recognised what should have been obvious: I was immensely stressed out.
I was lucky; I had money in the bank. I quit my job.
Within a week my BP was down to 140/92. After two weeks it was 133/88. I started to moderate my alcoholic intake a little (I will never, however, give it up entirely. It is far too great a pleasure in my life). I started eating fruit, which I don't like, so I just looked on it as nasty medicine. I still find the eating of fruit to be the hardest thing to make myself do, but I make the effort. Not as diligently as I should.
After about three months my BP levelled out and more-or-less settled at around 130/85, with occasional swings up and down, seemingly dependent on how far I fell off the wagon regarding exercise, eating and boozing. But it never came close to that initial scary reading again.
I am now almost 53 and have been working again for six months. My new job is as far away from my old stress-filled one as it could be, and I am happy in it. In order to get the job I needed to pass a medical. I went totally "spartan" for eight days prior to this examination - gym every day, no booze, no coffee, heavy on fruits and veg, green tea and so on - and I achieved a reading of 116 / 77 immediately after that. Now that I've got the job I have, of course, gone back to my less-than-righteous ways but I still keep an eye on the reading and it's generally around that 130-ish/85-ish level, which I can accept for a man of my age. The diastolic seems to be more volatile than the systolic, which is a concern, but the point of this rambling anecdote is that I have shown to my satisfaction that I can control this without drugs so long as I choose to make the necessary effort with diet and exercise, and that all-important stress management factor.
Anyone with this problem: get one of those good-quality personal BP monitors from Boots and track your own. It's a crucial tool in really giving you the ability to track and control your situation.
8 January 2012 1:50PM
I suffer from low blood pressure. I eat a lot of salt. Only thing that stops me getting dvts is drinking stupid amounts of water, going to the gym and aspirin.
8 January 2012 1:58PM
Great article, very informative. BUT it doesn't tell us how we cope with the blandness of food which has reduced salt and sugar levels, or the boredom of eating, or trying to eat, all that fruit. It might be an age thing with the older generation-that's me-but many foods simple don't taste as they used to in the 'old days', I think of beans, cornflakes, bread- the common things we all eat. We've lost the salt and the sugar, which is good for our health, but we have also lost the taste, which is good for our pleasure. Food should be fun, not merely fuel.
8 January 2012 2:02PM
Sorry, I probably should have said that the recommended daily amount of salt (here in Australia at least) is 2g to meet daily requirements but it might actually be that 1g is sufficient.
8 January 2012 2:04PM
Ah. Thanks.
8 January 2012 2:04PM
Not actually seeing a problem here.
8 January 2012 2:07PM
Please, if you get your own BP monitor, do check its calibration with your GPs. Some of the ones sold are well out of calibration, and could give false reassurance!
CTH, As for personality types, I'm short tempered, and my sibling is quite the reverse, and we were both brought up in exactly the same way by the same parents. Some things are genetic, even if others are due to conditioning. One peson I know had a personality change after a head injury.
I'd say it was not a bright idea to encourage any ratty person to think it's their parents' fault they are ratty...........that could lead to even more rattiness............... ; )