Being that February is National Heart Month I’d like to use this blog to address the relationship between high blood pressure and heart disease.
It has been well documented that high blood pressure contributes to heart disease. This includes coronary artery disease and the resulting angina and heart attacks. Additionally, changes in heart muscle due to high blood pressure can lead to heart failure, a condition in which the heart cannot pump enough blood to meet the body’s demands.
The changes in heart muscle due to high blood pressure are similar to those in a body builder. We have all seen the “pumped up” body builder stiffly walking down the street. Thickening, or hypertrophy, of the muscles in arms and legs results from lifting heavy weights. In essence, muscles get thicker and stronger so that lifting heavy weights becomes easier. The desired effect of bigger muscles is achieved but at a cost.
The muscles contract just fine, but have trouble relaxing. Hence the stiff walk. This is exactly what happens to the heart in a person with high blood pressure. After pushing against a large amount pressure the heart begins to thicken. It can squeeze more efficiently, but has trouble relaxing. The relaxation part of the heart cycle is called diastole. The inability to relax is thus referred to as diastolic dysfunction.
Diastolic dysfunction is common in those with high blood pressure. Since the heart cannot relax, it has trouble filling with blood. The blood has nowhere to go and backs up into the legs and lungs; shortness of breath and leg swelling result. These are signs of fluid overload and heart failure.
Much like other risk factors for heart disease, such as smoking and high cholesterol, the effects of high blood pressure are not felt immediately. Instead, it takes years for the negative changes to take effect. High blood pressure is often called the “silent killer.” One does not feel the elevated blood pressure until it is too late.
It is not easy to lower blood pressure in some patients. This is likely due to a combination of factors. First, high blood pressure must be identified and documented. Then, an appropriate medication must be prescribed. Once a diagnosis of high blood pressure is made, I spend as much time as necessary educating my patients about its risks and explaining the rationale behind a chosen medication.
Second, I find that many patients do not understand the reason for treatment. Make sure your doctor explains why a specific medication is being used.
Third, medication doses and names are hard to remember, especially if there are many. A useful technique I use is printing a list of all the patient’s medications. This “wallet list” can be carried in one’s wallet and reviewed on every visit. Finally, I review with my patients the cost of the prescribed medications. If the cost is too high, I discuss cheaper alternatives and strategies to lower drug costs.
In every month, but especially in February – the heart month, remember that high blood pressure and heart disease occur together. Your doctor and you can work at preventing the unfortunate heart problems caused by high blood pressure.
Do you know your blood pressure? See your physician and get checked today!
Published On: January 30, 2007