Blood Pressure: Why it's important to know your blood pressure

The Blood Pressure Association charity estimates that over 16 million people in the UK have been diagnosed with high blood pressure. A high majority of these people regularly take at least one prescription drug to control it. But, according to a growing body of research, the current mainstream approach is failing miserably.

A recent study published in the Archives of Internal Medicine in the US reports that only about 30 percent of those being treated for hypertension are well controlled. The others are still in a dangerous zone, despite regular treatment with drugs and regular check-ups with their doctors. Why? Of course, the answer is complex. But the study suggests that the signs of remaining risk are plainly visible - if only their doctors knew what to look for.

Keep an eye on your systolic pressure
Im sure youre familiar with a blood pressure reading; its been standard medical practice for generations. Blood pressure is represented as a fraction; systolic pressure, the top number, represents the pressure of the blood against the artery walls when the heart contracts, while the bottom number represents the diastolic pressure, or the pressure against the artery walls when the heart relaxes between beats. Generally, the threshold for high blood pressure is 140/90 - anything above that mark is characterised as hypertension.

Traditionally, most doctors have focused their attention on the diastolic pressure, both in diagnosis and in treatment. Although more and more research has supported the importance of the systolic pressure over the past several decades, many mainstream doctors have still not caught up. And as this latest research suggests, that lack of understanding could mean the difference between life and death.

In a study of 4,714 French men currently under treatment for hypertension, the men with systolic blood pressure (SBP) values between 140 and 160 were two and a half times more likely to die from cardiovascular disease than men with SBP values under 140. As the authors note, a great proportion of people under treatment for hypertension fall into this category; in this cohort, about 45 percent of the participants had SBP values in that range, despite their drug treatment. And, under current guidelines, that 20-point jump would most likely be considered a mild increase - even though the data indicates it more than DOUBLES your risk of death.

Effective drug treatment can still leave you at risk
The scientists also report that this increased risk was independent of the mens diastolic blood pressure (DBP) values; even after they adjusted for high DBP, the risk remained the same. On the other hand, the increased risk of high DBP did NOT remain after adjustment for high SBP. As the authors wrote, After adjustment for SBP, DBP levels lost all predictive value.

And while previous work suggested that SBP might be a better indicator of cardiovascular risk in patients over 60, most research still supported diastolic as the best marker for younger patients. But in this study, the role of SBP was not influenced by age - and in fact, the average age of the participants was 51.

Of course, most conventional doctors prescribe antihypertensive medications to their patients with high blood pressure. Many call the treatment a success once the diastolic pressure has gotten down below 90, even if the systolic is still above 140. But as this study shows, even with treatment, SBP values above 140 are still too high - and may require even more aggressive treatment.

If you have hypertension, you should be well aware of your systolic and diastolic numbers - and have a comprehensive plan to bring BOTH of them down.  The High Blood Pressure Foundation recommends the following tips to help lower your blood pressure:

 Stop smoking! Smoking doubles your risk of heart disease and trebles your chance of dying before reaching retirement.

 Limit your alcohol intake to 3, or preferably, 2 units per day (a unit is equivalent to a half-pint of beer, a glass of wine, or a single measure of spirit). A small amount of alcohol is probably fine for your health, and may even be beneficial, but larger amounts can increase the blood pressure and may damage your liver.

 Avoid being overweight. This can increase the blood pressure, and is bad for your joints and your breathing.  It may also help to avoid foods containing saturated fats, such as dairy products (butter, cheese and full-fat milk) and red meats.

 Try exercise regularly because it reduces the blood pressure and helps to keep weight down. Exercise does not have to be excessive and should be built up slowly. Walking, swimming, cycling and jogging are all appropriate forms of exercise. If you are in doubt, discuss this with your doctor first.

 Avoid adding salt to food at the table. Some people are very sensitive to the effects of salt, and for them it can be particularly helpful.

In past e-alerts we have written about natural ways to address blood pressure, like the Chinese immortality herb jiaogulan, which has been proven to regulate blood pressure and the Ayurvedic herb arjuna, which has been shown to offer significant cardioprotection. 

And if youre working with your doctor to address your blood pressure concerns, ask him what your goals are - and make sure those goals dont downplay the importance of your systolic pressure.