LIVING WELL IN NORTHWEST GUILFORD COUNTY Hypertension (high blood pressure) – the silent killer

by ANNETTE JOYCE

I remember sitting in my office one day about 25 years ago and feeling a little strange – sort of dizzy with a bit of a headache. A co-worker suggested it might be my blood pressure. Just as a precaution, I drove to the local fire department to have my blood pressure checked and soon learned my blood pressure was high enough that a trip to the doctor was in order.

I probably had dealt with the condition way before then, but wasn’t aware I had a problem. Since then, I’ve regularly taken medication to control my blood pressure. I try to eat right (which doesn’t come easy), maintain a consistent exercise routine and avoid stress as much as possible.

With the exception of a couple of high-stress occurrences over the years, my blood pressure has remained consistent and under control. Although my family has a history of high blood pressure and heart issues, until my long-ago incident I wasn’t too concerned and probably would have ignored the warning signs. Unfortunately, too many people do ignore the signs – until they find themselves in critical condition.

Hypertension affects more than one-third of all American adults, and more younger people – including children –are being diagnosed with it. Factors such as genetics, age, gender and race are outside of our control, but a healthy diet, regular exercise, limiting alcohol consumption and not smoking can go a long way in preventing hypertension, or at least keeping it under control.

120mmHg, can exceed 300mmHg.

What is high blood pressure?

“Put simply, hypertension is a measure of the amount of pressure that is being put on the arteries as they carry blood throughout the body,” said Dr. John Bream, founder of Bream Medical in Stokesdale. “Our arteries are designed to endure shortterm stressors; for example, when we do heavy lifting our systolic blood pressure, which should be less than

“When our blood pressure remains elevated for long periods of time, this creates chronic stress on our arteries and leads to poor outcomes such as stroke, heart attacks, and kidney disease,” Bream said. “But it can also lead to vision issues, erectile dysfunction, and peripheral vascular disease.”

A normal blood pressure reading is 120/80 or lower. According to a January 2021 report from the U.S. Food and Drug Administration (FDA), “your blood pressure is considered high (stage 1) if it reads 130/80. Stage 2 high blood pressure is 140/90 or higher. If you get a blood pressure reading of 180/110 or higher more than once, seek medical treatment right away. A reading this high is considered ‘hypertensive crisis.’”

Readings between 120/80 and 129/89 are considered prehypertension, Bream noted, and those with readings in this range are advised to take extra precautions and regularly monitor their blood pressure.

Who gets it and when?

“Hypertension, more commonly referred to as high blood pressure, is one of the most common ailments in America,” Bream said. “It is estimated that hypertension afflicts almost half of all Americans and was a primary or contributing cause of death in almost 700,000 people in 2021.

“Left untreated, hypertension most prominently increases the risks of heart attack, stroke and kidney disease, but because there are arteries that supply every organ of the body, it can affect every organ system,” he explained.

The 2021 FDA report revealed the number of people dealing with this condition is alarmingly high and growing. Even more disconcerting, hypertension is increasingly becoming a problem for younger people, including children.

“Approximately one in three – more than 100 million – American adults have high blood pressure. But

Stokesdale resident Randy Stewart began dealing with high blood pressure at an early age.

“I was about 20 years old and had no idea my blood pressure was high until I got turned down to go into the service,” Stewart, now 73, said.

Back then, Stewart’s family physician put him on supplements – niacin and fish oil – and he lost a little weight, which brought his blood pressure into a healthier range. For the next 25 years he had no issues – until an annual physical revealed his blood pressure was again elevated.

At that point, Stewart was placed on medication which he takes twice a day. He said he “feels fine” and is diligent about taking his medication – but admitted he might miss a dose here and there.

“If I do miss a pill and then check my blood pressure, it’s higher than it should be,” he said.

Causes

While genetics, age, gender and race are among the factors out of our control, lack of physical activity, an unhealthy diet (especially one high in sodium), being overweight, having sleep apnea, high cholesterol, diabetes, stress, and smoking and tobacco use put everyone at greater risk for hypertension.

Back in 2015, Dina Smith experienced how stress can have a direct effect on blood pressure. At the time, she was under tremendous stress after her mother and 6-month-old grandchild passed away and her daughter moved out-of-state, all within a threeday period.

Smith, now 58, lives in northwest Greensboro and said she had never had a problem with high blood pressure before those incidents, but the stress of dealing with overwhelming grief apparently took its toll.

It was while she was being prepped for surgery that a nurse discovered Smith’s blood pressure was elevated.

“The pre-op nurse told me that my blood pressure was ‘off the charts,’” she said. “I was placed on medication for a short term. After a few weeks, my blood pressure went down, I had the surgery and I was fine.”

Fortunately, she’s had no problems since then. Recently she donated blood and her pressure was 120/82.

What to do?

One of the worst things about high blood pressure is that most people don’t realize it’s elevated until something bad happens – which is why it’s known as the “silent killer.” The good news is that high blood pressure is treatable and the first step is to identify that it exists.

Besides running his practice, Dr. Bream works as an emergency physician and deals with this issue from all angles.

“In the ER, I see someone almost every day with symptomatic high blood pressure who was unaware of being afflicted with it until it was found on an ER visit for headache, vision changes, chest pain, or trouble breathing,” he said. “In the clinic setting, we see patients every day and start intervening on their blood pressure before it gets to the point where an ER visit is required.”

While high blood pressure is treatable, Bream stresses the importance of prevention.

“A healthier lifestyle – weight loss, smoking cessation, decreasing alcohol use, decreasing salt intake and exercise can all help to improve and prevent issues with blood pressure,” he said.

“However, for some people, lifestyle changes alone are insufficient to treat the blood pressure and medication is required. As I tell my patients, most things in medicine are 80% what you can do for you and 20% what the doctor and medications can do for you.”