Dear Nurse Bonnie:

What is normal blood pressure? What do the numbers mean? How can my high reading be that bad if I feel all right? Won't I get a headache or feel dizzy if it gets too high? Why should I bother to have my blood pressure taken if my doctor takes it every three months?

Mrs. M.P.

You've raised some questions that I have addressed in our IN-SHAPE publication entitled BLOOD PRESSURE. We are reprinting here that article in two parts. Please keep in mind that I am at 13 different sites in the community taking blood pressures and our drop-in clinic, open to anyone is held from 9:30-11:30 every Tuesday at the 2nd floor Senior Center at the Government Building, 888 Washington Boulevard.

WHAT DOES THAT BLOOD PRESSURE READING MEAN?
Please think of your heart as a pump and your blood vessel as pipes. Your heart beats and rests, beats and rests. The top number (Systolic pressure) measures the pressure within your blood vessels when your heart is pumping. The bottom number (Diastolic pressure) represents the pressure in your blood vessels when your heart is at rest. Pump, rest…Systole, diastole…top number, bottom number.

WHAT IS A "NORMAL" READING?
A better question might be, "What is a normal reading for me?" In general, a systolic reading below 90 is considered "normal". But, if you are a 90 year old who is under a physician's care, is otherwise asymptomatic, and consistently has a BP reading of 190/90, then that is normal for you. On the other hand, when a 72 year old who always had a blood pressure no higher than 130/70 suddenly has a reading of 170/86 and is complaining of the "the worst headache I have ever experienced," this warrants further attention.

WON'T I HAVE SYMPTOMS?
Hypertension (high blood pressure) is often referred to as "the silent killer" because you may have no symptoms at all! I sometimes hear people say that they see their doctor regularly, feel okay, and don't feel a need to have their blood pressure checked between visits. The people who do get their blood pressure taken between visits are often surprised to see a connection between some change in their eating or level of physical activity and their blood pressure reading. It some times helps to be a good detective, because people often seem to have forgotten about that anchovy pizza, kielbasa, nova lox, salted peanuts, pretzels, potato chips, canned soup, Chinese food or boullion they ate until further questioning.

On several occasions, I have been able to detect the first signs of impending trouble (blood clots and congestive heart failure) and refer the people immediately to their physicians for treatment. At these times I feel especially grateful to have been in the right place at the right time.

Most often, people have high blood pressure readings and have no symptoms whatsoever. Rarely, someone will complain of a headache, or feeling a little dizzy, or short of breath, or weaker.

The damage that occurs to the body over time and without a sign when someone has untreated hypertension has earned this disease the nickname of, "The Silent Killer". Please imagine a tree. Just as a tree has a trunk, then branches that are increasingly smaller in diameter way down to the tiny little veins in the leaves, so your body has a system of blood vessels of large and then increasingly tinier diameters.

The blood vessels are the route through which the blood travels to the furthest reaches of the body, carrying the oxygen and sugar necessary to keep each cell of the body alive and functioning at its peak. If the pressure in those tiny little vessels is high, they burst. Now the tissue that that little vessel has been supplying with life-giving oxygen and sugar has lost its route of supply. It dies. Over time and left untreated, this how hypertension leads to kidney failure when enough kidney cells die. This sort of damage can occur in any organ. Fatty deposits called "atherosclerotic plaques" are deposited in the interior walls of the blood vessels of people who eat lots of animals and animal products, fried foods, and foods containing palm, cotton seed, and coconut oils. These plaques further narrow the diameter of the space through the blood travels.

Now imagine blood streaming through the vessels under high pressure. A piece of the fatty deposit breaks off and travels through increasingly narrower blood vessels until it reaches one so narrow that it can pass no further. All the tissue that this blood vessel supplies with oxygen is now unable to get any. Without oxygen, the tissue dies. If the blockage has occurred in a coronary artery, it is a heart attack. If this fatty food turned plaque has blocked an artery in the brain, this is a stroke or brain attack. Those animals do have their revenge.

WHAT TO DO TO LOWER BLOOD PRESSURE AND REDUCE ARTERY DISEASE
Take heart (pardon the pun, please). It is NEVER too late to try to improve your health. According to heat specialist Dr. Dean Ornish, these four steps taken together lead to dramatic improvements…(ALWAYS consult a doctor before instituting a new exercise program):

• DIET: Count your fat grams and eat between 20 and 30 grams of fat daily. Count your sodium (salt) and eat no more than 2400 mg daily.

• EXERCISE: After consulting with your physician, establish an exercise regimen and stick with it! Walk the Cove! Swim at the Y! Call the Rehab Center and join an exercise class for people with arthritis.

• MEDITATE: Make a commitment to find five to fifteen minutes once or twice a day to SIT QUIETLY in a high backed chair in a receptive posture with your hands palm upward on each knee. Start by taking 3 deep, slow, cleansing breaths, in through your nose, out through your mouth. Know that there is a healing energy in the universe available to all of us if we just slow ourselves down and allow ourselves to be available for it to reach us. Imagine someplace you feel safe and good. If it is in a boat on a lake, feel it rock, feel the warmth of the sun, smell the fragrances you would encounter there. If a thought comes to you, allow it to float out like a cloud and concentrate on being where you are.

• JOIN A SUPPORT GROUP: Choose a group where you feel your anonymity will be protected if you choose to speak. Listen. If you believe in a Higher Power, know that He/She/It works through other people - let yourself be available for this support. It could be a cardiac rehab support group, a 12 step group (AA, Alanon, OA), a widow/ widowers group, a prayer group- your choice. Just show up!

• CHECK YOUR BLOOD PRESSURE: Tuesdays: 9:30-11:30, 2nd floor, Senior Center at the Government Center, 888 Washington Boulevard.