home *** CD-ROM | disk | FTP | other *** search
- MEDICINE, Page 54Over the Line
-
-
- Even moderately high blood pressure could be dangerous
-
-
- Doctors have warned about the dangers of high blood pressure
- for nearly a century, ever since U.S. brain surgeon Harvey
- Cushing and others noted that measuring blood flow was a good
- way of determining how much stress the heart was under. But
- exactly what physicians mean by "high" has shifted over the
- years. Now it appears that the danger point may be lower than
- previously thought.
-
- In a paper published last week in the Journal of the
- American Medical Association, the University of Michigan's Dr.
- Stevo Julius reported that even people with "borderline"
- hypertension may sustain damage to their heart and blood
- vessels. Such patients, argued Julius, should seek more
- aggressive blood-pressure treatment to lower their risk. Dr.
- Michael Horan, associate director of cardiology at the National
- Heart, Lung, and Blood Institute, agreed: "The message is that
- borderline patients should no longer be neglected. These people
- could already be in trouble."
-
- The definition of borderline is not clear-cut. In general,
- scientists see blood pressure as a continuum: the higher the
- reading, the greater the risk of stroke and heart disease. But
- for practical purposes, doctors often set a cutoff point at
- 140/90, urging patients whose pressure is above that level to
- seek treatment. (The 140 is a measure of systolic pressure, the
- maximum force with which the heart expels blood; the 90
- indicates diastolic pressure, the strength of blood flow
- between beats.) But in this study of nearly 1,000 patients, the
- researchers found that even people with a mean blood pressure
- of 130/94 already showed the warning signs of cardiovascular
- problems. The muscle in their hearts had become less elastic,
- and failed to relax completely between contractions.
-
- Horan stressed that these findings do not mean that all
- patients in this blood-pressure range should immediately start
- taking hypertension medication, but he did recommend life-style
- changes aimed at bringing the numbers down. Studies have shown
- that regular aerobic exercise as well as cutting back on
- saturated fats and sodium, among other measures, can reduce
- blood pressure. And, said Horan, if a patient is already at
- high risk for heart disease, because of a weight problem or
- family history, for example, medication may be justified.
-
-
-
-
-
-
-
-
-