Hypertension: The Silent Killer

This disease reminds us of the deadly leopard, crocodile and mountain lion.

This disease reminds us of the deadly leopard, crocodile and mountain lion. Hypertension is both stealthy and unnoticed until it is too late, just like the above mentioned professional killers. When the problems associated with hypertension make their presence known, there is often permanent damage. This is a disease process that affects untold millions of people here in the U.S. and abroad, many of which have not been diagnosed and/or adequately treated for it.

The list of potential dire consequences that may result from years of uncontrolled high blood pressure is lengthy to say the least but we will name a few just to be complete. Heart attacks, strokes, kidney failure, aneurysms, congestive heart failure and leaking or incompetent cardiac valves are just some of the more common problems resulting from hypertension.

As we all age, we begin to see ourselves less immortal then we did when we were in our teens and twenties. Often we begin to pay attention to our health more often then not. Many different companies offer a wide variety of assorted screening tests to the general public without having to see a doctor. They charge a flat fee, test you and give you the results for you to follow up with your physician.

Of all these services getting your blood pressure checked is one of the easiest things someone can do. It takes seconds (as most of you already know) not to mention that there are numerous over the counter blood pressure measuring devices being sold. So no one even has to be trained to take blood pressure to get a relatively accurate reading.

If you are thinking of getting one of the home models available, we suggest getting one of the devices that measure your pressure by means of a cuff that fits around your upper arm as they are more reliable in our experience. Please note that it is very important that the cuff that you purchase fit your arm correctly. If it is too small or large, you may get an inaccurate reading. What we all strive for is to have an average resting blood pressure of less than 140/90ml/Hg (forget about the units and just focus on the numbers).

The first number is the systolic pressure, which the pressure in the arterial system when the heart is contracting. The second number is the diastolic and is the system's pressure when the heart is in between beats. Derangements can occur in both the systolic and diastolic function of the vascular system.

Next, it is important to recognize that blood pressure varies over the course of the day and has been noted to sometimes rise just because a health care professional is measuring it (whitecoat hypertension). Because of these normal variations it is important to take reading over time and at various points in the day to get a good average. Finally, if your pressure was say 110/ 60 a few months ago, an increase to say an average of 135/85, while still "normal" merits more investigation.

When the diagnosis of hypertension is made it is only natural to have lots of questions and concerns. From our experience the number one concern is over the side effects of the medications. But before we get to that let us not forget that you can do many things to lower your own blood pressure without resorting to medication.

Not in any particular order, you can begin an aerobic exercise program, lose some weight, stop smoking, decrease your salt intake as well reduce the amount of caffeine you ingest. More than one drink of alcohol a day (one drink equals 1 oz of liquor or its equivalent) is associated with an increase in blood pressure. If after a reasonably good effort in trying the above recommendations then it might be time for some medication if your blood pressure doesn't decrease to normal limits.

Technology has improved some aspects of our daily lives. This is especially true when it comes to hypertensive medications. No doubt, the medicine of yester-year definitely had many more unpleasant side effects then the present high tech meds we have now. The problems with lethargy, frequent urination, impotence and the feeling of being drugged can easily be avoided especially with the new effective, low dose combination pills available to your physician. In many cases, you won't even know you are taking them except for the fact that they will lower your pressure nice and evenly.

There are a couple of medication issues that are useful for the hunter to consider. One group of medications, the beta blockers, is actually banned from parts of the athletic world because they enhance performance. They do so by reducing the amount of adrenalin one feels right before the performance.

Think about buck fever here. These medicines are not for everyone but are worth considering for the hunter whose shakes have left the buck running and the freezer empty and has hypertension in need of medication to normalize. Starting a course of diuretics before a long morning sit is obviously a predictable problem. In fact, starting a course of medications for hypertension carries some risk (lower now than before) so it is best to get all this stuff squared away as part of your off season preparation.

Now that you know something about hypertension, don't wait till the mountain lion is on your back before you do something. We see the consequences of ignored and under treated hypertension all the time. It is not a pretty sight and is so unnecessary. Early detection, lifestyle changes and treatment are the keys to success here. As usual, feel free to contact us at www.thehuntdoctors.com if we can be of more assistance. Be safe and enjoy the outdoors.

Editors note: This is the first installment of an on-going series of hunter health-related stories that will be featured here at www.gameandfishmag.com. The authors, Paul Plante M.D. and Steve Merlin M.D., are avid hunters and Board Certified Internists practicing in Columbia, South Carolina. The focus of their work will range from broad general health concerns and issues to specifics maladies encountered by outdoorsmen. We hope you enjoy their efforts and if you have a health related question for the hunt doctors that you would like answered personally, please e-mail them at The Hunt Doctors

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