Silent killer steals energy

Afflicting an estimated 74 million Americans, high blood pressure is not only a silent killer, but a silent thief of one's energy, says Dr. Michael F. Roizen, chairman of the Wellness Institute and chief wellness officer of the Cleveland Clinic.

"We feel tired as we get older, and one reason is not being able to dilate (widen) our arteries. Dilation gives one energy. High blood pressure robs you of that ability, so by getting it treated you end up with more energy every day. It's another motivating factor."

High blood pressure remains a national health epidemic and a major risk factor for cardiovascular disease, the No. 1 cause of death in the United States. There are more than 850,000 cardiovascular-related deaths here annually.

"If you look at the data, 30 percent of people over age 50 would die in five years with a blood pressure measuring 150/90. If treated, that number falls to between 6 (percent) and 7 percent. High blood pressure is a serious problem, but people need to know how easy it is to make themselves healthier by aiming lower. The key is to talk with your physician, and pharmacist; we can predict any side effects," Roizen says in a telephone interview with The Post and Courier.

The normal range in blood pressure is 110 to 120 over 70 to 80. Roizen's ideal target: 115/75.

"It is five times more important to know your blood pressure than to know your cholesterol count."

The medical community's grasp of the principal causes of high blood pressure is more concrete than in the past — not that the dynamic is entirely understood.

"We used to say that 99 percentof high blood pressure was 'essential' high blood pressure, which means we did not know the cause," says Roizen, co-author of the YOU book series, as well as the YOU Docs column that appears in The Post and Courier, creator of the RealAge Test and co-founder of RealAge, Inc. "We used to think it was linked to stress hormones, but all the time we measured them they were involved in less than one half of one percent of hypertension.

"Now we know there's a genetic predisposition in 33 percent of cases. We know that some cases are due to intestinal bacteria whose waste product is a protein that raises high blood pressure. We know that there is more secretion of Renin, an enzyme which regulates blood pressure, than in a normal person. So there are more and more causes we know of, though we're not sure how important all of them are. But genetic predisposition seems pretty prominent."

Diagnosing and managing high blood pressure are critical.

"It is very important for patients to learn to measure their blood pressure, to measure it repeatedly and at different times of the day. You need to own a blood pressure device, which is inexpensive and available now at most drug stores and big-box stores. Learn how to use it and monitor what is happening. Validate the readings with one done in your doctor's office. Ask your physician these questions: What is our goal? What are we doing to get there? What can I do in addition to monitoring?"

Roizen says effective treatment is a matter of "getting emotionally involved" with your body.

Unfortunately, a recent survey quoted by Roizen indicates that roughly a third of patients don't fill their prescriptions, even if they are free, and others don't take the medications as consistently as they should.

"Of those who do fill them, only one-third get to the 130/85 level. People always say 'aim higher.' This is one area where you need to aim lower: 115/75, if possible. Their are 10 different classes of drugs available, so there is a wide variety. Current blood pressure treatments are not your grandfather's treatments, and there are treatments that have fewer side effects."

The same survey also revealed an encouraging trend: that patients want to get more information and exercise better control.

"This surprised us somewhat," says Roizen, whose Web site www.RealAge.com harbors a new online education program called Aim Lower. "Ninety-one percent felt they wanted to be more of a partner in their prevention and treatment. They knew they needed better control. But the key is to talk to your physician. Diet and exercise have an amazing effect if you let them. Exercise not only strengthens the heart muscle but enhances its ability to relax. This also teaches your blood vessels to relax, and it is this that a lot of medications and lifestyle changes work on. It allows more blood flow with lower blood pressure."

The traditional Southern diet, high in salt and fat, is a major impediment.

"Part of the problem with fatty and salty food is that it causes us to gain weight," Roizen says. "Fat collects inside the kidney capsule — a tight wrapper around the kidney — and if you gather fat, you also gather it inside the capsule, which causes pressure on the kidney. The kidney then secretes Renin and starts a chemical process in the body that narrows blood vessels."

In some people, he says, the Renin system is too active. But there are many medications that work to inhibit the Renin system when necessary and can lead to effective blood pressure lowering.

Reach Bill Thompson at bthompson@postandcourier.com or 937-5707.

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