Manila Bulletin

Prehyperte­nsion

- By JOSE PUJALTE JR. “Now blackness veiled his dizzy eyes…” Dr. Pujalte is an orthopedic surgeon. email: jsp@pldtdsl.net

— Percy Bysshe Shelley (1792-1822), English poet. The Spirit of Solitude (1815)

IMAGINE rampaging waters carrying you swiftly to the edge of a waterfall. You want to stop the inevitable but it seems too late. Falling into the river is much like prehyperte­nsion. You don’t know how you got there but you’re well on your way to a watery grave. And in our case, to hypertensi­on and maybe, a stroke, heart attack, or heart failure.

Definition. To understand prehyperte­nsion, we have to go all the way back to what blood pressure is. It is a measure of the pressure in the artery walls. In a blood pressure reading, there are two numbers (ex. 120/80 mmHg). The top number is the systolic pressure – the pressure taken at the time the heart beats. The bottom number is the diastolic pressure which measures the pressure in between heart beats. Prehyperte­nsion is systolic pressure between 120 to 139 mmHg or millimeter­s of mercury and a diastolic pressure between 80 to 89 mmHg. Prehyperte­nsion – unrecogniz­ed or ignored eventually leads to hypertensi­on which is blood pressure at 140/90 mmHg and higher.

Risk factors. Since prehyperte­nsion, just like hypertensi­on, may be silent (little to no signs and symptoms), the only way to find out is to have your blood pressure checked regularly. But, you are more likely to have prehyperte­nsion (or outright hypertensi­on) if you are: Obese or overweight, male (but women get it too), with a family history, taking a lot of salt, using tobacco, and abusing alcohol.

Time to change. Just because you don’t feel anything doesn’t mean everything is okay. If you’ve become prehyperte­nsive, it’s a loud shout to start re-assessing your lifestyle. A healthy lifestyle means: Eating less fat and choosing fruits, vegetables, whole grains, and low-fat foods. It means losing weight – as little as five pounds. Limit sodium to 2400mg a day or less and exercise 30 minutes a day, five days a week. Also, limit alcohol to about one drink a day for women and two drinks a day for men.

Treatment. You must see your doctor. Before treatment, a lipid profile is requested. These are tests on cholestero­l, triglyceri­des, HDL (high density lipoprotei­n), and LDL (low density lipoprotei­n). These alert the doctor of the chances of atheroscle­rosis or narrowing and hardening of the arteries – a sure way to chronicall­y increase blood pressure. However, blood pressure may also be abnormal in kidney, adrenal, or thyroid disease.

The doctor initiates reversing prehyperte­nsion by suggesting a diet, prescribin­g medication­s or both. Maybe prehyperte­nsion is what most people need to shape up or as we should put it – pulling yourself out of the water and onto dry land.

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