Saturday, June 6, 2009

The Purpose of This Blog

In February of this year, while seeking treatment for an injury, it was discovered that my blood pressure was high. Very high. Like 185/110 high.

As the doctors recommended, I went onto blood pressure medication. But I also began researching the topic, and I discovered that no one really understands hypertension. Oh, the doctors have their pet solutions--ACE inhibitors, diuretics and the like--but in most cases these appear to treat the symptoms without ever addressing the root cause.

Medicine can't be blamed for not addressing the root cause. In a few cases, such as kidney disease, the root cause is identifiable; but in ninety percent of all cases, the diagnosis is "essential hypertension." That's medical-speak for "hypertension not caused by anything we understand."

High blood pressure certainly causes long-term problems and needs to be controlled--though there is a strong economic incentive to exaggerate these problems. Research is controlled by the drug companies, and the drug companies would like to see everybody in the world taking a daily dose of blood-pressure medication.

How much good do these medications do? For people with dangerously high blood pressure, they certainly reduce the number of strokes. Their record in reducing heart attacks, however, is rather more disappointing. And some blood-pressure medications have very serious side effects, including some long-term consequences that are only now coming to light.

High blood pressure and health is a little bit like body weight and health. If you look at the statistics on obesity and general health, it seems clear that reducing body weight to a desirable level has health benefits. But that doesn't mean that low body weight automatically means better health, and that all a doctor needs to do to fix you is to reduce your weight. There are healthy ways to reduce weight and unhealthy ways to reduce weight, and cutting off your leg will certainly bring your weight down, but it won't make you healthier.

There is a similar problem in hypertension. For example, one of the most common ways of treating hypertension is with an ACE inhibitor--a medication that blocks Angiotensin Converting Enzyme.

If the underlying problem is that the body is producing too much angiotensin, then this addresses the root cause of the problem. If the underlying problem isn't too much angiotensin, however, then this medication will still probably reduce blood pressure somewhat, but it won't address the root cause of the high blood pressure.

If that seems confusing, try this analogy. Think of blood pressure as the temperature inside a house. If it gets too hot in the house, one solution might be to open the windows. If it's cooler outdoors, this will certainly bring the temperature down.

But why is it too hot in the house to begin with? If it's just a lack of air circulation, then opening windows cures the root problem. But suppose the heater is on. If you open the windows, it will cool the house, but the heater will still be running. The solution will address the symptoms, but it won't address the underlying problem.

The difficulty faced in hypertension is that we usually don't know what the underlying problem is. So we treat the symptoms and hope for the best, but the fact is that in most cases we are flailing around, trying one thing and another and hoping for the best.

I have been intensively researching hypertension and related issues for months now, and I haven't come to any firm conclusions. But one thing I have found is that it doesn't take much study in this area to get far ahead of your doctor's understanding of the subject. The research in this field is voluminous, and most doctors know little more than whatever they were taught back in medical school plus whatever generalizations the American Heart Association sends out in its latest pamphelts.

I have come across a wealth of information--some contradictory, some surprising, some shocking. I don't have any bottom-line answers, but I have plowed through a vast quantity of research...enough research, in fact, that my head is likely to explode if I don't get some of this down on paper.

This blog isn't putting forward a point of view or a program. What I plan to do is just to share, hopefully on a weekly basis, information on blood-pressure-related topics. There are no fences around the subject matter. I'm of a skeptical temperament, but I'll be including information on everything relevant: standard medical research, exercise, meditiation, supplements, hypnosis, chiropractic, diet, white-coat hypertension, blood-pressure monitoring, and anything else I turn up. If nothing else, this blog will come to act as a repository for a lot of electic information in one spot.

Meanwhile, my own blood pressure is gradually coming under control; but I'm trying so many things at once that I can't tell you which ones are helping me!

3 comments:

  1. Hey, I love this site - are you still around? Curious if you've kept your BP down since 2009 and what you're doing about it.

    I just woke up in the middle of the night thinking about the last time I had a nurse take my BP and annoyed about it! I asked her (really, I tried to be polite!) if she could leave the cuff on my arm for 5 minutes and she looked outraged! Basically, she refused. I'm thinking the next time a nurse - or doctor; the doctors refuse also - refuses to follow any guidelines, I'm going to ball up my fist and tense my arm. When they tell me I won't get correct readings this way, I'll say, "But I thought it didn't matter how you took the BP?"

    Anyway, I found a small dose (12.5 mg) of Chlorthalidone, plus eating lightly and exercising regularly, has been enough to keep my BP around 125/80. Hope your BP is doing well too.

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