Thursday, 2 May 2013

One Hundred and Ninety Four Days

Some curious facts have come to light since my being classified hypertensive. After a brief chat with Methuselah who asked "Had you any benchmarks against which to compare these recent readings?", I was scratching around trying to think of when it would have been recorded in the recent past.

I recalled an annual health check offered by my employer and after a bit of searching, BINGO!  I found notes from these health checks extending back several years:
  • 'xx/xx/2006' 155/83
  • 'xx/xx/2006' 136/85 (retest)
  • '30/09/2010' 131/97
  • '30/09/2010' 132/94 (retest)
  • '27/07/2011' 140/82
  • '09/09/2013' 122/75
I remember the early ones - in both cases I was late for the appointment and walked up a flight of stairs to get to the appointment.  My BP was taken almost immediately - hence the retakes.  It should also be noted that these reading would have been taken around midday on a busy work environment - not conducive to relaxation!

More importantly, as recently as September last year my BP readings were normal (one caveat is that one-off readings are not truly indicative of BP any more than you could name a song from a single chord, but at least it is a start).

The question is what has happend in the 194 days between this reading on 9th September 2012 (122/75) and my first high reading on 22 March 2013 (179/110)?  In retrospect there were definitely some intense periods at work - all lubricated for the past few months with lots of coffee (enough to perhaps disrupt sleep).

Doctors just look at a single reading (or a few readings in a single period), your age and then you get medicated by numbers.  That is NOT how I roll.  I understand high BP is dangerous if it is prolonged, but I am also interested in WHY we get high BP; the underlying cause, as high BP itself is simply a system of an underlying phenomena.  I also want to resolve it!

The fact that I don't tick any of the 'normal' risk factors for hypertension, and that current tests show that I am in good health with very low viceral fat, and the fact that I can relax and get my blood pressure down (sometimes to as low as 126/73), suggests some underlying regulation is going awry.  Calling it 'Essential Hypertension' labels it for the convenience of the medical community but offers little else.

A brief detour to 'Why We Get Sick' is always worthwhile,

  • "University of Michigan physician Alan Weder and his colleague Nicholas Schork have tried to understand high blood presure as a disease of civilisation.  Instead of emphasizing the high levels of salt in our diets, however, they note that blood pressure must be higher to supply the needs of larger bodies and that there is a mechanism that increases the pressure during adolescent growth spurts.  In the ancestral environment, they argue, this mechanism would have made adjustments within a range of small body sizes.  Today, our nutritionally rich environment yields fast growth and large body sizes that were rare in the past.  The blood-pressure-regulating mechanism, pushed to adjust the system outside the range for which it was designed, often overshoots, causing high blood pressure." ('Why We Get Sick', Nesse & Williams, p154)
I'm not sure this applies to me as my blood pressure has been normal until quite recently.  Given the very recent onset of this condition, I suspect something more 'viral' by nature.  Over to the Harvard Gazette:
  • A new study suggests for the first time that cytomegalovirus (CMV), a common viral infection affecting between 60 percent and 99 percent of adults worldwide, is a cause of high blood pressure, a leading risk factor for heart disease, stroke, and kidney disease.
 Now THAT is something I can work with.  I am currently focusing on sleep and good nutrition (80/20 in my diet has been replaced with something closer to 99/1).  I've cut back on exercise intensity, but am still keeping busy.

The blood pressure numbers are falling...


August said...

I had something similar. I still don't know why my blood pressure spiked, but I was going through some sort of temporary, acute event. It was scary enough to go to the doctor, but the doctor acted like the high blood pressure was the cause rather than a symptom.

Chuck said...

your numbers area falling? how often are you testing. BP is easily and inexpensively tested with machines often at drug stores. you are right about one time, snapshot tests dictating treatment. this is a dangerous, irresponsible practice IMO.

Asclepius said...

@Chuck - I've got myself one of those BP monitors that fits on the upper arm. Since using it I've become aware of how my BP can vary significantly from second to second minute to minute (although you should wait a few minutes before repeat measure), and arm to arm. Also there are obvious peaks and troughs throughout the day. For me I'm also seeing lots of low numbers at times.

Part of me thinks this kind of dynamic range is normal - on average towards 140/90. Still high I guess but factor in my personal variabilty and it certainly doesn't look that bad!

Asclepius said...

@August - the numbers can be scary but they are just a single dimension of your health.

I am single digit BF, don't smoke, rarely drink (a bit of red wine once a fortnight if not less), I eat a good diet of whole foods (lots of quality meat, fish, veg and salad) and am active. I sleep pretty well and generally consider myself largely unstressed.

So even if people with high BP have a greater chance of strokes etc.... further down the line, I'd guess that these other factors could mitigate things for me.

I am not saying HBP isn't dangerous but simply pushing it down pharmacologically is, as you say, treating a symptom and not the cause.

alexleejohnson1000 said...

Perhaps this is a case of 'reactive hypertension'? Sometimes people talk about 'reactive depression' - as something not to be medicated. In other words, you lose your job, you get depressed. That's natural and should not be medicated. Clinical depression is considered to be a chemical imbalance that should be medicated. The question is whether medicating reactive depression prevents someone dealing with issues - like drinking to forget. If you take hypertension drugs because you are stressed at work then you are treating reactive hypertension rather then clinical hypertension - and perhaps preventing a more direct confrontation of the underlying issue. I am making this up as I go along but it seems to vaguely hold some water.

Anonymous said...

I had a dramatic spike in blood pressure in mid winter this year. It was also a time when I was sleeping very badly, probably due to work-induced stress. My blood pressure declined at the same time my sleep disturbances resolved. I also began to supplement with potassium, for what it's worth. I'm 53, have eaten more or less as you do for the last five years, and had previously had super-optimal BP readings.

Asclepius said...

@Alex - I certainly think my numbers are part of some 'natural dynamic' as they are coming down to comfortably low numbers. There is still the odd spike for example, depending how soon I measure BP after going from standing to sitting on the floor (where you'd expect BP to rise as the BP required to drive blood around a standing adult would be a lot more than when seated).

@Anonymous - I'm starting to think that the whole sleep/play/relax axis is right up there with nutrition and exercise.

FeelGoodEating said...


Sorry to be reading about your little scare....
Keep the positive vibe going....
I strognly feel that we will learn more years from now, that it's practically all that's required. (you are already living and breathing all the other good stuff)

For what it's worth...
the only time my BP crept up during testing over the last 5 years, was when I was very strict "paleo/primal"
Potatoes and rice seem to have leveled me out.

Hang in there and keep us posted!