A Major Health Alert

I'm diabetic (Type 2), but I found that most of the things I have to worry about are things that everybody should worry about.  In the long run, high blood sugar (essentially the definition of Diabetes) affects almost all the body's systems: kidneys, heart, liver, nerves, circulation.  I was surprised when my primary care physician wanted to lower my blood pressure. 

"What does diabetes have to do with blood pressure?" I asked.  He didn't answer the question; he proceeded to check out all my systems, leaving me to figure it out.  (He knew my colleagues called me Dr. de Silva, and made a common mistake, assuming that I was a specialist in some obscure health field.)

Well, there's an article in the New York Times about high blood pressure; why it's important, why it's often undiagnosed, and why (even when diagnosed) it goes untreated.

In 1999, I had visited my hometown, to celebrate my parents' 50th anniversary.  The enormous pile of medication I was carrying with me was mostly intact, except for my blood pressure medication.  It had sort of exploded!  (It's a phenomenon called efflorescence, where some substances abandon their crystalline nature and revert to a powder, when exposed to high humidity.)

When I told my brother, I got dragged around to my brother's PCP*, who agreed to see me as a matter of courtesy for my brother.  I explained about the misbehaving pills, and he got very serious.  "Can't play around with blood pressure," he said, and immediately prescribed an equivalent drug, stabilized for the tropics, and dug out a single dose for me to take immediately.  The point of that anecdote was to illustrate how seriously doctors take blood pressure; it could lead to stroke or death without warning.  [*Primary care physician.]

I'm still not one of those doctors, but I'm picking up bits and pieces here and there.  Blood pressure control is a big deal.  Once you are put on it (usually because you really, really need it), you don't want to unilaterally decide to go off it.  Fortunately, some of the most effective maintenance drugs now cost hardly anything. 

Why does high blood pressure matter so much?

1. If you have a potential aneurism in your brain, it could pop.  A good friend of mine was resisting going on BP medication.  He went to a conference in New Orleans, and died of an aneurism.  Any shock could kill you. 

2. The higher your BP, the harder your heart has to work.  All the time.  It just ages your heart more than it's supposed to age; you might be 50 years old, with an effectively 60 year old heart. 

3. The higher your blood pressure, the harder your kidneys work.  This is particularly bad for diabetics, because either diabetes, or diabetes medication, puts a load on your kidneys.  (There is some belief that heavy use of Tylenol will also be a burden on your kidneys.)

I'm sure I knew of other reasons to have your blood pressure screened regularly, but I have forgotten.  Until a better plan emerges, once you get on BP medication, just stay on it.  It's not expensive, and giving it up is dangerous.

 Archimedes.