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Say 'Aaah' | The Healthy Man

Getting the Gents' Blood Pressure Checked

October 09, 2000|TIMOTHY GOWER

More than 50 million Americans have high blood pressure--and one-third of them don't know it. The condition, also known as hypertension, tends to arise earlier in men than in women, on average by about age 32.

Because the average guy would rather clean out the garage than get a physical exam, younger men with high blood pressure almost always fly under the medical system's radar.

"We never find 32-year-olds with hypertension," says Dr. Steven Miller, chief medical officer at Barnes Jewish Hospital in St. Louis.

Women who have high blood pressure, meanwhile, are often detected when they become pregnant and visit an obstetrician. With that in mind, Miller came up with a plan. In 1997, he sent medical students with sphygmomanometers (the devices used to measure blood pressure) to four obstetricians' offices in the St. Louis area. At these clinics, Miller knew, the students would find men hanging around in waiting rooms, accompanying their pregnant wives and girlfriends.

The medical students checked the blood pressure of 191 men between the ages of 15 and 69. Forty men, or about one in five, had elevated blood pressure, according to the study's findings, which were recently published in the American Journal of Hypertension.

The men in the study who had elevated pressure were instructed to see their own doctors for a follow-up, since one high reading doesn't necessarily indicate hypertension. Still, Miller says many of them probably ended up receiving a bad-news/good-news message from their doctors: Yes, you have high blood pressure--and it's a good thing we caught it early.

Miller believes that this study shows it's possible to catch hypertension before it can do serious harm to your body. High blood pressure rarely causes symptoms, so men who don't have regular physical exams typically don't find out they have it until they're over 40 (when screening tests or other conditions are apt to send them to the doctor).

By then, however, many guys have been walking around for years with levels in excess of 140/90, the generally accepted danger threshold. During that time, chronically elevated blood pressure can damage vital organs, increasing the risk for cardiovascular disease, kidney damage and retinopathy (which can lead to blindness).

The pounding of high blood pressure causes the heart muscle to thicken and vessels to stiffen. However, Miller says that growing understanding of hypertension suggests that rising pressure causes other changes in the body that increase the threat of disease. You can inherit high blood pressure, he adds, but some familiar bugaboos seem to be present in most cases: eating too much, especially salty foods, and not exercising enough.

If sorting out guys with hypertension is tough, it's often just as difficult to make them take their medicine. Miller believes that situation is improving, though. Older-generation blood pressure medications had to be taken three or four times a day and caused unpleasant side effects, such as dry mouth, dizziness, fatigue and impotence among men and hair growth in women. Newer drugs, particularly angiotensin II receptor blockers, can be taken once a day with far fewer side effects.

Miller's study was primarily designed to show other doctors and hospital administrators that there are ways to detect people with high blood pressure who might otherwise slip through the cracks. His decision to start with young men who were about to become fathers was based on a hunch. "The first time I got interested in my own health was when I was going to have a kid," he says. "We thought the men would be mentally in the right place to do something about their high blood pressure."

Current dads may be thinking: Of course he found guys with racing hearts--they were sitting there wondering how to pay for college tuition in 18 years. Miller notes that it's true some of the men in the study may have had higher-than-normal blood pressure because they were nervous. However, he adds, growing evidence suggests that people who respond to stressful situations with a spike in blood pressure often develop hypertension later in life.

You don't have to be planning a family to be concerned about your blood pressure. Consider this one more good reason to have an annual checkup, exercise regularly and keep your weight under control with a healthy diet. In particular, watch out for foods high in sodium, such as deli meats and canned soups. Miller may have set a clever trap for the men in his study, but symptom-free hypertension is the real hunter; don't let it ambush your health.

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Massachusetts freelance writer Timothy Gower is the author of "Staying at the Top of Your Game" (Avon Books, 1999). He can be reached at tgower@mediaone.net. The Healthy Man runs on the second Monday of the month.

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