Friday, September 22, 2006

Reader mail reply

A reader replied to this post as follows

I am interested to know more about the prehypertension category, which I assume is what I have with my BP of 130/90 (?) I suppose my BP has been at this level for quite some time. I have been told to practise a healthy diet and for now I do not need any medication. I have read though that it could be beneficial for prehypertensive people to take medication to prevent it developing into full-blown hbp. I would love to get some opinion. I am female, 43, not fat (about 54kg)but very much lacking in exercise.

First of all. Let me emphasise that the best person to provide you advice is your own doctor. They will know many things about you that we have no hope of covering in a blog which is a limited medium at best. The advice given below is to provide a general guideline and maybe a little bit of understanding when speaking to your doctor.

The concept of pre-hypertension, is a concept to emphasize the importance of prevention of hypertension. Hypertension, which is high BP with "target organ damage (TOD)" can be prevented if we take prevntive measures. Possible options are diet, lose weight, eat almost no added salt, eat greens or vegetables and so on. These measures have been shown to reduce BP by about 10mmHg. Losing weight is particularly important, as it also helps you to avoid diabetes. What you do not want is to get "metabolic synrome " the syndrome of hypertension, abdominal obesity, low HDL, high triglycerides, and insulin resistance. So I am sorry, you may have to start an exercise campaign to reduce weight.

As for drugs, that should be avoided unless the above measures do not help. Early treatment with drugs is no longer wrong, especially if we understand that the therapy can be slowly reduced and maybe stopped, should the above lifestyle changes measures succeed. Drugs are very safe now, except that they may be expensive, and we do not wish to take medications, unless we really have to.

In summary,Make sure that you do not have any TOD, like cardiac LVH, eye changes, and micro-albuminuria. If you do not have any of those then lose weight, exercise, low salt diet, eat greens and vegetables. If you do have TOD, then you probably need some medications.

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