High Blood Pressure Warning Signs

High blood pressure was always a term I associated with older folks—you know those people who wobble and have white hair? Or, I reasoned, high blood pressure afflicts stout, Type-A male executives who drench their salad with blue cheese dressing while downing a second martini and waiting for their steak dinner. This condition surely did not apply to me—a mere 47-year-old female with a health-conscious lifestyle. In fact, some of my friends think I am “disgustingly healthy.” Aside from occasional indulgences like fettuccini alfredo and coffee milk shakes, I do all the typical “right things.” I don’t smoke, I eat well, maintain my weight, jog, and exercise. I’ve run the Boston Marathon, halfmarathons, crewed during college, and now lift weights and do Bikram Yoga (the ultimate stress-buster). I was even once described in a newsletter as having “a Zen like demeanor.”

My glow of good health dimmed when, during a routine physical, the nurse briskly took my blood pressure and frowned. She took it again. The same frown appeared, this time deeper. She looked me up and down suspiciously, shook her head and said, “You must have white coat syndrome.” She explained that “white coat syndrome” is when patients get nervous at the very thought of being in a doctor’s office. Ironically, in response, blood pressure temporarily climbs. And, sure enough, by the time the doctor came in, my “pressure” had dropped to an acceptable level. I learned that good blood pressure is 120/80 or below. Mine was around 130/95 or, said the doctor, “somewhere on the high-normal side.” She prescribed hydrochlorothiazide. This, she explained, is a diuretic, or “water” pill that will help flush extra water, salts and enzymes from my blood. When these build up, major organs like the pancreas and kidneys must work harder than usual to dissolve and process them. The heart must pump fresh blood to help them out and, in the process, veins, which deliver the extra blood, become thinner. If my pressure remained high, we could go up to the next tier of medications. These included things like lisinopril, an angiotension converting enzyme inhibitor. This is supposed to relax blood vessels, causing them to widen. I felt my blood pressure rising at the thought. Her pager beeped. With urgency, she left, no doubt to help someone dying, someone who was really sick, I thought.

I breezed out with instructions to cut back on salt and coffee and with a prescription for a little water pill. What was the big deal? I needed to purchase a blood pressure cuff and record my readings four times a day. And, I must watch for the usual signs of high blood pressure: dizziness, fuzzy vision, tingling hands and feet, swollen ankles, slower reflexes, confusion, and anxiety. Besides a little anxiety (which doesn’t count if you are holding down two jobs and have a teenager) I had none of these symptoms. I took readings for the first week and, when they consistently registered in the “high normal” range, with a few higher numbers here and there, I stopped. After all, who has time for this nonsense?

I resumed my life. But, somewhere along the way, I did not get my prescription refilled. Christmas was in one week and the days were melting away. I felt just fine and besides, I had cut down a little on coffee. Then, little things, very tiny things, began to happen. When talking to my daughter, I called the dishwasher a thermometer. We laughed harder when, a half hour later, I said I had to get my tinfoil changed. I felt a little strange, and, feeling guilty, I pulled out the expensive blood pressure cuff and took the reading: approximately 210/188.

My husband Robert called the doctor who, to my embarrassment, said to call an ambulance. The medical technicians wanted to carry me to the van but I insisted on walking. When I refused a wheelchair when we reached the hospital, two orderlies, without a word, lifted me up and put me in the chair. Yet another technician wheeled me into the emergency room, where I sprang up and said hello to the nurses. After all, I still felt and looked fine, I thought, compared to the guy in the gurney with blood seeping through his bandages.

I was escorted right into an examination room. The nurses acted very calm around me, way too calm. What was going on? For the first time, I was scared. My reflexes were checked, my pulse taken, my “pressure” was taken two more times. The doctor came in and the questions became more personal. Was I being abused at home? Was anything unusual going on in my life that could cause a lot of stress? What do I do for a living? Did I do any kind of drugs? That’s when I knew I had to tell them that I hadn’t taken my medication for several months. So, I did. There was silence. I got those terrible “how can you be so stupid?” looks from the doctor, nurse, and, of course, Robert.

“You’ve got to take your medicine, Kymberly,” said the doctor severely, using my full name. “High blood pressure is a serious condition leading to renal failure, stroke, heart and kidney failure.” I left with a new prescription for the water pill and a month’s supply of xanax to calm me down until the medication could take effect, which would take about two to three weeks. Only then could I be bothered to do some research on blood pressure. With horror, I learned my heart was working overtime to pump blood through my circulatory system, and, my veins were becoming progressively thinner; that one in four Americans have high blood pressure; that there are no symptoms; that it is called the silent killer. If left untreated, your arteries could spring a leak or burst, causing organ damage, stroke or a heart failure. Basically, my body was like an old car, the parts were wearing out and, if I was not careful, I could blow a gasket.

My sister Lauren, a nurse, got right down to business. “Don’t be stupid. Do you want to die? Or, end up in a wheelchair and drooling? Think about that, Kym. Drooling.” Her words, more than any fancy four-syllable medications or conditions narrated by busy doctors, made an impression. Now, I am humble. When my prescriptions run out, I remember “die” or worse still, “wheelchair and drooling.” I think about my daughters Hawthorne and Isabella, and Robert. Now, I take those small blue pills; I make and keep every doctor’s appointment. And, when I visit my internist, she is very glad to see me.

The Basics

r
• Blood pressure: the force of blood pushing against the walls of the arteries
r
• Blood pressure reading: a reading consists of two numbers and is usually separated by a slash. The first number is called the systolic and registers the pressure your blood exerts on your veins when your heart beats. The second number is called the diastolic and registers the pressure your blood exerts on your veins in between heartbeats. Readings are taken several times and an “average” is recorded.
r
• Normal: Blood pressure is approximately 120/80 or less.
r
• High Normal: 120-139/80-89 is considered prehypertension.
r
• High: Any thing above 140/90 is considered hypertension.
r