Hypertension: “Your arteries are like a hose”

“Your heart is a muscle—but it’s not like the other muscles in your body. When you go to the gym, you lift weights to build muscle and get stronger, but it doesn’t work that way with your heart. You don’t want to have a heart required to work against higher resistance. When your heart has to work harder, as it does with high blood pressure, you wear it out early,” says John P. Erwin III, MD, Scott & White Cardiologist.

Dr. Erwin explains the basics of high blood pressure and why it’s dangerous.

From the standpoint of your heart, when your blood pressure is normal, your heart is functioning in its preferred environment. But when your blood pressure increases, your heart has to generate more force and work much harder. High blood pressure, or hypertension, is a blood pressure over 130/80.

Why is high blood pressure dangerous? “It’s like this: Your arteries are like a garden hose. Imagine you block the end of the hose with your finger and increase the velocity of the water. It’s just like that with your arteries and blood. Imagine your brain is on one end of the hose and then you cover the end of the hose with your finger. Blood pressure is the force that you’re pushing blood into your brain, or into your kidneys on the other end. With high blood pressure, with the higher velocity, your arteries transmit that high pressure, forcing a jet of blood into your brain or your kidneys,” says Dr. Erwin.

Untreated high blood pressure commonly results in serious damage. Generally, there are no warning signs for high blood pressure. Dr. Erwin, says, “In the ’70s, it used to be referred to as ‘the Silent Killer.’ You don’t feel bad. There are no symptoms until something bad happens, such as heart attack, stroke, or kidney failure.”

Because there often are no symptoms, Dr. Erwin says that “many men have undetected high blood pressure in their 20s and 30s. It’s extremely common for men to have high blood pressure in their 20s. In fact, for many men, their high blood pressure goes undetected for years and it’s not until they go in for a something else, such as a shoulder injury, in their 40s or 50s, that their high blood pressure is detected.”

Another notable thing, Dr. Erwin says, is that “people shouldn’t be surprised if they are told they should be on blood pressure medications at a young age—20s and 30s for men and 40s and 50s for women. It saves lives to be on medications if the blood pressure is high.”

“People don’t feel bad from high blood pressure, and often the side effects from taking the blood pressure medications make the people feel bad, so they quit taking them. What often happens is that our bodies get used to having high blood pressure so that feeling seems normal. But hypertension is very dangerous. We need the medications, and very often we need more than one blood pressure medication to accommodate the many different factors that affect high blood pressure. Your physician will adjust the medications to find the right balance for you, ” Dr. Erwin says.

The Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure recommends screening adults for high blood pressure every two years if their blood pressure is normally less than 120/80 mmHg; however, the Committee recommends that adults with high blood pressure should have their blood pressure checked every year or more often.

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Hypertension: “Your arteries are like a hose”