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Getting Heart Healthy For The Holidays: Managing Your Blood Pressure

Why is High Blood Pressure Such a Problem?

High blood pressure directly killed over 41,600 Americans in 1996 and may have contributed to 202,000 additional deaths. It is particularly deadly in African-Americans. Malignant hypertension, an emergency condition resulting from untreated primary hypertension, can be sudden and lethal. Fortunately, it is also rare.

Because hypertension can cause damage in certain organs over time, patients who do not control high blood pressure face a reduced life span. High blood pressure contributes to three out of four strokes and heart attacks. People with high blood pressure can have as high as ten times the risk of stroke and five times the risk of a heart attack! High blood pressure causes one third of all cases of kidney failure--a rate second only to diabetes. The risk for developing congestive heart failure is also significantly higher with increased blood pressure. People whose high blood pressure has led to enlargement of the left side of the heart (left ventricular hypertrophy) remain at risk for strokes, heart attacks, sudden death, and heart failure even after their blood pressure is under medical control. Because many consequences of high blood pressure are not reversible, treating high blood pressure as soon as possible is extremely important. Hypertension also increases urinary calcium loss; this increases the risk of osteoporosis, particularly in postmenopausal women.

Some form of sexual dysfunction occurs in one of six hypertensive men. It is often caused by anti hypertensive medications, but there is evidence that the disorder itself may have a role. Impotence from hypertension is treatable. But men who wish to take Viagra to restore erectile function should be told that it interacts with many blood pressure medications, that it is associated with reports of fatal heart attacks, and that early trials were not done with men with hypertension. In women with high blood pressure, one study found that they found it more difficult than others to achieve sexual satisfaction and had impaired vaginal lubrication, regardless of medications. These symptoms may also be compounded by other symptoms of menopause.

Chronic high blood pressure is associated with mental deterioration in older people, including reduced short-term memory and attention, Alzheimer's disease, and dementia. The higher the blood pressure the greater the impairment. Studies indicate, however, that controlling blood pressure may help ward off this memory loss.

Hypertension contributes equally to the leading cause of death in both women and men: it is one of three major risk factors for atherosclerotic heart disease (the other two are smoking and elevated cholesterol). It is the most important risk factor for stroke. In addition, high blood pressure increases your risk of kidney disease. The famous Framingham Heart Study showed that men and women with high blood pressure-treated and untreated-have a two to four times higher risk of coronary heart disease, cerebrovascular disease, and death from all causes compared to women with normal blood pressure. Men with hypertension had a two-times higher death rate compared with women.

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 Despite all we know about the dangers of high blood pressure, it is estimated that a third to one half of all Americans with high blood pressure are unaware that they have this dangerous condition. Of those who know they have high blood pressure, only one in four have their blood pressure properly controlled. 

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