Ask a Doc: High Blood Pressure Silent But Deadly

June 03, 2015

Facts about high blood pressure

  • High blood pressure contributes to 1,000 deaths per day.
  • Only half of those with high blood pressure are well controlled.
  • 20% of those with high blood pressure don't even know they have it!

Dear Doc,

I am 55 years-old and recently went to the doctor after many years of not doing so. I was told that I have high blood pressure. My readings were 150 over 95. I was given some instructions on diet / exercise, and told to return in a few weeks. Do you think I will need medication for my high blood pressure?

May is the awareness month for ALS, brain tumors, celiac disease, skin cancer, national water safety and national burger month among others. Clearly we need more months, less diseases, and less lobbying for burgers! May is also National High Blood Pressure Education Month.

Blood pressure has two numbers the top number or systolic blood pressure (BP) and the lower number or diastolic BP. Systolic BP is the force on the blood vessel walls as the heart contracts and pumps blood out to the arteries. The diastolic BP is the pressure on the arteries when the heart is relaxed between contractions.

If your systolic BP is 120 or less and your diastolic BP is less than 80, your BP is considered "normal." Blood pressure between 120 and 139 systolic or diastolic BP between 80 and 89 is considered pre-hypertensive. If your BP is greater than 140 systolic or greater than 90 diastolic you are considered to have high blood pressure or hypertension.

In some things, less is more. Your golf score, less ex-wives (allows you to keep more of your money), and having lower blood pressure may allow you to add more years to your life.

The treatment of high blood pressure is the most common reason for outpatient doctor visits in the U.S. (excluding visits for pregnancy / prenatal care). About 70 million Americans or 1 in 3 adults have high blood pressure. In addition, 1 in 3 Americans may have prehypertension, elevated blood pressures but not quite greater than 140/90. More alarming are the facts that only about half of those with known hypertension are under control, and that 20% of adults who have high blood pressure don’t even know they have it!

High blood pressure is like that silent flatus (fancy medical term for fart) from your dog, or that disapproving stare from your new wife, which can be silent and also figuratively deadly. But high blood pressure is no joke and can be literally silent and deadly! In fact, hypertension has been given the name "silent killer"; as high blood pressure may be causing your body damage for years before symptoms are felt or recognized. High blood pressure contributes to 360,000 deaths per year (or almost 1,000 deaths per day) in the U.S.!

Rapid rises in blood pressure or very high blood pressure may cause headaches, neurologic changes, chest pains, or heart failure. If these symptoms develop, medical attention should be sought immediately. More commonly, high blood pressure silently damages the arteries of the eyes, kidneys, brain and heart over time. Like the pipes in your house, your arteries can be damaged if they are under too much pressure, leading to kidney disease, strokes, vision problems and heart failure!

In most cases, the cause of high blood pressure is not known but it is clear that genetics, poor diet, little exercise, smoking, alcohol consumption, older age and some medications contribute to developing high BP. In 5 to 10% of the population, another disease process such as thyroid, adrenal, or kidney disease, may be the cause of high blood pressure.

Healthy diet including lower salt intake, regular exercise, smoking cessation, limiting alcohol, and weight loss may significantly lower your BP to an acceptable level. If despite these efforts your blood pressure remains elevated, your health care provider may prescribe medication to lower your BP.

Follow your doctor's diet and exercise advice. The important thing is to return to your doctor for another BP reading, as medication treatment of high BP (unless very high or symptomatic) should not be based on just one reading. Your doctor may also measure your BP in both arms and while sitting and standing. If there are variations in these readings your doctor may choose a different medical treatment for you. With the right lifestyle modifications, you may not require medication.

Stay healthy and smile at the 1880’s tombstone inscription of one Lester Moore who died in a gunfight. "Here lies Lester Moore, four slugs from a .44, no Les, no more."

Nagpaul_arunDr. Nagpaul is a medical doctor and is board-certified in Internal Medicine. He currently is the Medical Director at Newark-Wayne Community Hospital, DeMay Living Center and Wayne County Public Health. This column is meant to be educational and not intended to be used to make individual treatment decisions. Prior to starting or stopping any treatment, please confer with your own health care provider. To send questions, please email Dr. Nagpaul at and put “Ask a Doc” in the subject line.

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Serving the greater Rochester and Finger Lakes region and beyond, Rochester Regional Health System combines the resources, skills and accomplishments of Rochester General Health System and Unity Health System in an integrated network of nationally recognized, community-focused services. The full care continuum now includes four full service acute-care hospitals (Rochester General, Unity, Newark-Wayne Community Hospital, and United Memorial Medical Center); comprehensive ambulatory services; leading cardiac, orthopedic, neuroscience, oncology, surgery, women’s health and medicine programs; more than 80 primary and specialty medical practices; innovative senior care programs, facilities and independent housing; a wide range of chemical dependency and behavioral health services; and ACM Medical Laboratory, a global leader in patient and clinical trials testing, with worldwide locations and lab partnerships.