Page 22 - Jan-March 2024 Edition

|Health Feature

BY DICK STOCKLEY

HYPERTENSION

Dick & Rosie Stockley
Have you noticed every news paper, every magazine, or news app has a health story in every
issue? It sells newspapers and magazines, it provides employment for a lot of journalists and it
makes virtue signalling politicians look caring. We are a health obsessed generation, we lap it
up, it’s a safe conversation topic in pubs, clubs and dinner parties. Never talk about religion or
politics but everyone wants to hear about your bad back, in-growing toenails or haemorrhoids.
Or perhaps not.
In eyes passim, I have talked about priorities: obsession with technology and ignoring the
simple. Last issue I suggested the most important screening tool a doctor has is a tape
measure: your waist measurement or bmi is more important than a colonoscopy. But the
media love drama, they love a new epidemic disease. I’m sure we all know “the hospitals in
China are full of pneumonia cases”: at least that’s the leading health story right now on 30th
November as I sit here writing. And the Covid enquiry still leads on BBC. And a perennial
favourite: antibiotic resistant infections. It sells. “Old man dies from stroke” is not a headline.
Non-communicable diseases just aren’t dramatic enough to stay in the news. Though almost
all deaths from Covid were due to “pre-existing comorbidities” we don’t lock down our
economies because of obesity, lack of exercise and bad diets. And right up there near the top
of boring is blood pressure. Try discussing it in the next music night at the ARA or your regular
mahjong evenings and you’ll find athletes’ foot gets a better response.
I got this from the WHO website: so, it must be true.
KEY FACTS:
• An estimated 1.28 billion adults aged 30–79 years worldwide have hypertension, most
(two-thirds) living in low- and middle-income countries
• An estimated 46% of adults with hypertension are unaware that they have the condition
• Less than half of adults (42%) with hypertension are diagnosed and treated
• Approximately 1 in 5 adults (21%) with hypertension have it under control
• Hypertension is a major cause of premature death worldwide
• One of the global targets for noncommunicable diseases is to reduce the prevalence of
hypertension by 33% between 2010 and 2030
Yawn. But think about it. Actually, you don’t want a stroke or renal failure and prefer not to spend
your last decade or 2 with impotence. So rather than become hypertensive with age you prefer
to avoid it. If you already have high blood pressure you want to treat it or bring it down so that
you don’t need drugs with the side effects that we seldom discuss at dinner parties. So what
works and what’s myth? First below 120 is best, 110 even better if it’s natural. Mine was 95/60 for
years, but I had to see a doctor recently to prove I’m still alive
in order to get my pension. I was, I was told, but my bp was 120/60. Maybe I was anxious to
know if I was alive. Or maybe those modern digital things don’t really work. So, rule number 1.
140/90 might be “normal” meaning no advantage in treating it, but lower is better. Measuring
blood pressure is not always easy. Those digital things do work but cuff size is important. I had
one lady I could never read the bp it was always above 180/120 because there are no cuffs
her size. So, we used the old mercury sphyg Dr Gibbons used in the 1960’s with the wrap
around cuff. Actually, the top specialist, Dr Silverstein, I saw in Nairobi used one too when I saw

20