HIGH "NORMAL" BLOOD PRESSURE
Ex. Hon. Physician, Jaslok Hospital and Bombay Hospital,
Mumbai, Ex. Hon. Prof. of Medicine, Grant Medical College and JJ Hospital, Mumbai
I have criticised GPs all these years for
blaming high blood pressure for many of the complaints which they detect incidentally.
Although, my opinion still holds true that blood pressure is a silent disease
and a silent killer but I complement all the GPs for getting into the habit
of recording the blood pressure.
In America, the modern trend is just the opposite, what it was 20 years back.
According to them, BP should be brought down to as low as possible in every
hypertensive patient. Even in elderly patients, in order to prolong life, the
aim should be to bring the "existing" (which may be, say around 140/145
mmHg) systolic blood pressure nearer to 120/130 mmHg and diastolic below 80
In a recent issue of New England Journal of Medicine, which is the Bible of
allopathic medicine, there was an editorial with the title of "High Normal
Blood Pressure". Here the editor discussed that the systolic pressure more
than 140 mm Hg and diastolic more than 80 mm Hg should be labelled as High ‘normal’
blood pressure treated to bring it down. At the same time, definition of hypertension
remains > 150/90 mm Hg.
I am sure that the family physicians will be happy to hear this. But I would
like to warn them to first try DASH (Dietary Approach to Stop Hypertension)
treatment, before putting the patients on drugs.
Finally remember that (like raised blood sugar) this is a silent risk factor
which may not produce symptoms.