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HIGH "NORMAL" BLOOD PRESSURE

OP Kapoor
Ex. Hon. Physician, Jaslok Hospital and Bombay Hospital, Mumbai, Ex. Hon. Prof. of Medicine, Grant Medical College and JJ Hospital, Mumbai 400 008.
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 mmHg.

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.


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