High blood pressure: Why me?

Naomi D. L. Fisher, MD
Naomi D. L. Fisher, MD, Contributor

“I go to the gym, and I never add salt. So why do I have high blood pressure?” Despite its astonishing prevalence of one in three Americans, many people struggle with the diagnosis of high blood pressure, or hypertension. It’s worth exploring why, because being an active participant in your care is crucial for optimal blood pressure control.

Certain features make any diagnosis easier to accept:

  • First, people are more likely to accept a diagnosis if they have symptoms. A person with cough and fever will believe a diagnosis of pneumonia. But someone who feels fine would not.
  • Next, people more readily accept a diagnosis if it is not serious. Most people won’t question the diagnosis of athlete’s foot, because creams can cure it. Diagnoses that carry worse prognoses are usually harder to receive.
  • Finally, people accept a diagnosis better when they understand its cause. Some diseases have clear causes: Down syndrome and older maternal age, HIV infection and contaminated needles. A smoker who learns he has lung cancer may not be shocked. But non-smokers who receive this diagnosis usually ask, “Why me?”

People diagnosed with hypertension are often baffled, and many ask, “Why me?” This doubt makes sense, in light of the principles above. Symptoms make a diagnosis more real. But unlike many other illnesses, hypertension rarely causes symptoms. In fact, it is ominously called the “silent killer.” Some people develop headaches when their blood pressure rises into dangerous territory, but in others, hypertension can go undetected until it causes a lethal heart attack. Fortunately, it is easy and painless to measure blood pressure.

When doctors deliver the diagnosis of hypertension, they package it with serious complications. These include heart attack, kidney failure, and stroke. Doctors discuss risks to motivate their patients, but sometimes end up creating fear instead. And fear can lead to denial. Is hypertension serious? Yes, if left untreated. But when blood pressure is controlled, the risks are greatly reduced. The important message is that treating hypertension can prevent severe complications and add dramatically to life expectancy.

Last, knowing the cause of disease is helpful. In reality we rarely find just one cause for anyone’s hypertension. There are almost always multiple factors at work. Some causes can’t be prevented, like genetics and age. High blood pressure often runs in families. Genetic risk is complex, probably resulting from a combination of harmful mutations in risk genes and silencing of protective genes. There is nothing we can do to change our genetics, just as we can’t stop aging. With aging comes a universal increase in systolic blood pressure (the top number) and in the risk for heart disease. On the other hand, tackling modifiable risk factors for high blood pressure, for example, losing weight and getting more exercise, often produces great benefits.

Your odds of developing high blood pressure are pretty good

To answer the question “Why me?” it helps to know the data. The Framingham Heart Study followed a subset of 1,300 participants ages 55 to 65 who did not have hypertension at baseline. Their remarkable finding: the lifetime risk of developing hypertension was 90%. So even if you haven’t developed high blood pressure by middle age, chances are nine out of ten that you will at some point. This number is most likely so high because more of us are overweight and are living longer.

So instead of being surprised if you are diagnosed with hypertension, it is actually more logical to be amazed if you never develop it. On an optimistic note, we have seen a decline in the frequency of severe hypertension. We owe this fall to better treatment. So if you learn you have high blood pressure, the most important response is to accept the diagnosis. Hypertension can’t remedy itself; your commitment is the first step toward great blood pressure control.

Watch this video for more commentary on getting a high blood pressure diagnosis:

Related Information: Controlling Your Blood Pressure

Comments:

  1. Patrick Mead

    Hi, I had uncontrolled blood pressure for years. Despite the medication, I never felt well and eventually had a TIA, which terrified me.
    After discovering this program fb.me/49ldrOzET/#BLOOD_PRESSURE_PROTOCOL, my BP came down from 200/140 to 130/80 in just 3 weeks. (Y)

  2. Anthonia

    I’m just 30 years of age and was surprised when l was treated for high blood pressure immediately l gave birth to my first child. Though atimes l use my medication for like 5 days & skip it for another 3-5 days. Is there no way to get over this disease? I mean is there any medication to use & cure it once or are there some foods that can put one off the medication & still be on a normal bp level?

  3. Jenny Williams

    When I read this story I realized just how similar it was to my husband’s condition. He had uncontrolled blood pressure for years and the doctors kept doing the same tests over and over, and when they couldn’t figure out what to do next they just gave him more medication. After discovering some natural remedies, his BP came down from 200/140 to 130/80 in just 3 weeks. The difference in his health and general wellbeing has been phenomenal.

  4. Elaine Shiner

    I used to read that the side effects of blood pressure medication were worse than the disease. If this has changed, that’s worth an article, and might make people less reluctant to accept their diagnosis

  5. Laura

    My husband struggled for years with hypertension. He tried exercise, the DASH diet, a low salt diet, a vegetarian diet, medications, etc. with littIe improvement. Finally, I discovered Dr. Mark Hyman’s books and decided to put my husband on a no-sugar, low glycemic diet high in healthy fats like nuts and olive oil with little to no starch & grains. Voila. His blood pressure started to drop within a few days. Within 6 weeks he was off his blood pressure medication. His blood pressure has been normal for several years now. It’s interesting that most doctors recommend cutting back on salt to treat hypertension, but never mention cutting down on sugar & starch.

  6. Suresh Bhave

    The article, however, does not provide the answer to the question. The question is, physical exercise is expected to prevent hypertension, yet, though I workout in the gym, why must I have hypertension?
    My BP was up at 149/79 a few years ago, though I walked briskly, 2.5 km in 18 minutes, every day and worked out at home. It seems this was not enough. So, I began working out in a gym, a mix of weight training and cardio, for so many years now, the BP is at 110/78, heart rate at 52 bpm.
    I think, gradual increase in the severity of workout is necessary for improvement. Unless, of course, another cause is discovered for the raised BP.

    • Suresh Bhave

      Sorry, amendment- BP is 110/70.

    • Michael Segal MD PhD

      I agree that there seems to be a threshold for exercise. Research on the subject such as “Potential causes, mechanisms, and implications of post exercise hypotension” in Journal of Human Hypertension (2002) 16, 225–236 doesn’t seem to focus on this. A lot of people assume that the importance of exercise is sweating out salt, but it is far from clear that is the mechanism.

  7. FAUZI OFFICIAL

    I thank you for your information that you provide is very helpful at all.

  8. Reddy Marri

    I have blood pressure and i am on medisations too, but i have high potassium levels what should I do to reduce the potassium levels.

  9. andres

    Please eat more potassium rich foods and drink celery juice and red beet juice, pure chocolate as well as follow the DASH dieet and reduce stress and loss weight if necessary., which is good for your blood pressure. Check you blood pressure yourselves at home.

    Andres from The Netherlands

  10. Subhash Kanade

    There is an article in TIME MAGZINE NOV 16, 2015, “Save your breath”,
    by Dr Andrew Weil , that gives good information on hyper tension.
    By exercising your BREATH , you can cure your BP.
    Regularised BREATHING has lot of additional advantages.
    It is independent of any one and should be part of your daily activity.
    Wish you all good luck.

  11. Surender Singh

    I do have body pain all the time after my triple bypass.Blood pressure stays 150/100 all the time.

  12. Chuck Bluestein

    This is very simple. Everyone gets it if they live long enough. Over 85% have it if they are over 85 years old. What causes it? Over 99% of people eat something daily that is not a food. It is a rock that hardens arteries. People were made to eat food and not non-foods. People that do not eat this rock never get high blood pressure. So what is this rock that is put in all processed foods including sweet tasting food. Salt. See why Michael Greger M.D. says that salt kills over 1,000 Americans per day.

  13. Thomas Johnson

    Some alternative evidence based ways of decreasing blood pressure include daily mindfulness meditations (i.e. look at the decades of research conducted by Harvard Professor Herbert Benson), daily hand grip exercises ( see research completed by Harvard researchers), 8 ounce daily servings of Cranberry juice ( see research completed byJanet Novotny of the US Department of Agriculture) as well 8 ounces of beet juice taken daily ( several recent articles on WebMD reference the documentation. drtbj

  14. Vince

    Most MDs . do not even correctly measure blood pressure. Blood pressure measured on the exam table has been show to be 15mm systolic high as compared to the AHA recommended measurement. Sit in chair back supported ect. Better than half of people have white coat syndrome of 10mm or more. If those facts are accurate than a in office measurement done incorrectly is going to be 20 to 30 mm high. Good for sales…..but how about people Let me quote from a recent review Therapeutics Letter April 7, 2016
    [98] Does SPRINT change our approach to blood pressure targets?
    ‘….The number of people with one or more serious adverse events was numerically greater in the low BP target group at 38.3% vs. 37.1% in the standard BP target group, RR 1.03 [0.98, 1.09]. However, deaths were significantly lower in the low BP target group at 3.3%, vs. 4.5% in the standard BP target group, RR 0.74 [0.60, 0.91], ARR 1.2%. These two findings are hard to reconcile, …
    ……Because of the BP target design, investigators could not be blinded to treatment group. This results in a high risk of performance and detection bias. Performance bias means the people caring for the patients treat the lower BP target group preferentially. Detection bias means investigators ascertain the outcomes in favour of the lower target group….

  15. S.Ojha

    I am maintaining my BP around 140/90 with pills(ARB+ diurectic),Three days back began rising and was around 173/100.I could not make out but was slightly unsure whether I had taken the medicine or not. If you forget like this and should you take the medicine or miss it? I mean -is the overdose more dangerous or the under dose?

  16. Marc

    Every cardiologist I’ve ever visited has pamphlets about BP in the waiting room. They all instruct that BP be measured sitting down, back supported, feet on the ground, after one minute of rest in the chair. The nurse comes in, sits me on the examining table, no back support, feet dangling and puts on the cuff the instant I sit down. I now politely insist on having my BP taken as their own literature recommends. Gasp. It often requires bringing a chair into the room.

    • Irene

      My experience in the doc’s office is the same. I have not summoned the courage to ask as you have that it be done according to their own literature, but henceforth I will. Thank you!

  17. Terry H

    Could a nagging ache in one foot/ankle be a sign of raised blood pressure?

  18. Ray

    Walk, run, swim, eat red beets if you’re not diabetic, eat garlic in salads or even raw and, above all, lower stress. Ray

    • John Walsh

      Garlic supplement works as well, but avoid odorless as the active ingredient is not as effective.
      Hawthorne berries supplements taken daily also remove the enzyme that your body produces causing hypertension.
      Both statements have been evaluated by the FDA.

  19. DP Alexander

    The funny thing about high blood pressure is the odd way of measuring it- what the presssure is after resting for 5 minutes. So, my BP might be 150/100 for the remaining 1435 minutes of the day, but so long as I can get it down to 135/89 for 5 minutes, I am not hypertensive. Perhaps someone can develop a better test of whether we are at risk of hypertensive complications than the 5-minute sit-down test.

  20. ali baba

    hypertension cause that father die from stroke and my mother die from kidney failure and my cousin ,my grand father all died from stroke. doctors do not help nor hypertension

  21. claire.b.smith

    146/75 and pulse 40. Don’t understand it. I exercise every day for about an hour, Don’t indulge in too much salt or vino (one bottle over a week). Eat reasonably well. What’s the problem? I’m 75 years of age.

    • Eli Rudd

      The reason is clear . At your age the veins are not as elastic as before .
      So they resist instead of adapting flexibly . This is the problem of my father too . My father blood pressure was always very low as he was the man of exercise . But it ihas been for two years that he is on blood presure pills as of his first high blood problem ( 21 degrees ) . His heart work well and he doesnt have any problem about it , but his veins have become aged . He is now 80 and on asperin pills too .
      Regarding asperin , th epatient should be under the routine monitor of a physician as it is very dangerous and it should be checked by hemogolobine blood test parameter . Asperin works as thiner and helps prevention of blood clogging . I guess the new advances in stemm cell treatments in the cooming 5 years will propose more effective solutions for such these aging problem .

    • Jose Diaz-Anglo

      Your veins may not be as elastic as before, however the good news, you can make then elastic once more.
      The solution: balsamic vinegar(modena) would be my recommendation $5.00 a bottle. Read about it , and you will see why.
      GOD bless you, keep exercising, eat more vegetables and green smoothies, grapefruit will do wonders.
      have a great day every day

  22. Mapleleaflover

    I’ve noted that hypertension has a significant genetic component. All of us in my own family have low to normal BP. A majority of my husband’s immediate family (as well as some nieces and nephews) suffer from high BP. He has always (since about age 45) had high BP.
    Coincidence? I think not!