Medicine Talk

The Blood Pressure Rebellion

By Dr. Terry Maresca
Tribal Connections

I'm amazed at how many people I see in my clinic with high blood pressure. They seem to be getting younger all the time, too. Currently in the U.S., three percent of children under 18 have this condition. There are clear links to the obesity and diabetes Type 2 epidemics in our tribes and urban areas. Lack of exercise, along with typical diets that far exceed the body's need for sodium (table salt) also play a role.

When it comes to adults with high blood pressure, I am frustrated by the large percent of people who do not have their pressure under control. Nationally, various studies have estimated this to be between fifty and sixty percent. Sadly, many of my patients believe their readings are OK, and so did their previous doctors. Both doctors and patients blame high readings on stress, smoking, and irregular medicine use among other things, and this may be partially true. The truth is, we as doctors are not often aggressive enough using medicine and non-drug alternatives to lower pressure. This attitude is a big part of the problem. To fight this, my clinic in Carnation, Washington has a blood pressure rebellion going on.

In this rebellion, my patients and I are on the same side.

The national standards for diagnosing and treating high blood pressure change every few years based upon research. What I learned in medical school 20 years ago is no longer true today. We now know that even small drops in blood pressure can decrease a person's risk of heart attack or stroke. The latest standards came out in 2003 in what we call the "JNC 7" report. Some of my patients believe in the target readings set years ago when they tell me that a reading of 140/90 is OK. It is not!