May 28th, 2014
Many of my patients have asked me with great concern whether they have heart disease, as if being diagnosed with it would be the end of the world.
The heart and its arteries have various functions. Heart diseases can come from many factors, such as
- High blood pressure
- Narrowed coronary artery (or myocardial ischemia)
- Heart valve problems
- Weak heart muscles and heart failure
- Irregular heartbeat
- Congenital Heart Diseases
- Other abnormalities of the heart such as Pericarditis (inflammation of the heart’s membrane) and heart tumor
It is rather difficult to pin a high blood pressure patient down with definite confidence that he or she has a heart disease. There are many people with high blood pressure in this world (and even more with current work pressure!) so if high blood pressure equals heart disease, then half of the world’s population is in trouble. And don’t get me started on work pressure victims…
Work pressure can be cured by Buddhist teachings, especially the Eight-Fold Path. Using right effort, together with taking the middle path, one could alleviate desire and thus get rid of self-imposed pressure.
OK, back to our topic. High blood pressure can be controlled by exercising regularly, diet control, weight watching and medication when necessary. Right effort and middle path would come in handy when one needs to stick to exercise habit and food control. Food must be consumed with full conscience in order to avoid health problems.
Heart disease and blood pressure are closely related, like water pipe and water pump. One cannot work well without the other’s help.
In the medical world, high blood pressure is considered a threat for heart and coronary abnormalities. In fact, high blood pressure is held largely responsible for artery problems at other organs, such as the brain and the kidneys too. It is a silence killer since most of the time people cannot feel when blood pressure is high. They will cause symptom and suffering only after enough damage is done to some organs.
Let me explain more about high blood pressure. Imagine water running through a pipe. There is pressure from the flow. However, our blood vessels are flexible, so we can measure our blood pressure externally at the arms, wrists and ankles.
Healthy blood pressure should be around 120/80 mmHg. The first number 120 is when the heart contracts and sends blood to other parts of the body, causing pressure. The second number 80 is the pressure when the heart is relax.
If the first number goes up above 130 mmHg or the second number goes above 85 mmHg, the blood pressure is considered high. Simply put, anything above 120/80 mmHg is high.
Blood pressure could only be measured when the person has been sitting still for at least 30 minutes and is in neutral mood free from stress, fear and worries. Pain, hunger, fullness or bad mood could affect the results because these feelings cause the blood pressure to spike.
If blood pressure is measured 5 or 10 minutes right after exercise, the numbers would be lower than normal. This lower blood pressure would continue for a few hours after exercise. However, if measured during the exercise, the numbers would be higher than normal.
Patients who come to check their blood pressure every few months cannot know for sure whether the numbers they see are their normal blood pressure, and whether their healthier habits have helped. I always tell my patients to check their blood pressure at home with automatic kits. The numbers are usually accurate when synching with doctor’s measuring device for the first few times.
The best time to check blood pressure is the moment you wake up, even before you go through your daily routine of brushing your teeth or taking a shower. Keep a record of it every morning. The numbers are reliable because the measurement is done after you have for the whole right rested, the exception being those who cannot sleep well.
In general, the morning blood pressure is the highest, given there is no other interference during the day. By keeping record of the numbers every day, diagnosis can work better and drug prescription can be more suitable for the condition.
I had a female patient aged around 60 years old. Her height was around 150 centimeters and she weighed almost 80 kilograms. She was troubled by diabetes, high blood pressure, high cholesterol levels and tiredness.
The first time she came to see me, her blood pressure numbers were 160/100 mmHg. She appeared tired and breathless because she had just walked into the room. I talked to her for 15-20 minutes and measured again, but the numbers were unchanged. I tried to determine what could have caused her high blood pressure but I could not find anything suspicious. I told her to control her food, exercise, try to lose weight and keep a record of her blood pressure every morning.
Six weeks later, she returned with 1.5 kilograms shed from her body. She could exercise by walking for 10-15 minutes. However, her “normal” blood pressure recorded every morning turned out to be 170/90 mmHg or even 180/110 mmHg.
I checked her blood pressure measuring device and it appeared to be working perfectly. I told her I would need to prescribe some pills to take care of her blood pressure because her condition had not been improved by diet and exercise.
She refused to do so and she said her morning numbers were not her normal numbers.
Me: Is it because you do not sleep well at night?
Her: No, but since you told me to watch what I eat and exercise more, I have this pent up desire for food every night when I go to bed. I always dream of delicious food and I wake up really hungry! I have to run to the device and get it over with so that I can finally eat. I guess the hunger and the frustration increase the numbers a little.
Prof Nithi Mahanonda is consultant cardiologist and interventionist, Perfect Heart Institute.
Reference : http://www.rbsc.org
ข้อคิดเห็นทั้งหมดนี้เป็นความคิดเห็นส่วนบุคคลของผู้อ่าน ไม่เกี่ยวข้องกับเจ้าของเว็บไซต์แต่อย่างใด โปรดแสดงความเห็นด้วยความสุภาพ ถ้าเป็นครั้งแรกที่คุณโพสต์แสดงความเห็น อาจจะมีการคัดกรองเนื้อหาได้ การแสดงความคิดเห็นควรอยู่ในประเด็น ห้ามโจมตีใส่ร้ายบุคคลอื่น หรือทำลิงค์ไปยังเว็บไซต์ที่มีเนื้อหาไม่เกี่ยวข้องกัน ผู้ดูแลเว็บไซต์สามารถแก้ไขหรือลบความคิดเห็นได้ทุกกรณี
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