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Saturday, August 25, 2018

Reading the new blood pressure guidelines - Harvard Health

Blood pressure maintenance in the normal range (less than 120 mmHg) has to start early--in the teens and age 20's--while it is still in the normal range. I suspect if your blood pressure has been elevated--let's say systolic 140's mmHg--for decades and now you're trying to get it to less than 120's, it may be too late to do so immediately without consequence. That's because the vascular remodeling which have occurred over the decades at blood pressure of 140's result in a diastology which is no longer favorable for hemodynamics at less than 120's. In essence, the arteries become harder, stiffer, with less elasticity for both distention and recoil. Imagine an old dry-rotted radiator hose (for those old enough to recall those days). :) I think more responsibly the management ought to target a percent reduction from baseline blood pressure. And, proven well tolerated, a continued and progressive approach to control.
from Rajesh Harrykissoon, MD

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