High blood pressure runs in Deidre Schram’s family. Her great-grandfather died of a heart attack in his 50s. Her mother, three aunts and an uncle have it. But when Schram found out about her own high blood pressure at age 36, she didn’t think much of it and chalked it up to stress.
That’s the thing about high blood pressure: It’s often referred to as “the silent killer” because there are no symptoms or signs and you don’t feel any different when it’s high than when it’s normal. And since it’s most commonly thought of as an issue for seniors and men, women usually don’t believe it’s a problem. After a few more high readings at the pharmacy and the doctor’s office, Schram, a mother of two, was diagnosed with hypertension (the medical term for high blood pressure) and put on medication, which started working right away. Now 40, she says that was a relief, considering it had taken a decade to get her mother’s blood pressure under control. “What they told my mother is, if your blood pressure is in the hypertension zone for 10 years, you’re basically taking 10 years off your life.”
Pay attention to the signs
Medical professionals urge that everyone, especially women, pay attention to their blood pressure, which is the measurement of the force of blood against the blood vessel walls. An optimal reading is around 120 mm Hg (millimetres of mercury) over 80 mm Hg. The top number (systolic) represents the pressure when your heart contracts and the bottom number (diastolic) measures the pressure when the heart relaxes. Norm Campbell, a University of Calgary professor of medicine and member of the Libin Cardiovascular Institute of Alberta, stresses that your readings don’t actually have to hit the 140 over 90 hypertension reading for you to be at risk of potential health problems. “Just an increase from your normal blood pressure damages the blood vessels.” And this increase can lead to heart disease, heart attacks, stroke, kidney failure, loss of vision and even dementia and Alzheimer’s.
One in five Canadians has high blood pressure. That number jumps to one in two for people aged 60 and older. New data says that Canada leads the world in hypertension treatment, but it also shows that we’re better at controlling it in men than in women. While generations of women are now well educated about “female” illnesses like breast cancer, there’s little public awareness about the importance of getting your blood pressure checked. “Heart disease and stroke are the leading health threats to Canadian women,” says Beth Abramson, a cardiologist and spokesperson for the Heart and Stroke Foundation. “They account for more deaths than all forms of cancer combined.”
Timing is everything
There are times in their lives when women are particularly at risk for high blood pressure. For instance, birth control pills can raise blood pressure in some women. And during menopause, there is a decrease in levels of estrogen, which previously protected the heart and blood vessels. Plus, there are special concerns during pregnancy. “A woman could be hypertensive before she becomes pregnant,” says Campbell, “and that can cause risks for the child being small and other complications. Then there’s induced hypertension (pre-eclampsia), which can lead to maternal and fetal death.” The mother is at risk for stroke and other serious complications if a bad case of pre-eclampsia happens toward the end of pregnancy. The only cure is to deliver the baby immediately. Women who have developed hypertension during pregnancy should be aware that, even if their blood pressure goes back to normal after delivery, they’re at a much higher risk for developing hypertension later in life, as well as in future pregnancies. On the other hand, many women are told that they have low blood pressure when they’re expecting and wonder if that’s a health issue. Campbell says no: “Low blood pressure is a sign of longevity.” The only time low pressure is dangerous, he says, is when it is brought on by illness.
For some, the act of getting their blood pressure measured itself can be problematic. “White coat hypertension” or “white coat syndrome” is when your blood pressure is high while checked by a health care professional, yet normal at other times. To diagnose this, patients are sent home with an arm cuff, which reads their blood pressure over a 24-hour period. If everything seems normal at home, the readings in the doctor’s office might be due to anxiety. But Campbell reminds those who have been told “not to worry, it’s only white coat syndrome” of the general high probability that they will develop true high blood pressure over time. “They still need to be carefully observed just like everyone else.”
The rates of hypertension are climbing in all age groups thanks to today’s sedentary lifestyle, processed foods and obesity. “As a society, we’re becoming more overweight and out of shape,” says Abramson. “We’re exercising our brains and our thumbs on our BlackBerrys, and not our bodies. We’re seeing risk factors for heart disease and stroke in younger people that we didn’t see 20 years ago.” She directs all her patients to adopt a heart-healthy lifestyle: exercise at least three times a week for 30 minutes, eat plenty of fresh fruits and vegetables, reduce salt, achieve a healthy body weight, quit smoking and, if you drink, do it moderately (for women that means one drink a day, or seven in a week).
The main cause of Schram’s high blood pressure was probably heredity, but she still follows the lifestyle guidelines to keep her condition in check. And she has to make sure her kids, a 12-year-old girl and nine-year-old boy, do the same. “I know my son likes to add salt to everything, so I’m constantly telling him it’s not good for him. Aside from that, I don’t think they have an extremely unhealthy lifestyle – they eat well and are skinny, like little kids should be. But they’ll definitely need to understand the hereditary factor.”
According to Abramson, one of the best things you can do for your kids is set an example. “If our kids watch us in the supermarket reading labels, picking up two boxes of crackers and putting down the one that has higher salt and fat, we’ll hopefully be teaching our children, as well as taking care of our own health.” And what she stresses to busy moms is to get your blood pressure checked, even at the local drugstore. Campbell wants home monitors in community areas, workplaces and is all for people having home machines. “In Calgary, the fire stations all assess blood pressure between
1 and 9 p.m. For women, if they like firefighters, this is a good excuse to show up.”
Kids are under pressure, too
Until recently, no one was worried about children having high blood pressure, though an annual check starting at age three is generally recommended. But that’s starting to change. According to Statistics Canada, a 2009 survey found that Canadian kids aged six to 19 have elevated blood pressure. (FYI: There is no targeted blood pressure reading for kids because their bodies are constantly growing.) While there’s no past Canadian data to compare it to, hypertension specialist Norm Campbell, of the Libin Cardiovascular Institute of Alberta, believes the rates are likely rising. A portion of the children who have high blood pressure developed it in connection with other illnesses such as kidney disease.
But for the rest of the hypertensive kids – who may be on the path to heart disease and other illnesses later in life – controllable factors like inactivity, unhealthy diet and obesity are to blame. And children with hypertensive parents are particularly vulnerable, thanks to genetic influences or a shared unhealthy lifestyle. Children diagnosed with high blood pressure are unlikely to need medication if they can increase their activity and decrease their salt and fat intake. “Thanks to the modern diet,” says Campbell, “the generation of children that are coming up now are predicted to live a shorter lifespan than us. This is the first time since industrialization that this has occurred.”