Blood pressure is usually reported with a top and bottom number-specifically, the systolic blood pressure is reported first over the diastolic pressure. Don’t be put off by the terminology. What it stands for is simple enough. The systolic blood pressure-that is, the top number-measures the pressure in the arteries when the heart is beating-that is, contracting. The diastolic blood pressure-the bottom number-measures the pressure of the blood in the arteries when the heart is relaxed. Your doctor will tell you that you have hypertension (high blood pressure) if the top number (systolic) is greater than 140 or the bottom number (diastolic) is greater than 90. Of the risk factors that threaten African American patients hypertension is the most common and the most severe. The upside is that it is treatable. To ignore it is to buy serious trouble

In this case, trouble comes in several forms. The first is coro nary artery disease itself. As you know, that means the arterie. around the heart are plugged up. The second is congestive hea-: failure, which means that the heart is overworked and thereforweak. And the third, most sadly, is stroke If high blood pressure is treated aggressively and not ignored, the risk of coronary artery disease, congestive heart failure, or stroke is greatly decreased. This may be the most important medical fact in this book, so let us repeat it: Controlling your blood pressure greatly decreases your risk of suffering coronary disease.

Failure to treat high blood pressure will eventually lead to damage to, and weakening of, the walls of the arteries. These weakened and damaged arterial walls eventually narrow and become clogged with cholesterol, fats, red blood cells, and platelets. Instead of a smooth stream bed, picture a fast-flowing stream whose bed is cluttered with rocks and debris torn loose from the banks and tumbled by the torrent. Bad arteries resemble this type of stream. The higher the blood pressure, the more likely the walls have become damaged, and that damage, with its debris, leads to blood clots and closing of the arteries.
Even mild hypertension needs to be treated. Sometimes that treatment means you need to change your ways-eating differently, cutting down on salt, alcohol, and other substances that make hypertension worse. Sometimes treatment means medicine. But the fact is that hypertension rarely goes away by itself. It’s your body’s way of saying you need to change your life. We take up this discussion in more detail.
Let’s add a word here about congestive heart failure (CHF) and strokes, the other two possible consequences of hypertension. CHF means that the heart is not pumping effectively. Because it is weak, it can’t push blood out of itself in an efficient way and has to work overtime. It must pump more frequently and harder to supply blood and oxygen to the brain. This condition leads to a heart that is overworked and enlarged. Untreated, CHF eventually leads to complete heart failure.
The last of the three major forms of heart trouble is stroke.The carotid arteries carry blood to the brain. If the blood pressure in these carotid arteries is high, the artery walls become weakened and start to close, reducing the oxygen flow to the brain. This decrease of blood flow and oxygen to the brain leads to ministrokes (TIAs or transischemic attacks) or full-blown strokes. And because there’s a decrease or stoppage of the blood flow to the brain, the brain itself dies.High blood pressure is more common in American’ than in whites and is a leading cause of early morbidity and mortality in the African American population. It doesn’t have to be that way. All that’s necessary is that we pay attention to what the body tells us and that we know how to get the right treatment.

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