Physicians are agreed that a single high reading, particularly systolic, means little. Some persons have great fluctuations for minor causes. A sudden slight fear or excitement such as might result from a visit to a doctor’s office may give a startling figure. One elderly woman when examined by a doctor from out of town was trembling so with excitement that her systolic pressure was over 200. Daily readings made in her own home by her physician did not go over 120 in a fortnight.
There are certain people, however, in whom the blood pressure is continuously elevated well above the normal, ah though no evidence of underlying disease can be found. This is called “essential hypertension,” weasel words which really indicate our lack of knowledge of the why or wherefore. It may be compatible with many years of health and of itself rarely produces symptoms. A physician friend tells of a recent study of one hundred cases of “essential hypertension” with excessively high readings observed over a period of thirty years in which it was found that those who died had lived on an average to within two and a half years of their normal life expectancy, and 10 per cent had exceeded their normal life span. Several of these people had shown at times a systolic pressure of over 300 which is very high indeed and of which some of them were unaware. The symptoms of high blood pressure are often not caused by the pressure but by nervousness and worry, and often these are greatly increased by fears which have been excited by the very knowledge that the pressure is high. A wise physician seldom tells a nervous patient the actual blood-pressure reading.
There is on the other hand one type of high blood pressure which is called “malignant” because it is progressive and associated with damage to the heart, kidneys, and brain; it may be fatal in a comparatively few years. Fortunately it is a rare type, and when it is recognized early, an operation on certain nerves may be done. This may result in a return to fairly normal health. It is a matter of critical and difficult judgment to decide when such an operation should be done.
Certainly persons with high blood pressure should avoid strain and worry. If they do so they have an excellent chance of completing their allotted span of life.
Mankind takes its • blessings and makes them calamitous. The internal combustion engine and the sphygmomanometer, or blood-pressure apparatus, are examples. No single invention could have contributed more to man’s happiness than the engine, but it was used to make possible the most devastating war ever fought. Unimportant blood-pressure readings have caused so much worry in patients and in forced meddlesomeness by physicians that the loss of all the instruments for measuring your pressure might on the whole prove a benefit. Just ignore your systolic blood pressure.
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