Endothelial Dysfunction

I am hopeful that everyone is up for a "Faye medical lesson", because if you keep reading, that is exactly what is going to happen. Today's lesson is on "endothelial dysfunction". It is a fancy medical term that describes a condition in which the thin layer of cells lining the blood vessels, also known as the endothelium, does not function properly. This leads to the blood vessels becoming larger, and more resistant. The endothelial plays a crucial role in regulating vascular tone, controlling blood pressure and maintaining fluid and electrolyte balance. When it functions normally it releases nitric oxide that promote vasodilation and anti-inflammatory function. When it doesn't function properly it doesn't release nitric oxide and is the culprit for high blood pressure and fluid retention. 

High blood pressure is considered a chronic cardiovascular disease. It occurs when the force of blood against artery walls is consistently too high, causing damage to blood vessels and leading to other diseases such as heart disease, heart failure and stroke. 

Men are more likely to have hypertension at a younger age; women often develop high blood pressure after the age of 60. This results in more women than men living with hypertension. In Canada, one in four people have hypertension, which is about 8 million adults. The associated cost is $13.9 billion/year. It is estimated that 1 billion people in the world have high blood pressure. In the United States about 50% of people aged 20 and older have high blood pressure and may be on medication for it. 

Hypertensive Canada is a world leader for providing guidelines for high blood pressure. For some reason I am finding the new "blood pressure standards" a bit unrealistic. In today's world it is believed that everyone should have a blood pressure of 120/80 or less. That is the gold standard and if you have anything outside of that you need either frequent monitoring or medication. I think this is why there is such a high percentage of people on medication for blood pressure. I can't get my head around the fact that I am to have the same blood pressure as someone half my age and not to mention my size. According to the charts anyone with a BP higher than 120 or less than 80 is considered elevated. 

Here we go with another Dr. P story. His way of thinking, which of course is more align with mine, was to pay attention to the bottom number or diastolic. The diastolic is an indication of the relaxation of the blood vessel. He started to get concerned or to monitor a blood pressure if the bottom number was higher than 90 and the top number or systolic exceeded 140. With the current chart that would mean the person had Stage 1 or maybe even Stage 2 Hypertension. He always considered age as the biggest contribution factor when it came to elevated BP. I am sure there wasn't a sniff of elasticity in some of those poor old blood vessels. Dr. P was not one to hand out pills, but he wasn't afraid to if need be. If you got a prescription from Dr. P, believe me you needed it.   

I do appreciate the fact that blood pressure medications work in a variety of ways. Some medications make your blood vessels widen so blood gets through more easily. Others remove extra fluids from your blood or block natural hormones your body makes that raise blood pressure. Age, race and sex are considered. This often results in requiring more than one type of blood pressure medication. It is not uncommon to start with one, add a second and at times a third. It only makes sense like so many things, as we age, our bodies just don't function like they used to. I found in my career that the first BP pill worked wonderful for a period of time. Then the BP creeps up again and the dosage may be increased, or another BP pill was added or both. The first remains and now the person has 2 pills blood pressure, and if that didn't work a third may be added. For some people they needed a lot of help to keep their blood pressure in control. Their "in control" was not even close to the gold standard. 

Everyone knows someone that they refer to as a "Type A". We always assume they will have BP issues and that is often the case. There is also the calm, petit little people that deal with it as well. I believe family history is the biggest contributing factor when it comes to high blood pressure or other cardiovascular issues. 

Apparently, high blood pressure is a treatable disease. Lifestyle changes are what are important. If that is the case, I have decided we should all make a lifestyle change and live like a cat. Sleep half of the day in the sun and all night. Eat when we want and drink when we want. Who exercises a cat, no one. A dog has an exercise routine, not a cat. A cat's exercise regime consists of stretching when they get up from their many naps and running when they hear the treat bag. Cats seem to have attitudes, and they like it when others understand their attitude. A cat will only hang out with the people they like; they never go to someone that doesn't suit them. They could care less what people think of them. But if they love you, they will sit with you and sing. I guess if you are someone that hums when you go about your day, you are keeping your blood pressure in check. Maybe if we were more carefree and lived like we want, we would have less issues. It is doubtful when they say make a lifestyle change, they mean live like a cat. But it might be worth considering, in some ways it seems easier than human lifestyle changes. It just might be the solution to the problem of high blood pressure.