22 LISTENER SEPTEMBER 14 2019
and a diuretic – and has had to change two
medications when they caused gout and
breast swelling.
Van der Merwe believes high
blood pressure is
“unquestionably” the
biggest cardiovascular
risk. “It’s all about
long-term vascular
damage and vascular
remodelling and I
don’t like the idea that
you might wait before
starting treatment. The
younger you are, the
higher the stakes. A
lot of people in New
Zealand start treatment
only once they’ve had
a heart attack or stroke, which is putting
the cart before the horse. These conditions
are preventable if they’re treated in a
timely way.”NO DISTRACTIONS
Ann Bain tries not to let her blood pressure
stress her out. Towards the end of our
interview, she takes her reading again and
it’s dropped to 161/98 – still too high.
Van der Merwe says to get accurate
readings on home monitors it’s important
for patients to be on their own in aquiet room, have their arm comfortably
supported, with feet on the ground and legs
uncrossed. There should be no distractions –
not even a television, pets or children. “Just
being with someone
and talking will push
your blood pressure
up.”
Bain says although
van der Merwe, her
specialist, has told
her to call him if her
reading goes over 170,
she doesn’t. “You can’t
call him at 2am and
say ‘Walter, my blood
pressure is 200/100.’”
She says a 24-hour
ambulatory monitor
found her blood pressure actually went up
when she is asleep.“It should be 130, but it’s
very rarely that. It’s all over the place. And I
just don’t know why.” lSO
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GET N
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Pressure test
If you have high blood
pressure, try these lifestyle
changes:
*Volunteers interested in taking part in the
Auckland study, which is expected to start
recruiting later this year, can email James
Fisher at [email protected] for more
information. The investigators will be seeking
participants with high blood pressure (patient
group) or normal blood pressure (control group),
and with no other known health problems.
To get accurate blood-
pressure readings
on home monitors,
there should be no
distractions: “Just
being with someone
and talking will
push your blood
pressure up.”
✔ Restrict salt intake to less than
5g a day.
✔ Restrict alcohol to less than 14
units a week (men) and less
than 8 units a week (women).
✔ Eat more vegetables, fresh
fruit, fish, nuts and unsaturated
fatty acids such as olive oil.
✔ Reduce weight to avoid
obesity.
✔ Exercise regularly – 30 minutes
of moderate exercise five
to seven days a week is
recommended.
✔ Stop smoking.
✔ Avoid binge drinking.
Substances that may increase
blood pressure:
✔ Oral contraceptive pills,
especially those with
oestrogen, can cause mild
hypertension, but it can be
severe in 5% of women.
✔ Diet pills.
✔ Nasal decongestants.
✔ Stimulant drugs such as
amphetamines, cocaine and
ecstasy. These usually cause
acute, rather than chronic,
hypertension.
✔ Liquorice.
✔ Immunosuppressive
medications and steroids.
✔ Some cancer treatments that
stop tumours from growing
their own blood vessels.
✔ Anabolic steroids and non-
steroidal anti-inflammatory
drugs.
HYPERTENSION