The lowdown on high blood pressure

Little known fact: everyone has blood pressure. Lesser known—it goes up and down all day. Don’t get easily convinced that you have high BP

He said it almost as though it were a rite of passage, like a boy becoming a man. “Hey, the doctor said I have BP.”

After a few moments searching for a suitable response, I said, “Welcome to the club.” It was only a matter of time before he’d be wallowing in words like ACE inhibitors, systoles and diastoles, beta blockers and diuretics.

“You have it too?” he said, excited to find a comrade. “What’s your number? When did you get it?”

My friend was only 45, a few years younger than I was. Till his visit to the cardiologist, he’d been feeling absolutely chipper, with no inkling that he had a condition that would require medication for the rest of his life. 

Most people think of blood pressure as something their fathers have. Not true. You’re born with blood pressure because you’re born with a beating heart that’s busy pumping blood. When it squeezes, your blood pressure goes up briefly, called a systole. When it relaxes, the pressure goes down, called a diastole. A person with no blood pressure is highly likely to be stone cold dead. 

The thing my friend had—and I would too if I were to stop my medications—is high blood pressure, or hypertension.

I was more than a little concerned because I’m a suspicious and sceptical man with a deep distrust of big pharma. The more people are diagnosed with blood pressure, the more blood pressure medications they will sell. So when a doctor you don’t really know that well breaks the grim news that you have hypertension and need to start medicines, nod grimly back and say, “Let me think about this thing a bit, sir. I’ll get back to you.”

When I lived in Africa, I was fascinated by the Thomson’s gazelle, and not just because its name was derived from the Arabic word for ‘poem’, ghazal. This graceful creature lives in a state of perpetual alert, poised for flight. When it senses a predator nearby, it will start  ‘slotting’, or jumping up and down as high as 12 feet in the air, to warn the herd.

Your BP is a bit like that, ready to jump at real and imagined threats. One of these is the sight of a doctor’s white coat, which apparently stirs a primordial fight-or-flight response. This so-called ‘white coat hypertension’ is a big reason why BP readings are higher in medical settings.

Some other non-obvious reasons why your BP read may come out high—

You need to pee. Or poo-poo. Both those pressures can push your BP up, so clear your innards before you sit down.

You’re speaking. When you talk, you’re excited and your BP rises. Sometimes, it’s a chatty nurse working on her bedside manner—but not helping your BP a bit. Shush her politely.

You didn’t get a good night’s sleep. Or you don’t breathe well when you sleep, called apnea. Both will give you higher BP in the morning.

You checked your BP at the wrong time. Blood pressure, lowest when you’re sleeping, usually starts rising before you wake up and continues to go up, peaking around noon. It starts declining late afternoon and evening. Choose your moment wisely.

You’re worried that your BP might be high. Yep, that can do it too. If it’s high, you’ll get even more worried, which will make it worse. Your inner Thomson’s gazelle will start slotting like crazy.

You’re lonely. The systolic pressure of the loneliest people in a study went up more than 14 points over four years. Loneliness, fear of rejection, disappointment, are all BP triggers. And yes, COVID-19 loneliness can raise your BP.

When I check my BP every morning, I do all the right things. I clear all bodily effluents, drink some water, sit still for a few minutes and most of all, try to calm my mind. That’s the tough part for a person like me. If I think about calming my mind too much, it will start getting ruffled, so I must calm it anonymously. Facing me is a gorgeous, intricate Tibetan thangka painting of the Buddha in green, beige, orange and gold, peaceful in itself. 

If I switch perspective, I can see two faces—the obvious Buddha but an unobvious demon. To see it in the photo above, look for the wide orange lips at the bottom, a green-gold bar moustache above it, and the Buddha’s knees as the eyes. The Buddha himself is now inside the demon’s head.

My own head is already feeling soothed by my inner Buddha. The deep blue water at the bottom of the frame, with monks waist-deep carrying flowers makes my subconscious feel cool and still, reverent like them.

If I can maintain this chill moment somehow, I know I will get my best blood pressure reading. 

Buddha willing.

Here, viewed from there. C Y Gopinath, in Bangkok, throws unique light and shadows on Mumbai, the city that raised him. You can reach him at cygopi@gmail.com
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The views expressed in this column are the individual’s and don’t represent those of the paper

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