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High Blood Pressure Strikes Even the Young

But treatments can manage this dangerous disease

FRIDAY, Dec. 27, 2002 (HealthDayNews) -- High blood pressure was the last worry on 18-year-old Ryan Bendixen's mind when he began to suffer nose bleeds.

"I was in great shape, really fit, but about once a month I'd get really substantial nosebleeds when I was working out," says the 32-year-old Bendixen, who at the time was a member of an elite U.S. Army infantry unit.

When he finally saw a doctor, he discovered he was struggling with severe high blood pressure. His health was so compromised that he was permanently discharged from the Army, and had to go on medication.

He had no clue he had blood-pressure problems. "The nosebleeds were the only indicator," he says.

However, nosebleeds and headaches are often the only signs of high blood pressure, says Dr. William Elliot, a professor of preventive medicine at Rush Medical College in Chicago. That's why the disease is called the "silent killer," and why it's important to have your blood pressure checked on a regular basis -- at least once every two years for most healthy adults.

"There are few outward signs of hypertension, and while people don't ignore nosebleeds, headaches are not something people take seriously," Elliot says. "In the general population, for instance, 60 percent of people with hypertension will in retrospect [after they've started treatment] say they did have headaches. The only way for you to know is to have a blood-pressure test."

Elliot says high blood pressure (or hypertension) in young people like Bendixen is relatively rare. Approximately 4 percent of those aged 18 to 29 suffer from high blood pressure, compared to more than half the population aged 60 to 69.

However, treatment is vital, even for young people.

"Hypertension is a chronic, long-term ailment that, if left untreated, is going to lead to trouble down the road," Elliot says.

Bendixen's blood pressure was 180/115 when he was diagnosed, which put him in the most severe category of hypertension, Elliot says. Optimal blood pressure is 120/80, and hypertension is defined as anything over 140/90, according to the U.S. Centers for Disease Control and Prevention.

Blood pressure is a measure of how the blood travels through the arteries. The top number, called systolic pressure, represents the blood pressure when the heart is pumping. The bottom number, called diastolic pressure, represents the pressure when the heart is resting between beats.

The higher the blood pressure, the harder the heart has to pump. This places greater strain on arteries that have to carry blood moving under greater pressure. Over time, the increased wear on the body can lead to major health problems, including stroke, heart attack, atherosclerosis and kidney failure.

Risk factors for the disease include being overweight, having diabetes and a family history of hypertension.

In Bendixen's case, his family history was the clue to his hypertension.

"My grandfather died of a stroke, and my mom and my sister have hypertension. We have a genetic predisposition," he says.

Fortunately, there are remedies for high blood pressure. In many cases, reducing salt intake and losing weight lowers blood pressure to acceptable levels, although Elliot says such measures aren't always easy to do.

"It's a challenge. A lot of people find it much more convenient to take a pill than reduce salt intake and lose weight," he says.

Medications include diuretics, which rid the body of excess fluids and salt, and beta blockers, which slow down the heart and open up the blood vessels. Other options include ACE inhibitors, which prevent the arteries from constricting, and calcium channel blockers, which relax the arteries, Elliot says.

Diuretics are the oldest and least expensive of the medications, and, according to a large, new National Heart, Lung, and Blood Institute study, the most effective. An eight-year study of approximately 42,000 people aged 55 and older with hypertension found those on diuretics had slightly lower blood pressure over the course of the study. They also had significantly less risk of developing heart failure than those taking the calcium channel blockers or ACE inhibitors.

Bendixen, now a passionate mountain climber who lives in Denver, has tried many drugs over the years and suffered through side effects such as a hacking cough and frequent urination. For the last two years, he has taken Diovan, a member of a new class of drugs that helps eliminate sodium from the body. For him, it has been a great success.

"I can't tell I'm taking it. It has no side effects," Bendixen says. He usually goes on two climbs a year, and a number of his ascents have been sponsored by Novartis Pharmaceuticals USA, the maker of Diovan.

What To Do

The National Institutes of Health has information on how lifestyle changes can lower blood pressure. And the American Heart Association has helpful tips on keeping your blood pressure low.

SOURCES: William J. Elliot, M.D., Ph.D., professor, preventive medicine, internal medicine and pharmacology, Rush Medical College, Rush University at Rush-Presbyterian St. Luke's Medical Center, Chicago; Ryan Bendixen, hypertension patient, Denver
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