SATURDAY, Nov. 20, 2004 (HealthDayNews) -- Joe Montana, one of the greatest quarterbacks in football history, was the picture of grace under pressure as he carried the San Francisco 49ers to countless come-from-behind victories.
That's why a diagnosis of high blood pressure two years ago left him stunned. Now, he's on a mission to alert others to the dangers of this life-threatening condition and to describe how it can be controlled.
Montana, nicknamed "Joe Cool" during a 15-year career that saw him win the Super Bowl MVP three times, had no idea anything was wrong when he went for a regular checkup. But the doctor was so alarmed at his blood pressure reading, he sent Montana straight to a cardiologist.
"The year before it [blood pressure] had been fine," said Montana, 48, who was in otherwise excellent physical condition and had no idea he wasn't completely healthy, although he did have a family history of high blood pressure.
That's the insidious nature of high blood pressure, said Dr. James M. Rippe, a Boston cardiologist who is working with Montana on the education campaign. High blood pressure, or hypertension, affects approximately 60 million Americans, he said. And it's often a silent disease that, if left untreated, can lead to stroke and heart attacks.
"It is a big danger if you don't know what your blood pressure is and how to control high blood pressure," said Rippe, an associate professor of medicine at Tufts University School of Medicine. "And if a high-level athlete like Joe can have high blood pressure, anyone can."
The ideal, healthy blood pressure reading is below 120/80 mm Hg, Rippe said. The top number, called systolic pressure, represents the pressure of blood flow as the heart beats and pumps blood through the body. The lower number, called diastolic pressure, is the reading between heartbeats when the heart rests and refills with blood.
As people age, their blood pressure increases, approximately 10 percent every decade after their 20s, Rippe said. High blood pressure is diagnosed as a consistent reading of 140/90 mm Hg or above, a level that puts you at twice the risk for heart failure and stroke. Medication is often required to high blood pressure under control, he said.
But any reading above 120/80 mm Hg means there's too much pressure on the heart, Rippe said. It should be treated first with lifestyle changes, including weight loss, exercise and reducing salt in the diet, and then with medicine if necessary, Rippe said.
Montana's blood pressure was "dangerously high" when he was diagnosed, which means medication was required. His cardiologist also recommended that Montana change his exercise routine and improve his diet.
"I'd been working out since I was 8 years old and thought I could take it easier," said Montana, who wasn't exercising as regularly after retiring in 1994. And, although he wasn't overweight, his diet, from years on the road, was less than healthy.
"I loved potato chips -- I could eat a whole bag. And fast food," he said.
Montana's initial medicine and lifestyle changes didn't bring down his blood pressure. So his doctor changed medicines and tinkered with the dose until his hypertension was under control. His blood pressure now averages 116/75 mm Hg.
That Montana took the time to make sure his blood pressure was under control is very important, Rippe said. "The awareness of high blood pressure is reasonable," he said, but proper control of hypertension lags far behind.
"Only about half of those people who know they have high blood pressure are being treated, and only one-third of those people have their blood pressure under control," he said.
That's why Montana and Rippe are working with Novartis Pharmaceuticals Corp. on an awareness campaign; they're speaking to groups across the country to urge people to control their blood pressure. The program, called Take Action for Healthy BP, is designed to get patients and health-care professionals to work together to develop effective treatment regimens for high blood pressure.
"The responses I get on the road, people saying, 'I heard you're working on this campaign and I had my blood pressure checked,' are good," he said. "I feel like I can affect someone's life."
And what of the legions of football fans who felt their blood pressure rise as Montana engineered heart-stopping wins against their teams?
"Tell them not to watch the replays," said Montana, laughing.
The Mayo Clinic provides a fact sheet on the risks of hypertension.