Nothing raises my blood pressure quite as reliably as reading about blood-pressure research. Just this past week, for instance, three completely reputable institutions managed to release three completely conflicting conclusions about the value of that increasingly controversial doctor’s-office measurement. I had to sit down for a while. Take a few deep breaths.
A little background might be helpful. On those rare occasions when I visit My Beleaguered Physician, the stratospheric systolic readings the nurse coaxes from my iatrophobic cardiovascular system never fail to raise alarms.
“Your blood pressure is off the charts, Mr. Cox,” MBP notes.
“It’s just white-coat syndrome, Doc,” I reply.
“We tested you twice. It didn’t come down much.”
“It’s just a snapshot, Doc, a moment in time. I’ve taken my blood pressure at home many times, and it’s just fine.”
“I think I should write you a prescription.”
“I think we should change the subject.”
Thankfully, MBP is a reasonable fellow on a tight schedule. With only about eight minutes to spare with each patient, he just smiles, shakes his head and moves on.
For years now, the American Heart Association has been dialing down its recommended blood-pressure levels until we’ve reached a point where about half of American adults — and 80 percent of those over the age of 60 — now qualify for hypertension medication. And last week, the organization published research from the University of Texas suggesting that those who somehow escape their doctor’s office with a healthy reading can still join the hyper-tense masses by producing an unhealthy number at home.
Why anyone would want to do that is beyond me, but that’s just me — and also maybe the Binghamton University researchers who released a study arguing that your blood pressure and heart rate are always changing.
This makes complete sense when you think of the way various physical activities ramp up your heart, but lead study author Gary James, PhD, and his colleagues found individual blood-pressure readings varied widely over a three-month period among sedentary women doing pretty much the same thing every day. “The body,” they concluded, “does not defend blood pressure or heart-rate set points.”
In other words, my cardiovascular system may pump away in a completely healthy manner while I’m enjoying my breakfast on Monday and then push me to the brink of stroke Thursday morning while I’m finishing my yogurt. None of which has anything to do with that stratospheric reading at MBP’s clinic or the perfectly normal result at home.
Beyond the snapshot argument, however, looms a larger reality that may catch the Medical-Pharmaceutical Complex by surprise: At the cellular level, the heart responds in different ways to the same stimuli. That’s the point University of Tokyo scientists emphasize in a new study published in Nature Communications.
Some heart cells actually adapt to high blood pressure, they concluded. These cells tend to be thicker than their less-adaptive counterparts and require more energy to keep the heart beating, but some genetic composition keeps them from succumbing. “These results are the first to show that some cells fail and others adapt to high blood pressure within the same heart,” said lead study author Seitaro Nomura, PhD. “I am very interested in the increased activity of genes that are important for making energy in the cell.”
Nomura and his crew see this breakthrough as an opportunity to genetically reprogram failing heart cells, a move that I’m sure will be greeted with a certain level of excitement among gene splicers everywhere. At least until the next batch of studies reveals the potential of a completely different approach.
Meanwhile, I’ll keep my distance from MBP, enjoy my breakfast, and concentrate on deep breathing.