High blood pressure does not hurt…until it does

“162/102. Your blood pressure is way too high. It’s been like this for the last few months. I would like to start some medication to lower these numbers,” I say with certainty.
“Doc., I’m fine. I’ve got nothing wrong with me. If it was really such a problem, I would feel something wrong,” says the patient.
“These numbers will cause you to have a heart attack or stroke of which I think medications can help prevent.” I retort.
“Doc., I’m not buying it,” says the patient with a confidence that he clearly knows more about this situation than me.
In all actuality, I don’t care about the numbers on the blood pressure cuff. They are indirect measures of the danger that is coming. It could be months, years or decades away; but it could be tomorrow. While I am sitting in a relatively calm exam room, I am staring in the face of an oncoming, violent heart attack and stroke. I am trying to divert their presence from this man’s life. I can see it as plain as day but this gentleman, across the room is oblivious to its imminent arrival. I am using the word “oblivious” as a kind way of saying he is willingly defiant to the advice of a professional who honestly cares about his wellbeing.
Current scientific evidence supports my claim that treatment of elevated blood pressure with exercise, weight loss, tobacco cessation, lowering salt intake in the diet, moderating alcohol consumption and with specific medications can dramatically lower the risk of serious life-changers and life-enders such as stroke and heart attack. There are multiple other complications that can also be diverted with treatment.
As a general rule and with only a few minor exceptions, 140/90 and below is considered a healthy blood pressure. Both numbers need to be at or below that goal. Adults should have this checked regularly; at least once a year. If it is high, they need to take the next step to proceed with treatment if the diagnosis of hypertension (elevated blood pressure) is made.
Joshua Baker, DO FAAFP