It seems that once you get out of the military you can never fully leave. There seems to always be a part of you that stays in or a piece of your military service that keeps affecting you after you leave. As part of an educational series I will look at and address several of the common medical issues that seem to follow veterans after they leave the service. The little part of the military that never leaves you, might be a condition that is going to be with you for a really long time.

            The following information is not meant to diagnose, treat, or replace your physician. Please seek medical advice from your primary physician and only use the following information for educational purposes.

            Due to either stress, long hours or the continued running around; it seemed that my blood pressure was always up during my time in the service. I remember going to SRPs or physicals and having to sit in a room with my eyes closed for several minutes just to get my blood pressure down within what the Army considered a normal range. The last thing anyone wanted was to be medically flagged. I was much younger at the time and never worried much about my blood pressure until I returned to school to become a Dual Role (Family/Adult-Gerontological Acute Care) Nurse Practitioner.

            What is high blood pressure? Well according to JNC 8 (Joint National Committee) which is a committee that provides evidence-based guidelines for the management of high blood pressure in adults, high blood pressure is different for different groups of people. There are different ranges if you are over or under 60 years old and if you have chronic kidney failure or diabetes.

            The medical treatment is different for each group. The treatment also changes based on race. For example, African Americans start on a different class of medications than non-African Americans due to the response to different medications.

            Does one reading mean I have high blood pressure? I currently work in an Emergency Room and often get this question. High blood pressure or hypertension is a chronic condition and should be looked at that way. I often tell patients about how your arteries, which carry the blood away from the heart, have two pressures in them. One pressure when the heart beats (systolic)-the top number and one pressure when the heart is relaxed or at rest (diastolic)-the bottom number. If you think of your heart and arteries like a hydraulic system you do not want to have long term high pressure in those pipes. You will wear out the O-rings and pipes causing issues.  Heagerty 2007, talks about how the walls of the vessels are actually changed and become enlarged due to the high levels of pressure. This can make the diameter of the vessel even smaller which increases the pressure. So does having a spike in blood pressure hurt you? If it is too high it can, however having it elevated above your goal chronically is where the larger danger lies. So if you are stressed out in the VA for an appointment it might be elevated during that time. The concern is if you consistently run at above goal.

Sitting in that dark room in order to get my blood pressure down to pass a physical did not do me any good since I was chronically running too high. Unless I spend my whole life in a dark room alone, fudging those numbers doesn’t do me any good. The point is, you need to know what your numbers are averaging and what your normal is.  According to the Mayo Clinic you want to check your blood pressure in the morning after you first wake up, before food or medications, and again in the evening. They recommend that you take your blood pressure several times and at different times during the day in order to get a better average. I have suggested to patients to keep a log of their blood pressures and bring them into their next appointment with their doctor. This gives your doctor a better idea of what you normally run and how high above goal you are.

            So now you found out your blood pressure is a little high, so what? Well, not only does the high blood pressure affect your blood vessels, it also affects your organs. Just like in the hydraulic pump system, the small little pipes that you have in organs like your eyes, kidney, heart and brain can all end up failing and causing serious medical problems. High blood pressure according to the American Heart Association can lead to stroke, heart attack, vision loss, kidney disease/failure, sexual dysfunction and heart failure.

The best thing to do if you are worried about your blood pressure is to get it checked. Go to a pharmacy and use their machine a few times in a week and write down your readings. You could pick up a home blood pressure monitor and check it often. Trust me, a home machine is much cheaper than the cost of a stroke. The best course of action is to see your doctor, that way they can treat your blood pressure and make sure someone is managing it.

            If you were in the military there is a good chance you could have high blood pressure and at the very least you should have it checked out. Remember this article is meant to be educational and never meant to replace your physician’s advice or recommendations. You severed your country, now make sure you aren’t left with a little going away present called Hypertension.

References:

Ask MayoExpert. Hypertension (adult). Rochester, Minn.: Mayo Foundation for Medical Education and

Research; 2017.

Eduardo Hernandez-Vila (2015) A Review of the JNC 8 Blood Pressure Guideline. Texas Heart Institute

Journal: June 2015, Vol. 42, No. 3, pp. 226-228.  https://doi.org/10.14503/THIJ-15-5067

Heagerty, Anthony M. Predicting hypertension complications from small artery structure. Journal of

Hypertension: May 2007 – Volume 25 – Issue 5 – p 939–940 doi: 10.1097/HJH.0b013e328122d9af

The American Heart Association, Heath treats from high blood pressure. Oct. 2016. Retrieved from

http://www.heart.org/en/health-topics/high-blood-pressure/health-threats-from-high-blood-pressure