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Tuesday, May 18, 2021

Why some men have higher blood pressure than others, but they’re often unaware of it

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A recent study found that, on average, middle-aged men who are overweight have five more systolic (the top number in a blood pressure reading) and two more diastolic (the bottom number) readings than do men who are normal weight.

This is a striking finding, but an even bigger surprise is the finding that people who have hypertension — either high blood pressure or a condition that raises blood pressure so that it is above the normal range — may have five more systolic and two more diastolic readings than normal-weight men.

This increased sensitivity of middle-aged people to hypertension — which can lead to heart disease and stroke, and is also one of the leading causes of death in the United States — has led researchers to look with a lot of interest at causes for blood pressure variability in middle age. The two main ones that are being studied are: the tendency of people to develop high blood pressure in middle age, and the rate of blood pressure reduction that normal people maintain.

As someone who once studied this, let me say: If your blood pressure is above 120/80 mm Hg (versus the normal range of 120/80 mm Hg), then your doctor should order more measurements, and an ultrasound or stress test to check for the presence of inoperable coronary heart disease. If your blood pressure is higher than 120/80, your doctor should consider that you may have disease, and may need to start diet changes or to start to take a medication. It is crucial that people of all ages have their blood pressure checked often, when they are younger and at a normal weight. Their blood pressure can climb steadily after age 45 and then all too quickly.

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