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Health Team

High blood pressure often strikes silently

Posted March 5

When some patients start to feel the effects of high blood pressure, it’s already done damage to their bodies.

Hypertension, which affects one in three American adults and causes heart disease, stroke and kidney disease, struck 56-year-old Gregory Crisp of Burlington long before staff noticed it while taking his blood pressure at a dentist appointment.

“She took my blood pressure in the dentist’s office, and she said, ‘Dead man walking,’” Crisp said.

At the time, Crisp’s blood pressure had soared to about 200 over 150. Normal blood pressure is less than 120 over 80, while blood pressures between that number and 140 over 90 put patients at risk. Blood pressure higher than 140 over 90 is considered hypertension.

“I was a goner and didn’t even know it,” Crisp said.

Doctors say hypertension can be challenging to manage.

“We’re still not doing a good job of managing hypertension,” said Dr. Raven Voora, a nephrologist at UNC Hospitals.

Voora said it’s also difficult to gauge how well high blood pressure medications work throughout the day, especially at night.

“Relative to daytime blood pressure, nighttime blood pressures are much lower,” Voora said.

But some patients’ blood pressure remains high at night. Doctors call these patients “non-dippers.”

Crisp wore a 24-hour blood pressure monitor that showed that his blood pressure did not drop at night, even on medication.

“There’s certain populations that may benefit from taking their blood pressure medicine at bedtime rather than in the morning,” Voora said.

Some patients’ problems are caused by skipping medication doses, a habit Crisp once had.

“Now I’m taking every dose and making sure that it’s in control,” he said.

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