HEALTH NOTES

Evening Post, Volume CVI, Issue 68, 29 September 1928, Page 19

HEALTH NOTES

BLOOD PRESSURE MODE OF LIFE (Contributed by the Department of :"■-. ' .Health.) Diseases of the heart and arteries aro amongst tho principal causes of invalidity and death; and in this respect occupy a! position far in advance of cancer, writes Dr. M. D. Silberberg, of the Alfred Hospital, Sydney, in tho "Bulletin of tho Public Health Department of Victoria." There is a tendency to take them too much for granted becauso they aro so common. Nevertheless, "blood pressure" has bocome a current topic; every one chats about it as if it wero a newly-discov-ered disease. ■ The lay public cannot bo expected to grasp tho subtleties of medical terminology. The moro uncritical aro often quite content with such'a diagnosis as "liver,'*' "stomach," "nerves," or "blood pressure"; obviously an elliptical way of referring to diseases associated therewith. It is a time-saving method, otherwise- an involved account of pathology and physiology would be necessary with each diagnosis. However, one-is frequently asked, "What is this blood prcss-aro we hear so much of , and what is normal pressure?" In practice, we mean tho pressure of blood in tlio arteries,' and are not so much ■concerned with pressure in the veins, and capillaries, though these are also-important. Blood pressure is similar to pressure in irrigation pipes, and serves to distribute the blood to the tissues at varying velocities and amounts according to the' general and loCal bodily needs. If we. visualise the largo arteries as resembling tubes of rubber.and fabric like' hose pipes and'tho small arteries as- all rubber, wo have a fair analogy of.'the properties of the muscular and elastic coats of the arteries and arterioles. Wo can also readily see why a perished section, i.e., degeneration, may "blow out," causing, a minor or serious hemorrhage according to its structural relations. It may merely be a. nose bleed, or a fatal hemorrhage into the .brain'- substance, or elsewhere. But as we shall see, blood pressure is not"merely -concerned with the possibility 'of burst vessels. Normal blood . pressuro is produced by various factors. Firstly there is the pumping force of the ventricles of the heart. A volume of blood is thus thrown into and stretches tho large arteries, which, by virtue of their elasticity, release this elastic recoil, and so send on the stream as a pulse wave. But tho blood does not flow out at the periphery at the same rate as it is pumped in. The smallest arteries aro almost wholly muscular tubes under the control of the vasomotor nerves. This nervous_ mechanismadjusts the outflow according to the tissue demands; there is cither vasoconstriction or relaxation. This peripheral resistance is of tho greatest importance from the point of view _ ot blood pressure. It acts as a fairly coarse adjustment of the blood distribution; a much finer adjustment being arranged for, in capillary tone which is also under autonomic control. CAUSES OP HIGH BLOOD PRESSURE. Persistently high blood pressure initself is a sign that all is not well. There is no doubt that the high pressure'mode of life will precipitate supernormal blood pressure in tho middleaged and later periods of life. How is this brought about? Let us take as a common type a busy man between the ■ ages of 50 and 60 managing a big busi-, ness concern; or a prominent politician with endless public engagements. His day is one long rush getting things done against time, "beating the clock," all his mental energy is keyed to a pitch of high concentration and drive, an urge to get things done in; a hiirrv, assuming big responsibilities, directing affairs, controlling subordinates,' answering telephone calls, dictating correspondence, and all the time subjected to a dozen petty annoyances from interruptions, inefficient service, stupidity, passive and active resistance, non-reception of ideas, and so on. The long sustained mental tension causes a constant surge of nervous impulses which react to maintain.a heightened blood pressure. Such a state of affairs kept up for months will very frequently produce permanently raised blood pressure. It is brought about through stimulations acting through the ductless glands and interacting with the autonomic nervous system. If one adds to the above mode of life an excessive intake of food, an undue abuse of tobacco and several whiskies or beers per diem, insufficient exercise and recreation, then high blood pressure with its attendant evils is almost inevitable. Furthermore, one must consider normal wear and tear changes of age- summed up in the aphorism, "A man is as old as his arteries," which in turn, partly depends on one's heredity, whether good or mediocre tubing was laid down in the first place, and the use or abuse to which such tubing is subjected. OTHER FACTORS. Still further, few of us are wholly free'from focal infections of some sort, such as infected teeth and gums, catarrhal diseases of the nose, antra, etc., alimentary intoxications, and so on. We sex, therefore, that the causation of high pressure is based on faulty modes of life, faulty habits, chronic infections, and age changes. Temperament plays a big part and explains why some women are common sufferers. Many have the unfortunate habit, of keeping themselves in a simmering state of worry and anxiety about petty household annoyance concerning domestic trials, tribulations of maids and children. They thus produce through endocrine and nervous disturbances a state of high blood pressure. These types need to cultivate a more philosophic outlook and see things in proper perspective, and not unduly magnify trifling annoyances. Women about the period at the menopause, especially those who are over weight, are particularly prone to high blood pressure. SYMPTOMS. People with high blood pressure may have no symptoms for some time. Indeed, their friends may compliment them on their robust appearance, and they may feel full of vim and energy. The condition may only be discovered during a routine examination, as for instance for lifo assurance, Government appointments, etc. Sooner or later, however, the early symptoms appear, and are similar to those of neurasthenia. Irritability and irascibility are prominent, difficulty in concentration, faulty memory, insomnia, headaches, throbbing iv the head are all common

symptoms. Fullness in tho head or giddiness, shortness of breath, and palpitation may be complained of. Sometimes the first indication is a violent opistaxis, or more rarely an attack of apoplexy. The later symptoms are manifold and are referable to the various systems whoso blood supply becomes'lnterfered with. The classical type of the full-blooded, short-necked, obese individual with florid face is well recognised as having apoplectic tendencies, but thiu,. pale individuals may also suffer from high blond pressure and arteriosclerosis. Neither sex, class, nor race is immune, though there is little doubt that the hiin-y and skurry of modern civilisation is a big factor in causation. Hence its prevalence amongst the brain workers in the community. PREVENTIVE MEASURES. It should be obvious from the foregoing remarks that prevention is possible. A rational mode of living is the basis of prevention. A proper proportion of work and recreation, leaving one's troubles at the office and not carrying them home, a reasonable philosophic attitude to the-petty annoyances of the daily round, and maybe a more fatalistic attitude to those real anxieties which must be faced, and which worry, only aggravates and cannot remove. Temperament and early training count for a great deal, and in this regard we may hope for better things, now that child psychology is being understood and knowledge of it diffuses through the people. Dietetic excesses are harmful, especially in regard to meat and stimulating dishes such as soups, meat extracts, etc. Sedentary workers should reduce food intake and avoid the "middle-aged spread" and arrange for suitable outdoor exercise. Excess weight is rarely a health asset, as any life assurance, statistics will show. Vegetables and fruits and cereals and dairy products should constitute the main part of the diet. Excessive smoking can cause definite harm in various ways, and ex*_u;s in alcohol scarcely need stressing. It should also be recognised that oven moderate drinking, steadily kept up, is far from harmless. A regular medical overhaul for the aged should be a slogan, but we of the medical profession are loath to drive this home lest wo be accused of selfinterest.