Here are your risks.

“160 over 100,” I said to my patient — unable to hide my grave concern after manually checking his blood pressure.

“That’s not too bad. It used to be higher than that,” he replied.

Sadly, this was the third time this week I’d heard a patient express relief over a blood pressure reading that was much too high.

As I looked at the patient, an African American man in his mid-forties, all I could think about was the myriad chronic issues my patient was risking at that very moment, from heart disease to kidney failure and more.

I felt an urgency to lay out the facts, so he could make the lifestyle changes necessary to save him from numerous chronic illnesses and possible early death.

Heart Disease

Almost one quarter of African American men die from heart disease — often heart disease that started as untreated hypertension.

Kidney Failure

African Americans are about 35% of the 35 million people who suffer from kidney disease — that’s over a third of all cases!

High blood pressure can constrict and narrow the blood vessels. Eventually, this damages and weakens blood vessels throughout the body, reducing the kidneys’ ability to remove waste and extra fluid from the body. Extra fluid raises blood pressure even more, creating a vicious cycle that leads to more damage and eventually kidney failure.

Irreversible Damage

Years of walking around with elevated blood pressure changes blood vessels, the heart and kidneys before a patient is even aware that this is happening.

Along with heart disease and kidney failure, chronic and uncontrolled high blood pressure can lead to stroke, heart attack, metabolic syndrome, dementia, brain fog, aneurysm and more.

High blood pressure pills are not a magic cure-all.

“So, what do you want to do; give me a pill?” my patient asked.

Unfortunately, many patients believe that high blood pressure pills will undo damage and get them back to baseline. However, a pill cannot save someone. Pills will only augment the work patients must do when they leave the exam room.

These are my concerns.

“Sir,” I said, an urgent plea in my tone, “Health is not achieved in this exam room.”

Hearing the concern in my voice, he revealed his hesitancy about pills. He explained to me that he watched his father take twelve pills a day, only to succumb to heart failure.

He told me how his mother, a type two diabetic, almost ended up on dialysis.

We spoke about how he still felt like a young man and taking a medication was contrary to this mindset.

He asked if he would be able to eat wings and drink beer on the weekend. He asked if the medication would make him tired. Last, he asked the most important question. He wanted to know if he would be on this medication for the rest of his life. All I could do was reply, “I hope not” because he had the power to turn this around. It was up to him, in addition to the support and guidance he would receive from his primary care provider.

This is what’s important.

It is fulfilling to help all patients, including someone with a more challenging path on their journey to wellness — a journey that includes discussing lifestyle changes and health goals for the upcoming year.

“My ultimate goal in each of these annual wellness visits is that all my patients grow old with me.”

My Patient’s Motivation for the Appointment

The patient discussed his motivation for making the appointment. He wanted to be sure there were not underlying issues that can impact his health. He already knew blood pressure was the number one threat to his health but was hoping he could make lifestyle changes to improve his blood pressure.

Actions that Improve Blood Pressure

Lifestyle changes are the primary intervention to improving blood pressure.

The most successful patients are those who are willing to do the following:

• Stop smoking (if applicable).
• Adopt the DASH diet.
• Exercise 30 minutes — five days per week.

My Patient’s Hopes for the Future

His guiding star was much more personal. He spoke about his daughter and how she is always the first to greet him at the door when he returns home. He spoke about how he wants to be there to watch her walk down the aisle, buy her first home and if she wishes, have her first child. He would like to reach all these milestones in a fair state of health.

So I asked him, “What changes are you willing to make today in order for that to be your future?”

Schedule an appointment.

Are you struggling with high blood pressure or another chronic health issue? Our WakeMed Primary providers can help. Find a primary care provider within the WakeMed system that best fits you and your needs.

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Learn More About DeAundre Dyer, DO

Dr. DeAundre Dyer is a board-certified family medicine physician with clinical interests in mental health, LGBT health, gynecology, pediatric and young adult health. Dr. Dyer is also interested in osteopathic manipulative therapy, and chronic disease management, such as diabetes, hypertension, heart disease and obesity. Dr. Dyer believes in partnering with the patient and acting as their health advisor. He believes the hard work of health starts when the patient leaves the office. Dr. Dyer tries to motivate and support his patients to achieve small goals on the path to the larger goal of health. Schedule an appointment with Dr. Dyer today.