High Blood Pressure and Heart Disease

The major cause of death in this country is from diseases of the cardiovascular system, and the most common disease is high blood pressure, which causes inadequate circulation to the heart and overwork of the heart muscle. Some types of high blood pressure are due to glandular disorders, and these have specific treatments.

But the most common kind is called essential hypertension. Its cause is unknown. Although the name given to the disease makes it sound as though it is somehow essential to the person and incurable, I do not feel this is necessarily the case.

High blood pressure, or hypertension, is a condition in which the diameter of the blood vessels all over the body is made smaller by contraction of the muscles in the walls of these vessels.

But the elevated pressure does not come on all at once, nor does it simply become elevated and stay permanently high. On different visits to the doctor’s office, the patient’s blood pressure is sometimes elevated and sometimes not. The elevation of blood pressure occurs with situations of tension in the person’s life. It is common for a person’s blood pressure to go up when he or she is excited or nervous, and nervousness often occurs upon physical examination.

Many doctors have the patients take their own blood pressure at home, so reliably does it go up under the stress of being in the doctor’s office. In fact, one of the first treatments the physician gives for high blood pressure is merely tranquilizer medication. By keeping the person calm, the blood pressure elevations do not occur as frequently, and the high blood pressure has been treated symptomatically.

The patterns that are causing the tension, however, are not eliminated by the tranquilizer. As a result, the contraction of the walls of the blood vessel may begin to recur as learned response patterns cause the tension level to break through the bonds artificially imposed by the tranquilizer. The blood pressure begins peaking more and more often, and the patient is begun on a diuretic, or water pill. One main function of this medication is to remove a certain amount of water from the body. It thus lowers the total volume present in the bloodstream, and through this, along with several other mechanisms, the symptoms of high blood pressure are again erased-for a while.

The blood pressure soon begins to rise once again, and more vigorous methods of controlling it are employed. Drugs may be used that function through their effect on the kidneys or the nervous, vascular, or endocrine system, but the blood pressure often continues to rise.

In some cases the rise in blood pressure continues to the point that severe headaches, brain problems, or kidney problems result. We can imagine the blood having to flow through all of the spastic vessels to reach the various organs of the body. It must then flow back through the veins to the heart to be pumped out again. As the muscles in the walls of the vessels begin to contract, it becomes more and more difficult for the blood to flow through them. Just as when the garden hose is kinked, the output of water decreases, so too is the volume of blood reaching various organs of the body diminished. In order to compensate for this decreased blood flow, the heart must pump harder. If you had to blow up a balloon through a small straw, you would have to blow much harder than someone blowing it through a larger straw in order to keep up with him or her.

This increased work, of course, falls on the heart muscle. The heart muscle is supplied with blood from arteries in its walls. Like all the other vessels in the body, these vessels may also be narrowed and in spasm. When this spasm has been present for a long time, it may become impossible for the vessel to ever again reach its original diameter.

The heart has to pump harder and harder with a smaller and smaller supply of blood to its own muscle. This is the situation seen commonly in people with angina pectoris. The chest pain is caused by a heart that goes into spasm, partly because it is not able to keep up with the work it is being called on to do. The problem may actually become so bad that a portion of the heart muscle dies, leading to a myocardial infarction, or heart attack.

It probably comes as no news to most people that heart attacks and high blood pressure are closely associated with each other and also very much associated with the amount of tension in one’s life. Those people who live in a tense home situation or have tense and demanding jobs tend to have much more cardiac and high blood pressure disease than people in more relaxed daily surroundings.

Remember the negative conditioning of the dog back in Chapter 8? If we conduct this experiment with a special instrument on the dog to measure its blood pressure, we find that each time it gets a shock, its blood pressure goes up. Actually, the pressure can increase in all of us in any time of tension or fear, because it is part of the normal response pattern. If it occurs regularly, along with a programming stimulus, it becomes negatively conditioned. Soon each time the stimulus comes along, the blood pressure goes up. Perhaps in human beings we do not see continuous elevated blood pressure very often in younger people because it takes some time for this overall mechanism to become firmly established. In addition, the greater flexibility of the walls of the blood vessels of younger people give them much more ability to absorb periodic tensions. As one grows older, however, blood pressure elevations occur repeatedly, until the conditions of high blood pressure and its unhappy results may be produced.

You’re probably asking yourself, “What about all the talk of diet, exercise, and heredity as related to blood pressure and heart disease?” These are definitely important factors, and should not be ignored by anyone seeking to maintain the health of the circulatory system. But in addition to the management of diet and exercise, management of emotions is important. The more unrelieved tension and incoherent response patterns in one’s life, the more rapidly the blood pressure is likely to rise through the years. A person who has a genetic predisposition to develop these problems, or who has had early warning symptoms, has an important choice to make. That person cannot change his or her heredity, but he or she can decide whether to continue to be high-strung, hurry from one appointment to another, worry, and lose his or her temper. That person can begin, one by one, to eliminate these dangerous responses. My advice is that he or she learn to become a person who can choose to remain relaxed and calm even during stressful situations in spite of how uptight he or she may have been in the past. The person who follows this advice stands a much better chance of retarding any gradual increase in blood pressure and, perhaps more important, avoiding the emotional crises that may be the cause of the acute elevation in blood pressure responsible for heart attacks, strokes, cerebral hemorrhage, and kidney disease. Whereas it might be permissible for another person to worry, get upset, or feel tense, for an individual with hypertension, it may be more dangerous than walking on a broken leg.

This is not to say that the person should avoid all his or her usual pursuits, only that the person should become aware of any stress that creeps into his or her life and alter his or her responses through deconditioning (for instance, not getting upset if he or she is late) and positive programming (becoming as “patient as Job” an, as “relaxed as a sleeping babe”).

Martin came to see me because of a dual problem. He ha. known for years that he had hypertension, and he had attacks c sweating and pounding heart whenever he had to wait for anything On his first visit he had one of these attacks as a result of sitting for one-half hour in my waiting room. His blood pressure was significantly elevated.

He told me that this response had been present for years, but that no one had ever told him it might be related to his high blood pressure. His emotions during these waiting periods were annoyance and impatience. The location didn’t matter. Whether he was in line at the Department of Motor Vehicles, the post office, or the bus stop, he would get sweaty palms and armpits, his heart would pound, and he might even develop a headache.

Following a complete physical exam, including laboratory test to rule out the curable causes of hypertension, I started him on mild medication and explained the possible mechanism of his disease I sent him home with instructions on how to decondition this pat tern and tapes for spasm relaxation and positive programming Within a month he had all but eliminated the troublesome reaction. His blood pressure was well within the normal range, an’ I slowly weaned him from his medication. Repeated examination have failed to detect any further elevation, even after long period in my waiting room. Thus we have an excellent example of how the course of this problem may possibly have been altered; it would be premature to assume it has been cured forever. There may still be a continual climb over the years, but if there is, I believe it will be much more gradual than if he had not learned to relax.

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Avatar Written by Emmett Miller MD

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