By Tedler D. Depaynos, MD
A coffee mate was curious after reading an article of Hypertension (HPN) or high blood, what is systolic and what is diastolic in a blood pressure (BP) of 130/90? Surprisingly, our lawyer friend who was just finishing his black unsugared coffee answered that 130 is the systolic and the diastolic is the 90. The former is due to the contraction of the heart and the diastolic is due to the contraction of the blood vessel as the heart relaxes. If not for the sudden call of his secretary perhaps he could have explained further. There was a loud mummer from the table that the lawyer has researched well and somebody even whispered loudly that perhaps he used to have a medical ambition.
The classical definition of HPN is BP beyond 140/90. There was a time when what was considered only was the systolic in defining HPN even if the diastolic was more than 90. At present however, HPN is considered when the systolic is beyond 140 even if the systolic is 90 or below and vice versa, the diastolic is above 90 and the systolic is 140 or below. Of course, if the systolic and the diastolic are beyond their upper limits, the patient is definitely with HPN. As emphasized, however, most MD’s start prescribing hypertensive medicines even if the BP is just 140/90. And definitely, the other ailments of the patient is considered and the lifestyle and stress he maybe under going.
Actually before our lawyer friend left, he emphasized that his change in lifestyle which made him relaxed and non-stressful, controlled his blood pressure.
Another coffee mate agreed that for elderlies, a non-stressful lifestyle should be a must. He recalled that he used to suffer from epigastric pains from time to time when he was still stressed out in his work. He had been taking over the counter Maalox from time to time to relieve his pain and his MD prescribed to him “esomeprazole” because he was diagnosed to have “hyperacidity” or Acid Related Disease. The “Maalox” is supposed to neutralize the acid while the “esomeprazole” is to control the secretion of acid. Relief was, however, always transient once he consumed his prescribed medicines because there was always recurrence. He even underwent esophago-gastro-doudenal endoscopy which revealed simply mild “doudenitis” or simply inflammation of the superficial mucosal lining of the duodenum. When it reaches the serosa, “ulcers” appear. He underwent the procedure because the non-relief of his “hyperacidity” made his MD entertain a more serious condition like a gastric ulcer which may be malignant. He was glad that his pain was just due to inflammation.
He then claimed that it was only when he retired from his managerial government obligations that deals with the environment several years ago and began a non-stressful existence when he recovered completely from his epigastric complaints.
Stress may cause inflammation of the gastro-doudenal lining by stimulating the secretion of excess gastric acid. If it is already weakened by the bacteria H. Pylori or vice versa, ulcer might be formed. Actually, it could also be weakened by the intake of strong analgesics like aspirin, diclofenac or NSAIDs.
It is a dictum that stress may also weaken the immune system which may lessen the body’s resistance to the H. Pylori bacteria. Hence it may also delay the healing of ulcers despite the intake of adequate anti-ulcer medications. The bacteria, H. Pylori thrive in the ulcers so that part of the treatment of ulcers is the giving of antibiotics to eliminate the bacteria. Usually 2 antibiotics are given for 2 weeks.
It is found out that a cause of insomnia or sleepless nights common in business executives may also be due to their stressful work and responsibilities. Some of them tend to form the habits of drinking and smoking in an attempt to make their body relax. Those habits, however, may contribute to the formation of stomach or duodenal ulcers or peptic ulcers in layman’s terms.
Hence shifting to a non-stressful life may not only prevent the formation of ulcers but may also speed up the recovery if there are any and help prevent recurrences.
When we then asked about his present lifestyle, he mentioned that from time to time he travels around with his bed mate visiting their children abroad, and does carpentry and gardening at home. He even has a small poultry in a corner of his wide grounds that supply their egg and chicken and duck needs. He regretted that he should have taken a vacation from time to time when he was still busy with his work like what Pres. Duterte is trying to do now.
Most of our coffee mates were all smiles and a little envious that he could do all the relaxing adventures and when he paid for all the bills their envy doubled because he obviously has huge retirement benefits. **
