Dr. Norman Kaplan on Hypertension

Norman M. Kaplan, M.D., has literally written "the book" on hypertension. He’s the clinical professor of internal medicine at the University of Texas Southwestern Medical Center in Dallas, and his textbook, Kaplan’s Clinical Hypertension, is in its ninth edition. He received the Lifetime Achievement Award by the American Heart Association’s Council for High Blood Pressure Research, and received the Stevo Julius Award for Leadership in Medical Communication presented by the International Society of Hypertension. Here, Kaplan explains the importance of making lifestyle changes in the first 30 days after receiving a hypertension diagnosis.

What can people do at home in the first 30 days to manage hypertension?

One of the first things they should do is start taking their blood pressure at home, so I suggest people invest in a home blood pressure monitor. With that, they are able to learn a lot about their own blood pressure and its cycles just by taking note of when their blood pressure is elevated, when it has lowered some and so forth.

After that, I talk to people about lifestyle changes, which can pose some hurdles because many people are unwilling to change, even for the betterment of their health. This means a different and generally lower calorie diet, cutting down on the amount of alcohol consumed, regulating salt intake, getting more exercise, stopping smoking and other things.

Do you find that patients are often shocked or frightened by their diagnosis of high blood pressure?

The patient has to be made aware they have high blood pressure, but we try not to scare them with the diagnosis. Fear is not a good motivator. People tend to shrink away from things they fear, and as doctors we need patients to face their diagnosis and work with us to help manage their hypertension. For that reason, I tell patients the truth—that their hypertension means that they are at greater risk for other complications like stroke or heart attack—but that usually they are not in immediate danger, and that if they take care of things in a reasonable and sensible way hypertension can be managed. If it is managed, the possibility for further medical problems can be reduced significantly. Understanding that high blood pressure is treatable is a great step forward in reducing the anxiety that can come with the diagnosis.

What is the most difficult thing about a diagnosis of high blood pressure for most people?

Definitely the lifestyle changes, and sometimes people simply cannot change their habits enough to bring their blood pressure to entirely safe levels. But people should know that there is an abundance of information available now on the subject of high blood pressure, so becoming informed is much less difficult than it would have been a few decades ago.

The American Heart Association’s web site is a good place to start, since they make so much information free and readily available to the public at large. Even so, there are many people who are either unaware they have high blood pressure, or are not adequately treated for their high blood pressure. The main things to know are your blood pressure numbers. Check them often, and make sure you talk with your doctor about the best routes for treatment. Those things can help make your game plan easier to map out, and safer.

Can you give our readers some information that may not be known about high blood pressure or its treatment?

There was a study published recently that focused on the value of treating older people—over the age of 80—with high blood pressure. They found that the patients did gain some excellent results. The thing we can get from that study is that we are never too old to benefit from treating a condition. We should never just slow down and neglect our blood pressure when we get older because there are indicators that hypertension can be managed at any age.

SIGNATURE QUESTIONS

What is the belief you personally go to during times of change?

The belief that all people can take actions to improve their health.

The best thing about change is...

...the feeling of satisfaction that you have acted to improve your life.

What is the best change you have ever made?

Deciding to be an academic [teaching] physician.

For more information on Dr. Norman Kaplan, visit www.utsouthwestern.edu.