What should be the normal Blood Pressure for a Sri Lankan By Dr Harold Gunatillake

The blood pressure that is considered normal for men and women seems to be changing
from time and again. When we were medical students in the fifties, we were told that the
upper pressure should be less than your age plus 100:
meaning, if you are 50 years, your normal systolic pressure should be 150mm.Hg or less.
With time, studies revealed that the incidence and the risk of heart disease and stroke was
quite high with such blood pressure readings.

Then, it was realised that the strain on the Heart muscles with this respective BP considered
normal, was too severe, resulting in high incidence of heart problems, including failure.        

The blood pressure of an individual depends on the force of blood ejected from the left lower chamber (ventricle) of the heart against the resistance of the peripheral arteries and the rate of pumping (pulse rate).          

The medications prescribed for hypertension by the doctors, consider all these three factors in your blood pressure management.

If the systolic pressure is too high a peripheral Vasodilator alone may bring down the
BP in the early stages.
How this works is that lowering the peripheral resistance, you reduce the force of
the ejection of blood from your heart, referred to as the ‘systolic pressure’
The more popular drugs used to bring down the pressure is the Angiotensinconverting enzymes (ACE) inhibitors, help relax blood vessels and also prevents anenzyme in your body from producing angiotensin 11.

The other drug is angiotensin receptor Blockers (ARB) As said earlier these drugs widen or dilate your blood vessels and releases the pressure on the heart.

Then, doctors prescribe calcium channel Blockers. They work by slowing the movement of calcium into the cells of the heart and blood vessel walls. Heart muscles need calcium to contract.

If the heart rate is rapid, in addition to high blood pressure, your doctor will prescribe a beta blocker that lowers the BP in part by decreasing the rate and force at which the heart pumps blood.

This explains the modern methods of bringing down the high blood pressure and the doctors modulate them as required.

It was considered for a few decades that the systolic BP of a Sri Lankan person should be maintained below 120mmHg and the diastolic pressure at 70-80mmHg.

The European Society of cardiology has changed the baseline to 140/90 from the existing 130/80mmHg. This baseline BP applies to people over the age of 60, and those below the baseline is considered as 130/80 Sri Lankans are smaller in stature and strength compared to the Western men and
women, and it is reasonable to maintain the pressure for men as 120/70-80mgHg and for women- systolic as 110mmHg and diastolic as 70mmHg. This should apply to all ages- young and the old.

Such lower pressures maintain the cardiovascular system in prime condition, lowering the risk of heart attacks and stroke.
It is very important that diabetics with chronic kidney disease should adhere to such low pressures.

Bottomline
Sri Lankans should maintain systolic and diastolic blood pressures much lower than those recommend by the European Society of Cardiology which applies to the Europeans.