Why are two different numbers used to measure blood pressure?

The first or top number measures the systolic pressure or the pressure that the heart is exerting when it is actually pumping. The bottom number is called the diastolic, and it measures the heart’s pressure between beats or when it is at rest. This means that the top or systolic pressure is the maximum pressure, while the diastolic or bottom number represents the minimum. This will explain why the bottom number is invariably smaller.

Is it true that the bottom number is the most important one?

A. There used to be some feeling that the diastolic reading was more critical than the systolic. However, today most doctors regard both as equally important. In any case both generally move together in the same direction. That is, an increase in one will generally be followed by an increase in the other and vice-versa.

What about the popular saying that a person’s blood pressure should equal 100 plus his age?

In most western countries peoples’ blood pressure does tend to rise until the age of 55 or so. However, there are groups in the South Pacific, South America and Africa whose blood pressure remains the same throughout life. Even in this country, some five per cent of the population retains the same level of blood pressure in old age as they had in youth. The fact that blood pressure usually does go up with age does not mean it must or should go up. Dr. Josef R Hrachovec, a research physician at the Gerontology Centre at the University of Southern California says in his book, Keeping Young and Living Longer, that “low blood pressure throughout life is truly and perfectly normal.” It’s also most desirable and, in many cases, perfectly attainable.

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The question the reader will ask at this point is ‘Given all this epidemiological study, do we know the causes of cancer?’ Broadly the answer is ‘yes’ in many circumstances and for many cancers, and the opportunities for prevention that this understanding generates are there to be taken. We do not always know how the factors that have been identified by the epidemiological studies discussed in this chapter link up to what is being learned in the laboratories of the molecular biologists. This connection is being made rapidly and will be increasingly clear by the end of the century. Epidemiology has been very successful in discovering or confirming which features of our lives in the Western world can be now identified as causes of cancer.

A few hormones can certainly cause cancer. When large quantities of the female hormone oestrogen were given for medical reasons during pregnancy, rare kinds of cancer were liter found in the daughters of these women. Large quantities of oestrogens which were formerly given to women for menopausal symptoms undoubtedly caused cancer in the uterus although newer preparations do not. Oral contraceptives represent a complicated case, perhaps involving a real increased risk of breast cancer, particularly in young people. On the other hand, the Pill is capable of reducing the risk of ovarian cancer and cancer of the body of the uterus. Both risks and benefits can therefore be claimed for the Pill and controversy about its use is likely to continue.

At a more subtle level, it is possible that some of the effects of child-bearing may include a reduction in some cancer risks, probably generated by changing hormone levels. This is particularly apparent in cancer of the ovary, where having been pregnant appears to be protective.

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People with BDD may drop out of elementary school, high school or college because they can’t concentrate, don’t want to be seen, or are depressed because attended classes for the past three years. Instead, he’d been living with his parents. “First I started missing classes and school activities because my hair bothered me so much I couldn’t go. I was too embarrassed over it. It always looks strange. It never looks neat or natural. It sticks up and looks bizarre. If I spray it, it looks greased down. Barbers ruin it, so I cut it myself and it looks ridiculous. I spend hours in front of the mirror combing it and trying to fix it. Once I had a perm, and it looked better for a while, but when it grew out I looked like a terrorist.

“First I started missing some classes, and my grades started dropping because I couldn’t concentrate. But I was determined to blast through everything, and I pushed myself, but that didn’t work. I started missing so many classes that I took a year off. I didn’t tell the school officials why because I was too embarrassed. I tried to go back, but I couldn’t concentrate so I dropped out again.”

Rebecca had also missed many classes. “I wouldn’t go to school. I couldn’t concentrate because I’d be worrying about my skin or going to the mirror all the time to pick it. And when people saw me, I thought they were judging how it looked. I finally left college because of it. I was very active in high school, and I had lots of friends. But I couldn’t leave my room in college. After I left school I stayed in bed for two weeks…. I let myself down by leaving. I want to go back in January, but I won’t be able to succeed unless I’m feeling better. This problem is an obstacle to getting on with my life.”

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