London's Pulse: Medical Officer of Health reports 1848-1972

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Deptford 1924

Annual report on the health of the Metropolitan Borough of Deptford

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87
is not so serious as arterio-sclerosis. To explain how high blood
pressure comes to pass. Between each heart-beat the circulation is
kept up by the contractile power of our elastic arteries. The
tension in the arteries can be estimated bv an instrument called a
sphygmomanometer. Now in arterio-sclerosis the arteries lose their
elasticity because a gritty deposit settles in their walls. This deposit
lessens the bore or the lumen of the arteries, hence the blood cannot
be forced through them. The left side of the heart tries to overcome
the resistance in the stiff arteries, and so becomes overworked and
finally enlarged. The blood pressure becomes high and there is a
danger of rupture of the blood vessels and apoplexy. The causes of
high blood pressure and arterio-sclerosis are not far to seek. Generally
several causes operate together. The high speed of life in business
and the whirl and gaiety of the social round; late hours, over-feeding,
over-smoking, continual excitement; drinks, dances and dinners. It is
not so much the drinks as the drinks between the drinks which do the
damage. Strong coffee and strong tea are far from blameless. Passions
such as anger, worries and anxieties play their part. Intestinal stasis,
constipation, lead to absorption of poisons, and these irritate the blood
vessels. If H.B.P. lasts for a year or two then A.S. must follow. The
symptoms of H.B.P. are increased shortness of breath, giddiness,
singing in the ears on stooping, and a constant sense of fatigue out of
proportion to the work that has been done. Every man of 45 and 50
and over should have his blood pressure estimated every year by his
doctor. It is no use burking the issue. If the pressure is up, face the
facts, be honest and cut out bad habits, such as the other little drinks
which do us lots of harm. Early hours, long nights, no excitement,
the minimum of stimulants, change of scene, plain and simple diet,
must be the rule. No more rich gravies, no strong meat soups. Black
coffee and strong cigars must go, even pipe smoking may have to be
stopped; the cigarette smoker who inhales is passing nicotine into his
system and this by itself is a powerful raiser of the blood pressure.
The patient should go in for fasts, his intake must be brought down
and output increased. Dairy produce must take the place of strong
meats; the simple life must be lived. In conclusion, I appeal to all
men and women between 40 and 60 to lead the simple life. There is
no hope for the person who refuses to amend his ways if high blood
pressure is diagnosed, for nature will be certain to send in the bill.
Get back to nature's simple laws and she will reward you with a long
middle-age period, and will give you light in the evening of your days.