Cardiologist doles out 'tough love' to blood pressure patients

By Dennis Thompson
HealthDay Reporter

(HealthDay News) -- Most days, Dr. Maureen Mays feels like the school principal.

"People get sent to me when they're in trouble," she said. "I have to be mean to them and make them change their lifestyle and take medicine."

May is director of preventive cardiology at Oregon Health & Science University , and part of her job involves providing not-always-welcome advice to people with high blood pressure. Complicating matters, not all her patients have accepted the fact that yes, indeed, they do have high blood pressure.

"They don't come in saying, 'I have high blood pressure,' " Mays said. "They say, 'My doctor says I have high blood pressure.' There's a fairly high level of denial out there."

Mays said that her main problem in prompting change comes from the fact that high blood pressure doesn't really have any noticeable symptoms, even though it can lead to life-threatening problems like heart attack and stroke.

So Mays doles out her heart-healthy advice -- eat better, reduce salt, exercise, take your meds -- to patients who tend to feel she's picking on them.

"People with high blood pressure don't feel bad, and so they really feel like they're being asked to change their lives for no good reason," she said. "Sometimes I tell colleagues I really wish high blood pressure caused elbow pain or something. But there's no outward signs or symptoms of it until it's too late."

Lifestyle changes are the hardest to encourage, Mays said, and exercise is the toughest sell.

"Most people will make minor food changes, but getting people to do a little exercise every day is incredibly difficult," she said. "It's the simplest, cheapest, best medicine available, it only takes 20 minutes a day, and it's nearly impossible to get people to do it."

Each patient faces their own challenges in improving their health and getting their blood pressure down.

For example, one woman loves to cook for herself and her family, and it is ruining her health, Mays said.

"She will not stop eating horrific amounts of very bad food," Mays said, adding that the woman has terrible diabetes, is very obese and yet is always making and consuming pastries, muffins and the like.

"She cures her own hams!" Mays said. "She tells me what she makes and I go, 'Oh my lord.' "

Since the woman won't stop eating what she cooks, Mays has helped her control her blood pressure through medication. "She just is the same every time, and we add more medicine," the doctor said. "Her blood pressure is going down, but she still has all these other risk factors."

On the other hand, Mays has a male patient in his 20s who is making remarkable progress.

Six months ago, he came into her office weighing 530 pounds. "He was a terrible fast-food addict," she said. Now, just through diet changes, he has dropped down to 460 pounds.

"He's cranking, and no meds," Mays said. "He's done it all by himself." The patient has limited himself to one fast food meal a week, and eats healthful foods the rest of the time.

Then there's the gentleman with severe heart disease who put himself in the hospital by treating himself to an all-you-can-eat Chinese buffet.

"He gained 18 pounds of fluid in 24 hours and went to the hospital with heart failure," Mays said. "Of course, we all gave him rations of grief. We said, 'We told you that you could eat out once a month. Did you have to choose that place?' "

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