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Treatments. In some cases, threatened heart attacks can be warded off. This happens when narrowing of coronary arteries gives warning of its advance by pain in the chest (angina pectoris). This is felt when the heart cannot deliver extra blood required to digest a big meal, to combat cold, or to sustain unusual effort. The degree of heart impairment can be measured after exercise on a miniature flight of stairs—the Master two-step test. The treatment, besides weight reduction: nitroglycerin pills slipped under the tongue when pain is felt. They dilate blood vessels and relieve pain almost instantly.
What of attacks that strike without warning? Many of these are of the type suffered by the President, and leave no sign of "heart failure." This term, frightening if misunderstood, is a doctor's way of describing the condition when a heart cannot meet the demands upon it and begins to lag. The President's treatment was typical for uncomplicated cases: morphine at once to relieve pain, complete rest, anti-clotting drugs (first heparin, later Dicumarol) and an oxygen tent.
If damage to the heart is so severe as to make it liable to recurrent failure in its pumping action, initial treatment is the same. However, this is then followed by drugs such as digitalis which give the heart added power.
The Question of Blood Pressure. All these experiments and treatments are concerned with one general form of heart disease—arteriosclerosis. The other major form of arterial disease is hypertension. In this case, the heart becomes enlarged from the effort to pump against the increased resistance of hardened, narrowed arterioles. But as it enlarges, it needs more blood to fuel it, and must work still harder to supply itself. To forestall or arrest this vicious circle is the longstanding aim of Hypertension Specialist Page.
Main trouble is that doctors have no idea what causes 90% to 95% of high blood pressure. This vast majority of the estimated 15 million U.S. cases they list under the misleading label of "essential hypertension." For the small percentage of cases whose origin can be traced, Dr. Page gives four known causes: 1) kidney disorders; 2) hormone upsets, often from tumors of the adrenal glands (astride the kidneys); 3) disorders of the nervous system in which normal impulses are either absent or intensified; 4) hardening and loss of elasticity in the aorta. Whether "essential" or of known origin, hypertension may be either benign or malignant. A patient can live with the benign type for years with only moderate care and little discomfort. The malignant form may kill him within months.
Who gets high blood pressure and why? Many laymen have a pat answer: "It's the pace of modern living." But doctors putting this theory to the test find no proof. Many men under the greatest strain never develop it, while some under the least strain do. Occupation is no guide. Body-and-soul researchers have tried to find a personality type that is especially prone but no clear pattern emerges. Young women are more likely to have heightened pressures than young men, but paradoxically they are less likely to develop disabling disease. After middle age, men are marked for trouble much more often than their wives.