Summoning Up the Blood

Patient No. 6 looked "aged and physically enfeebled," but her manner was childlike. She was 42 when she told her story. Her disease: high blood pressure, ranging up to 250 systolic pressure (125 is about normal).*

Like the other 23 patients described in a recent book by five Manhattan doctors (Personality in Arterial Hypertension), her life had been sensationally unhappy. The doctors think this common factor significant. Is there some connection between emotional upheaval and high blood pressure? The doctor-authors speculate: emotional tension makes blood vessels constrict and cuts the flow of blood to the kidneys. The kidneys, short of blood, release a chemical which raises blood pressure.

None of the 24 patients fits the traditional picture of a high-blood-pressure patient: a choleric, domineering individual of whom everyone is afraid. Almost every one of the patients studied could be classed as "submissive and dependent.' Many cried easily. They blushed and sweated on slight provocation. Those who had rages usually kept them to themselves ("It goes on inwardly"). Most had been poor at one time or another or neglected, by parents and relatives. Some had endured cruel stepmothers and wife-beating husbands. High blood pressure (first signs: headaches, sweating) usually showed up after some crisis, when they looked around for someone to lean on and found themselves alone.

Unhappy No. 6 was typical: she was one of twelve children of an Austrian immigrant living in a steaming Manhattan slum. She submitted always to her parents who were too busy to pay much attention to her. She did badly in school because of nearsightedness.

Submission & Rage. When she wanted to get out of her engagement at 17, she let her mother persuade her to go on with a marriage that turned out all but disastrous. Her mother-in-law lived with them. Her own mother would not take her part when she quarreled with her husband. Toward both her mother and mother-in-law her attitude was "a mixture of precarious dependence and violent but suppressed rage."

Her first attack came shortly after a confinement. High blood pressure caught up with her in earnest when her husband lost her savings in a bad business deal. At 45 three years after the doctors heard her story, she had accepted the fact that death confronted her any day (probably by a heart attack), and was "placid" and superficially contented.

Colonel James Sweeney of Army's Bushnell General Hospital has found that only 17% of his private and soldier patients have pressures over 140 (doctors do not get really worried until pressures are above 165). Dangerous pressures, he says, are extremely rare. In the Military Surgeon he remarks that men with high blood pressure usually feel pretty well and leave the doctor alone. It is the man with low blood pressure who always feels rotten, complains of all the ills that flesh is heir to --and lives to a ripe old age.

*The reading when the heart is contracted.

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