As we age and develop arteriosclerosis, or hardening of the arteries, the vessels lose their elastic properties. The systolic pressure may rise but the diastolic pressure remains only slightly above normal. This form of hypertension does not often require treatment.
A persistent rise in pressure is either primary or secondary. Primary or essential high blood pressure is by far the commonest and the cause is unknown.
We know there is an hereditary factor, as it tends to run in families and is often associated with being overweight. A high salt intake is another factor thought to play a part.
Essential hypertension may occur in the young but becomes more common after the age of 40. It affects women more than men but is more severe in the latter.
It is a slowly progressive condition and may not cause symptoms until it has been present for many years. Occasionally, in less than one per cent, it rises rapidly and causes severe and dangerous symptoms and, if untreated, may cause death. This is called malignant essential hypertension.
*435/71/1*
The Achilles tendon comes from the calf muscles at the back of the leg and attaches to the heel bone.
It is named from Achilles, the son of Peleus in Greek mythology. His mother, Thetis, dipped him in the river Styx when he was a baby, so as to make him invulnerable. His only weak spot was that part of the heel where she held him and which was not bathed by the waters.
Eventually, after the battle of Troy, he was slain by an arrow, shot by Paris, which hit him in the heel. We use the term «Achilles heel» to mean a weak spot in someone’s personality.
Injury to the Achilles tendon is a common injury suffered by sportsmen, particularly squash players.
The modern mania for jogging is producing a new crop of sufferers.
Complete or partial rupture of this tendon may occur. Adequate rest is necessary for healing and the injury may be treated by placing the foot in a plaster boot for about eight weeks, then raising the heel about 2 cm (1 in.) for a further four weeks. Early operative repair of a ruptured tendon also gives good results.
In the past, sprains of this tendon were often treated by an injection of cortisone. This has been abandoned, as sometimes complete rupture of the tendon has followed.
Those taking high doses of cortisone for some other condition have occasionally suffered a spontaneous rupture.
Athletes, and particularly those going back to active sport after many years, should pay particular attention to warming-up and stretching exercises.
One exercise to stretch the calf muscles and Achilles tendon is to stand about one metre away and stretch out the hands to touch a wall. The elbows are then bent so that the body rocks forward, keeping the heels flat on the ground. This position is held for 10 seconds.
*181/71/1*