However one very interesting thing is that the new set of tablets that I am on don’t have this effect on the sort of Droop factor of being impotent. And it shows to me again that actually playing around with ones tablets, so one doesn’t have the ones that one doesn’t want is well worth while.

I think I was amused by how difficult it is to alter ones life style. I have always exercised quite a bit, I play tennis and am fairly active, I bike around, and I enjoy my food. I am not particularly overweight. I am 6ft 1 34 and I weigh about 14 stone, and they are quite compatible- slightly overweight but not huge amounts. So it wasn’t as if I was bulging out in every direction, and could lose stone after stone, and that would make things all right. So I did what I could only it wasn’t much when it came down to it. I probably could have tried harder. I was trying to lose weight and I did lose weight. It did have some effect on the blood pressure when my weight came down. I tried to give up salt. I actually use one of these potassium products – instead of sodium chloride, potassium chloride containing products. I am not sure how good they are. I never really did check up whether it works. Then again this is where the non scientific side of me as a doctor says ‘well I don’t care I am at least trying to do something.

I think that probably the art of having something like hypertension is to just get on. It is like brushing your teeth in the morning, it is something you have to do. But you want to interfere with your life as little as possible. I mean one of the things I really fear nowadays is the over-medicalisation of our lives instead of getting on and enjoying sunshine or doing nice things – reading books or writing books or whatever one enjoys doing – one will be sitting around clutched in the corner of a kitchen gazing at ones genomes or ones genes looking at what the future holds and thinking medicine, medicine, medicine- – –

You know it would be ghastly. One really wants ones GP and ones treatment and everything to be as low profile as it possibly can so one can get on and enjoy the rest of life.

It’s not a very sort of ‘get together’ thing like perhaps breast cancer or something might be in women where they would share experiences. Men are not good at sharing experiences anyhow and I think that most men would tend to pretend that they don’t have it to their colleagues. I am amused when I meet my male colleagues who also are on anti-hypertensive treatment and I do find it reassuring in a way that I am not alone, and we do share experiences. ‘What anti-hypertensive are you on?’ And ‘Do you find it has this effect, or do you get impotent on it?.

This is sort of a little aside on it because I think it is a continual worry. But it is very rare – once a year or something I will meet a colleague who has it.

They had 24 hour monitoring devices at my local hospital and I thought yes I would have that. It would be nice to know- – – I thought amusing at least to know what affected my blood pressure. Did I get up with it in the mornings? Or did I just get blood pressure when I was exceedingly stressed or angry? And I thought it would be particularly fun to see if in fact when driving whether road rage shoved my blood pressure up. And so I had these 24-hour monitors. I had a couple of them and yes they did show great variation actually during the day.

I can’t remember what seemed to put it up, but it was interesting that ones blood pressure didn’t seem to be flat 24 hours a day, it seemed to vary a huge amount. And that was also true when I went to the doctor and had my blood pressure taken. Always my first blood pressure, when it was taken, was higher than my second one. So there did seem to be quite a lot of variation according to my mood at any one time, or anxiety at any one time.

I have bought myself one of those sort of automatic monitors from Boots which sort of clings onto my arm, makes a funny noise, pops up and decreases. Again I haven’t checked up on the literature to see how accurate these automatic sort of blood pressure machines are. But actually taking my own blood pressure from time to time has been the most convincing thing that I do actually need to have anti-hypertensive tablets. Everytime that I stop taking them for a variety of reasons- running out or deliberately giving them up for a time – I find that on the automatic blood pressure taking machine it goes up. In some way that’s convinced me more than anything else.

The pills I was started on were called ACE inhibitors and the brand name was called Caposide. And it actually also contained a diuretic. Now a diuretic makes you pee and I took the tablets in the morning and it made me pee. And it had the beneficial side effect that if it made me pee a lot during the day I didn’t pee so much at night so I didn’t have to get up so much at night. And it did definitely have a marked effect. I mean you did know once you had taken the tablet that it was a diuretic and you had to rush off to the lavatory several times over the first few hours. Particularly if you hadn’t been taking them for a bit.

The ACE inhibitors on the whole I thought were good. I mean they controlled my blood pressure for a long time. They did have a droop factor so to speak- one still had the same sex drive it’s just that ones performance certainly was affected. And that did begin to get to me after a time. And these again were in pre-viagra days so one has nothing to sort of compensate for it and it began to worry me as to whether this was going to be the end of my sex life- – – even although I still wanted to make love.

I think my children, since I have had hypertension, do see me as being a bit more vulnerable than I was before. They gaze anxiously at me and do make remarks from time to time. If I am enjoying a cigar or something, they give an, ”Is that good for you Dad?’ sort of attitude. I say, “Oh go away stop reminding me about these things”. I don’t think they are over-anxious about it but it does go back to the medical aspects of life interfering with the best things in life I think. It is very difficult, it is a balancing act to do things you have to do but at the same time not let them impinge upon your life.

There came a time about three years ago when even taking the tablets my blood pressure wasn’t being controlled. So, what should I do? Because I was happy with these tablets, I had sort of reached an equilibrium where it was acceptable. So I had to reassess with my GP that this lot of tablets- the ACE inhibitors – weren’t doing any good. I actually saw a different GP this time around, in the same group practice, who had slightly different opinions on the whole thing. This was somebody who was very expert on the computer and he brought up loads and loads and loads of alternatives.

I was rather overwhelmed with the choice by this stage. ‘My god do I really have to chose?’ So we did discuss the alternatives and it ended up with him suggesting what is called an alpha blocker and I can’t remember actually the trade name for it but I tried those and they had the most extraordinary effect on me. I mean I walked around in a daze for weeks. I had to go up to London to lecture and I suddenly found myself in Paddington station, I didn’t recognise where I was almost. I mean I could just about if I really concentrated hard at feeling where I was. It wasn’t the sort of thing that you wanted to lecture on very much.

Now I am very aware that there is huge variation between people and how they interact with medicines, so I wasn’t totally surprised. Even with tablets for migraine I realise that some work and some don’t work – that some work with some people and some work with others. And so when these alpha blockers had this effect on me I didn’t really panic. I thought ‘oh god that’s one well put off the menu completely.

I think that once you have got hypertension there is the knowledge it is going to be there for a lifetime. I am not sure other than if one loses weight, exercises very well, gives up all salt one might bring it down a bit. But the fact is I think in my own situation it is a kind of titration. I still want to go on doing the things I really enjoy doing and I know that I am going to have blood pressure for lifetime so I am aware that this pill taking is going to go on really until the end of my life.

It’s very difficult from time to time, if ones got hypertension, not to relate symptoms to it. Every time that I get a headache – although I have read some literature which suggests that headaches and hypertension are not necessarily associated – every time I do get a headache, and I am quite a headachy kind of person in the first place, I tend to think ‘oh it’s my blood pressure.

I do think there are different types of headache and I think I have now begun to recognise if I haven’t taken my tablets for a bit if I sometimes do get a headache that I will think ‘Ah that is a hypertension headache.

That’s because I haven’t taken my tablets but I don’t check my blood pressure and associate directly with the headache. I have always suffered with migraine and cyclical headaches. The cyclical headaches have tended to go away, but now I do think I get probably something to do with the hypertension, because certainly when I am taking my tablets I get less headaches.

Well there are two factors affecting my pill taking in this area. I am extremely forgetful – I don’t think it is Alzheimer’s and I hope it’s not Alzheimer’s – I just lead a very busy life and one just forgets. But there is a factor that every time one takes the pill it reminds one that one is less than perfect. One has hypertension and I hate that.

I hate the fact that every time I see those damn pills the association appears – ‘you have got hypertension and if you don’t take me you are going to continue to have it. It is a kind of continuous reminder of vulnerability. It is not it stops one from taking tablets, it just makes one less driven to remember to take the things. And I yes I did try and do without them from time to time also, and to check my blood pressure and see if I still needed them. I always did unfortunately.

I think that I tended rather than just get a repeat prescription I would actually go and see my GP because I wanted to have my blood pressure checked because I didn’t actually have my own sphygmomanometer at that time and I probably wanted the reassurance that I need the tablets before getting more tablets. And my blood pressure would be up because I hadn’t actually been taking the tablets for a fortnight say and bang I would start off using them again, have my blood pressure checked on the tablets and yes it was lower’ so I was reassured ‘yes I should be taking these tablets.

I bullied my doctors to look for something that I only had to take once a day. That was very important to me in my treatment of my hypertension. I just knew that I wouldn’t be able to remember to take tablets more than once a day. I have got my present tablets are meant to be taken only once a day – I think, but I haven’t inquired too carefully to find out. I am just assuming that if I take them in the morning they will control my blood pressure during the day, and if they don’t do it so well at night then I am resting at night and maybe my blood pressure is a bit lower at night anyway so I don’t need them so much. I saturate my surroundings with tablets. I have them in my bag I have them everywhere I can think. I still manage to always find that I’ve run out wherever I am.

I do feel that I am a sort of hypertensive character. A type ‘A. I am quite hyperactive and quite compulsive. I am a finisher. I like doing things. I do see myself very much as a type of person who is likely to get hypertension. I am a little bit obsessive – probably my friends would say I am very obsessive.

I actually found out that I had high blood pressure completely coincidentally. It was about 10 years ago, I was lecturing in Blackpool to the Health Visitors Association and there was a huge great exhibition of medical equipment and all sorts of

things and there was this – I say now wretched- stand, because I really wish I hadn’t done this, but there was this stand where they had these automatic blood pressure measuring machines. Where the machine sort of pumps up your blood pressure and measures it. So I thought ‘oh well it’s fun I’ll just try this out’ And I tried it out and it was something absolutely appalling like 180 over 120.

And I couldn’t believe it. At first I was convinced that it was a machine that wasn’t working. So I tried a couple more times. I didn’t actually tell the people on the stand what it was, I kept it to myself and sort of rushed off with this knowledge that I obviously did have hypertension and I strongly objected to the fact of having the knowledge- – – I mean I would much rather not have known about it in a funny kind of way. There is a kind of dilemma in that. Once one does know about it one has to do something about it. Especially being a doctor. But I would rather not have found out. I think I would be able to live much more happily not having found out.

However, having found out, when I got back I went to see my General Practitioner and talked to him about it and he took my blood pressure again. And yes, there did seem to be a problem.

I had a number of alternatives, and I knew these alternatives. I could lose weight, I could try and give up salt, I could take lots of exercise and see if that had any effect on my blood pressure. So I did what I could only it wasn’t much when it came down to it.

I probably could have tried harder. It finally became obvious that I would need to go on tablets. My blood pressure had stayed up. I mean I think that at the best it was about say 160 over 110 or something and it was apparent from the medical literature that I had read and from what I knew that it probably would be a good idea if I actually accepted some treatment.

Well there wasn’t any family history of hypertension that I knew about at all. My father died at the age of 65 from a heart attack, and I have an older brother who had a heart attack when he was about 35 years old, so I have been rather conscious of family history of heart problems. But I think having said that, I really was quite busy putting it out of mind. I am the kind of doctor who really is fairly cynical about medicine up to a point and certainly I tend not to think about these things as they apply to myself.