Responsibility – The case of Mr. Can

As scientists we all subscribe to methods where the answer seldomly lies in the story of one person. However, I still have a strong conviction that the sharing of personal experiences as part of peer-to-peer scientific discussion helps advance collective wisdom.

To illustrate the questions I want you to ellaborate on, I made up this fictive story.

Let me therefore tell you the story of Mr.Can. Mr. Can. is a 72-year-old retired man originally from East Africa. In his late teenage years, he moved to Sweden to educate and create a living. His family had spent their lifesavings to cover his travel-expenses to move abroad and pursue a better future. Despite the great pressure of living up to expectations, he knew that their destiny relied on him as well. Earning money equaled the survival and well-being of not only him but also his relatives.

I used to start the day with a double expresso at the coffee shop of the hospital lobby. That’s where I met Mr. Can the first time, many years ago. He often had his morning coffee before his regular visits with his healthcare team. I had noticed this dark, tall and smiling elderly man. One day he began a conversation with me about how his black decaf coffee was just as good as my double expresso, and how everything is about taking the right choices, especially when it comes to health. I guess that a person like Mr. Can would like my ambitions and approach to life, and I know that I would enjoy his determination, listening to his experiences and his positivity.

Mr. Can has had a lifelong career as a construction-engineer, which often meant working full days sitting behind his desk. He was also a soccer-player and up until his retirement he has played for 8 different teams, and coached several, and this has added plenty of physical activity to his relatively normal and healthy lifestyle.

One day we went for a hike, and I asked him about his passion, he mentioned his 4 grandchildren and soccer. Mr. Can told me that sitting in the stands at a soccer game is enough to make your blood pressure sky-high, between the stress of victory and the occasional alcoholic beverage.

Much to my surprise Mr. Can went on and confided to me that he was in fact diagnosed with a high blood pressure (Hypertension) at age 30, and had to start to rethink his health and his life. He had a stage 1 hypertension which is a elevated blood pressure, that refers to a systolic pressure of 130-139mm Hg and a diastolic pressure below 90mm Hg.

Mr. Can was asymptomatic meaning that he did not show any clinically signs of hypertension, yet he was diagnosed as hypertensive at the age of 30, at a yearly check-up at his doctor. And Mr. Can’s hypertension was most likely attributed to mainly heritable risk factors, as his father, uncle and son also have hypertension, so he was left with very few options to modify the situation by himself.   

Mr. Can explained to me, that it was a very tough choice for him to come to terms with likely danger to his heart health that the diagnosis presented and that his survival chances depended on his life-long acceptance of having a chronic medical condition which is what he chose for in the end.

I would like to give the story of Mr. Can a happy ending – he has successfully managed his blood pressure for the last 42 years, keeping it in a healthy range with the use of medication and regular visits with his healthcare team.

A story like this is to me very inspiring and pleasing, and makes a simple case for solving hypertension amongst us. Yet, why is it then that only an approximate of 1 in 5 adults (21%) with hypertension have it under control (WHO) and hypertension remain a major cause of death worldwide?

If we combine our knowledge or experiences, we might be able to accelerate the process of reducing hypertension – official goal is to reduce hypertension globally   by a third by 2030 so time is precious!

The story of Mr Can could make a good example of being responsible and taking several right actions in terms of living with hypertension, yet all stories are not alike, and therefore the question is still open- how can we optimize any given variable to reduce the overall prognostics of hypertension?

Hypertension is not only a personal health problem that many people live with, it is also a global healthcare burden and an immense economic burden for the society.