High Blood Pressure

Have you heard the phrase "silent killer?" Well I use it a lot of times to speak to patients who have uncontrolled high blood pressure, or hypertension, who don't necessarily feel bad so they are not convinced their blood pressure needs to be treated. 

High blood pressure, depending on how high it gets, can cause symptoms of headaches, can even set people off into what we call pulmonary edema (fluid in their lungs) depending on how high that blood pressure gets causing vascular resistance that the heart has a hard time working against and subsequently fluid backin up in the heart.

Most of the time though it doesn't cause symptoms, it's elevated until that crushing chest pain, stroke or kidney disease diagnosis comes in unexpectedly. 

This is why going to visit your Doctor is important, getting your screening done and understanding the risk factors.

One of the most common concerns I get from patient's is "once you start me on the medication my body will get used to it and I can never come off." 

Here are some reasons one may never be able to come off

*Genetics-they play a big role in our hypertension. This is one reason people live longer we are able to use medication to override the negative effects of some of our genes that are "out to get us." Some of the genes may have been protective in the past for our ancestors but today they may not be and therefore we use medication to help curb the negative effects.

*Unable to make lifestyle changes- if some of the lifestyle changes are to loose weight are difficult and not realistic we will likely continue to need that medication. So if adherence to better eating habits and weight loss are not successful then naturally medicaiton is the necessary means to prevent a stroke until the patient is able to achieve that goal.

*Stress- unable to change your stressful job or learn new coping skills through therapy may pose a challenge to coming off of medicaiton. The good news is sometimes we can use a medication that can help with some of the anxiety and blood pressure!

*Other diseases- there are other diseases that can cause blood pressure to be elvated. Some patients have conditions that are not curable and one of the other damaging effects of that condition is hypertension. While I am all for diet and exercise as a first line to improve high blood pressure usually these patients are not able to control their pressure as they have another underlying process causing this. 

Sometimes high blood pressure is permissable. For certain age group a little elevation of blood pressure may be beneficial. The 90+ study showed developing an elevation of blood pressure in the age group 80 to 90 may be beneficial to preventing development of dementia! (Please check with your Doctor first before deciding this).

What if I don't control my Blood Pressure?

Well that's a risk! And one that may have irreversible consequences! Here are some things that could go wrong.

*paralysis from stroke
*inability to communicate from stroke (check out locked in syndrome- I actually had this happen to a patient while in residency so it does happen!)
*kidney damage-sometimes leading to need for dialysis few times a week. Once patients are placed on dialysis due to the seriousness of the disease their life expectancy goes down severely. Not to mention time lost spendign it in a dialysis center.
*Increased risk of cataracts
*Damage of the retina (eyes have small blood vessels so they are easily affected by uncontrolled blood pressure). 
*Heart failure. Long term uncontrolled high blood pressure remodels your heart, first enlarging it then weakening the muscle fibers loosing the contractility and leading to a slew of problems. That in itself is a lecture! Your heart is a pump necessary for living so affecting this is extremly dangerous. 

These are just a few of the bad things that can come out of not having controlled blood pressure. 

What are some lifestyle modifications one can try?

*weight modification. Weight loss is very important. Now a days we have safe medicaitons that can assist with this as well. But we know that loosing weight can significantly improve blood pressure for certain candidates. I've been able to get people off of three different anithyprensive medications just by helping them with their weight loss journey!

*DASH diet-diets rich in fruits and vegetables, low infat dairy should just be part of everyone's standard diet. A quick pintrest google of dash diet is bound to get you some awesome recipes!

*Reducing sodium, this is particulary helpful in certain race groups! Less than 2.4grams of sodium per day and less than 6grams of sodium chloride per day.

*Exercise-not only good for blood pressure lowering, but for stress control and increasing those feel good hormones. You might even notice sleeping better! Aim for 30 to 40minutes of moderate exercise activity at least 5times per week. More if you are trying to loose weight. 

*Avoid certain medicaitons. Chronic use of NSAID's such as ibuprofen, aleve, etc can cause blood pressure to rise and lower extremity swelling. 

If you have high blood pressure avoiding some of the over the coutner protducts like Clairitn D or Zyrtec D is improtant. Talk to your Doctor to learn what you can or can't take.

I hope this has shed some light on high blood pressure. If you would like to read more here are some links!

Don't forget to check my instagram page out at @crescentdpc

https://www.ahajournals.org/doi/10.1161/HYPERTENSIONAHA.117.09335

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4046467/