High Blood Pressure?

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May 3, 2013 by Dr. Becker

Do you have high blood pressure and not know it? High blood pressure, also known as hypertension, is the most common of the cardiovascular diseases. This condition is present in 30% of Americans and even more common in Alabama. Hypertension is the leading cause of stroke and heart attacks and is present in many people who are unaware of this condition. The only way to diagnose hypertension is to have your blood pressure checked. I recently gave a talk at a community gathering where blood pressure was screened for all people attending. Roughly 200 people attended and had their blood pressure checked and only a handful of them had normal blood pressures. Several people actually had blood pressure elevations in what I would consider to be a dangerous range, requiring immediate medical attention. One of the problems with high blood pressure is that it typically has no symptoms associated with it. Some people experience headache or a feeling of fullness or flushing; however, these symptoms often are not present and are not reliable. It is very common for people to live for many years with elevated pressure and never be aware of it. Often the first sign of untreated hypertension is a stroke or heart attack. In the meantime, the elevated blood pressure is causing considerable damage to the heart, blood vessels, kidneys, brain and eyes.

If your blood pressure has been checked and is 140/90 on two or more occasions, you have hypertension. If you have diabetes, a blood pressure over 130/80 is considered too high. There are many misconceptions about treating high blood pressure, such as the fear that starting blood pressure medication will make you dependent on it in some way. This concern is not justified. I find that frequently if people get serious with diet, exercise, weight loss and salt restriction, they can often discontinue blood pressure medication. There are many different categories of medications which can be used to treat high blood pressure and are chosen based on a number of factors including race, sex, age, and diabetes, as well as other factors. Many people worry that their blood pressure medication will cause side effects such as fatigue, frequent urination or erectile dysfunction. While there is potential for side effects with any medication, we can usually find a medication or combination of medications with minimal, if any, side effects. In our practice, we frequently see people with severely elevated blood pressures who have not been getting any regular medical attention. We will usually need to prescribe two or more medications in order to get the pressure adequately controlled. The only way we can adequately treat this frequently overlooked condition is by regular medical checkups, especially if you are over the age of 40, are overweight or have a strong family history of high blood pressure or heart disease.

Most of the time there is not a specific medical cause of hypertension. There are some rare conditions such as kidney disorders or tumors which can cause what we call secondary hypertension.  It is common for people to attribute high blood pressure to being under a lot of stress or that their blood pressure only goes up when they are in the doctor's office. While blood pressure varies throughout the day and can be elevated by conditions such as pain or certain medications, it still needs to be monitored and treated accordingly. More than 90% of the time when hypertension is diagnosed, we do not find a specific cause. Elevated blood cholesterol, while not directly contributing to hypertension, is often associated with it. The combination of hypercholesterolemia and hypertension magnifies the effect of both of these conditions and accelerates the damage to blood vessels which can lead to stroke and heart attack. If there is diabetes as well, the damage is magnified and accelerated even more. The only way to determine whether you have these underlying conditions is to come in and see us and let us perform a relatively simple evaluation. The evaluation includes a physical, blood work and an EKG. We have the opportunity to dramatically enhance the quality-of-life you can experience if you just let us help! Please do not be one of the people who walked around for years without seeing their regular physician for some simple yet important things that can help you lead a longer, healthier life.
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