Hypertension 3 – Causes/Diagnosis


It’s another long weekend here in Trinidad and Tobago! But before enjoying the relaxation let me push a little further into our discussion on hypertension.

It slipped me to mention in my previous blog about other causes of hypertension. While the vast majority of cases of hypertension, about 95%, are called ‘essential hypertension’ where the cause is not really known and has something to do with the kidneys, 5% of cases of hypertension actually have an identifiable cause.

A red flag goes up especially in younger individuals who may develop a variety of conditions which may be hormonal, renal or otherwise, which may be associated with ‘secondary hypertension’. These include polycystic kidneys, nephrotic syndrome, phaechromocytoma and thyrotoxicosis among others. Doctors ought to actively search for a cause in younger persons.

… So you’ve heard a bit about hypertension. Suppose you would now like to discover if you have this silent killer or not, how is it done? Well checking blood pressure is so easy nowadays we are without excuse. You can check at the hospital, health centre, doctor’s office, pharmacy, at a friend’s, at home.

You can use older methods that require someone with a sphygmomanometer and stethoscope or you can do it all by yourself at home with a completely automated device. I advise all my hypertensive patients to get a blood pressure gauge at home because they are generally affordable and they can better alert their doctor as to what is happening with their blood pressure.

Diagnosing hypertension is a slightly different matter. It should not be done based on one reading unless the blood pressure is extremely high. A few readings ought to be taken and the average used. Remember we spoke about how your blood pressure could be temporarily elevated due to different states of the individual (increased physical or emotional activity). One would not want to mistake one of these readings for hypertension so a number of readings should be taken to get a true picture.

I advise my patients to take their blood pressure when relaxed so we can get the best readings. Current guidelines recommend being seated quiet for 5 minutes prior to checking it.

We’ve heard these figures over and over but we must try to remember that an elevated blood pressure is equal or greater to 140/90. Over 160/100 is severe hypertension. 120/80 and under is ideal. Next time I’ll tell you what these figures mean. It’s real simple.

I would like to remind everybody that one isolated elevated blood pressure does NOT kill. Some people panic and get stressed when they hear their blood pressure is high. What we need to do is repeat it. If the high reading is the trend then we need to treat it. But the great thing is, WE HAVE TIME! High blood pressure does not cause its deleterious effects after one day, after one month ore even after one year. It is a chronic illness and it takes YEARS for the effects to be seen so we have time to get it right and control that blood pressure.

Next time our main chat will be about treatment. … I’m thinking of going to Cedros, at the south-western tip of the island for the holiday. Usually calm sea waters for me to find peace and meditate. Also a place where I was the community doctor, so I’m known there. Let you know if it happens (keeping my fingers crossed)..

Hypertension 2 – Causes


Hello there. This is Dr Louella picking up the discussion where we left off. I must, of course, say a special hello to my peeps in Trinidad and Tobago. In the previous post I discussed about hypertension (high blood pressure) and that it really does not have any symptoms. Blood pressure is the force or pressure the heart gives the blood when it pumps.

Today I would like to touch on what causes high blood pressure. Well our kidneys are what set the level of our blood pressure. In hypertension something in that mechanism goes wrong, they’re still not too sure what, causing our blood pressure to be set at a higher level.

Now normally a person’s blood pressure fluctuates based on their physically activity and the emotional state they are in. This makes sense. When you exercise, your heart beats harder and faster, thus elevating your blood pressure. When you’re in an argument with someone, you find that your heart is pounding. When we are stressed, our blood vessels constrict, increasing the pressure of the blood flowing through it. I have seen people’s blood pressure go through the roof when they’re in extreme pain.

But all of these are temporary states. The body requires more blood to reach the various organs and it does so by increasing the blood pressure. In fact, if our blood pressure does not increase at these times to meet the demands, we would be in all sorts of problems. When the state is removed the person’s blood pressure comes back to normal.

A person whose blood pressure comes back down to normal after a brief period of elevation due to an identifiable cause, does NOT have hypertension. A person whose blood pressure is elevated most of the time when relaxed, does. You can now understand the value of monitoring blood pressure over a period of time and not making a diagnosis based on one reading. Also since emotions and activity affect blood pressure, the value of being relaxed when taking a reading.

I am always in amazement that, in Trinidad at least, medical professionals get so hung up on a person’s blood pressure no matter what the principal complaint. If a person is really sick, they’re going to be stressed and their blood pressure will rise. Treat the illness. I say that in the context that ONE high blood pressure rarely kills. We have enough time to deal with that.

Well, this is Dr Louella, signing out. We have a lot more on this topic but another day. I hope you learned a little something that you can apply to your life and make it better. Ciao!

Hypertension 1 – Symptoms


The pumping action of the heart creates a pressure and circulates the blood.

Hello everyone. This is Dr. Louella and welcome to my blog site. It’s is a calm evening here in Trinidad, the land of calypso. I want to talk to you about something I so frequently encounter in my family practice: hypertension or high blood pressure. While it is a very common disorder, many people still do not understand the basics of high blood pressure.

Firstly, blood pressure is derived from the pumping action of the heart as it forces blood into large blood vessels. This causes the blood circulate to around our bodies and the force with which  the blood flows is called the blood pressure. Just as we are unable to feel the blood circulating around our bodies, we are unable to feel our blood pressure.

A common myth in Trinidad is that high blood pressure causes neck pain. It would be much more appropriate for persons to think that perhaps they are stressed (or in some cases, have a neck strain) causing tightening of the neck muscles and hence the pain. Stress is a frequent cause of pain to the back of the neck. Knowing this, persons would be less likely to run to have their blood pressure checked (or God forbid, to run to take a blood pressure pill) when a neck pain occurs, and more likely to stop, figure out what is stressing them and come up with solutions.

Had they checked their blood pressure, however, it may very well have been high. But this high blood pressure reading is more likely to be as a result of the stress or pain (or as a result of chronic delinquency in taking their medication) and not the cause of their neck problem. In other words, stress and pain, can both raise your blood pressure temporarily . But they are not the cause of hypertension. If they bothered check, someone who frequently misses his or her high blood pressure medicines is likely to find that their blood pressure is high even when they don’t have a neck pain.

So what really causes hypertension? And what myths about high blood pressure are deceiving you?

Stay tuned, I’ll teach it all. But you got to talk to me!!! Questions and comments. I will give it in bite sizes for you to digest this knowledge and act on it to make healthier choices. Here’s to life! Later!!!