Hypertension 3 – Causes/Diagnosis

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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)..

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