Hypertension 4 – Complications


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Hi guys. It’s Dr Louella again. We need to wind up on hypertension but first I must report that I did not make it to Cedros (Trinidad) for the holiday, as I had no company for the two hour drive. But there’s gonna be a next time!

Well so far we’ve been through the symptoms, causes and diagnosis of hypertension and it’s time to get to the bottom line of how to treat it. But not quite. Because the problem with many people is that they don’t fully understand WHY we treat hypertension.

And why is that so? … If you recall, hypertension has no real symptoms. It does not make you feel sick. So in many people’s minds they do not really see the need to take medication when they are not sick. Many of them only take meds when they think their blood pressure is high. But there is no way to know without testing and you cannot test 24/7.

Once your blood pressure is higher than the ideal level of 120/80 your blood vessels are traumatized by the pressure of the blood flow and gradually, over months and years, the inner lining of the blood vessels is damaged. This can lead to thickening of the blood vessel walls by increase in the muscle content in smaller blood vessels and by cholesterol-filled atherosclerotic plaques in larger vessels.

Atherosclerosis is hardening of the blood vessel walls by the growth of plaques which are filled with cholesterol. The picture below shows the progression.

From: cdc.gov

Once thickening of blood vessels occurs, the lumen or passageway of the blood vessel narrows so less blood can flow through it. This especially affects blood vessels in the heart and brain causing ischaemic heart disease, which may lead to heart attack, and stroke.

People with ischaemic heart disease usually suffer with recurrent chest pain due to poor blood supply to the heart.  During a heart attack the blood supply is cut off completely and part of the heart dies. This may result in sudden death of the individual or they may have to live with a severely weakened heart.

There are other ways hypertension can damage the heart. The high pressure of the blood can put a strain on the chambers of the heart as they contract leading to thickening of the muscle of the largest chamber, the left ventricle. This becomes stiff and less able to contract. It is further weakened by the poor blood supply in the narrowed arteries. Finally, the heart muscle starts to stretch and can no longer perform its function.

The description above is that of heart failure and is usually accompanied by an enlarged heart. The heart muscle in heart failure does not have its full strength and the heart cannot properly perform circulation of the blood without the help of medication. The individual often suffers with extreme fatigue, shortness of breath and/or swelling of the feet.

Ok! That’s a mouthful. As we can see, hypertension causes some major problems in the heart. Next week we’ll finish these complications. We have not yet spoken about a big one, stroke. I will share my own personal experience with this awful disease. See you then!

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