By Gilda Morales, ANP, DC
HYPERTENSION
There is a reason that hypertension, or high blood pressure is called the “silent killer.” Usually, there are no symptoms unless one’s blood pressure is exceptionally high, in which case, a headache may be present, but not always. Many times, patients are in denial, stating that they feel fine and are in denial. I always tell them that it’s very common not to have any symptoms until the stroke or heart attack.
There are several risk factors that can contribute to high blood pressure, including a family history of hypertension, smoking, alcohol use, being overweight, excessive use of salt and a sedentary life style. However, in many cases, there are no causative factors and the patient simply becomes hypertensive.
Although there are many kinds of medications available to treat hypertension, sometimes a lifestyle change such as losing weight and exercising may decrease blood pressure enough to avoid or delay medication. However, if lifestyle changes do not decrease blood pressure enough, then medication will have to be utilized for life to control it. Usually, first line medication for high blood pressure is a diuretic, or “water pill,” which serves to reduce fluid volume, thus lowering pressure, however it is not unusual for a patient to have to take multiple types of medication to get it under control.
A common mistake made by many patients is thinking that blood pressure medication only needs to be taken when they feel their pressure is high. However, any medication works best when taken at the same time every day. The consequences of not being compliant with blood pressure medication are serious and can include strokes and over time, congestive heart failure. This occurs when the heart chambers enlarge from having to pump blood under high pressures, causing the heart to work less efficiently and fluid to build up in the lungs and around the heart and lower extremities. This can lead to decreased perfusion of other organs like the kidneys, ultimately leading to kidney failure and multi-organ failure. The good news is that treatment is simple and effective if the patient is compliant with his/her medication and lifestyle changes.
