Problem Statement :
Recent population based studies have shown of the three poeple walking on road in th productive age group(20-60years of age ) one has hypertension i.e 1/3 . That figure increases to one in two as the age advances above 40years and ahead. (http://www.whoindia.org/LinkFiles/NMH_Resources_National_CVD_database-Final_Report.pdf)
Story:
I would like to introduce all the blogs with story of one my patients and questions they asked me, so that even you may find your answers.
Mr Vijay(Name changed for privacy) , 42 years old gentleman works for a reputed MNC at administrative post. He was apprently well 4days back when he developed sudden episode of inability to speak or write and mild paralysis/weakness of the right hand which improved completely over a period of 30minutes. He was seen by us on the same day, investigated. He was told that he had minor stroke as his MRI was showing some lesion. He did not have family history of similar events. He was smoker and noted to have hypertension. His rest of investigation were reported to be normal. He was discharged after 3days. While discharge we had chat with him to know his views and doubt. We allied his fears of recurrence.
Mr Vijay: what is hypertension? why did i developed it ?
Dr: here the word tension means the pressure in the blood vessels,
some amount of pressure is reqiured to push the blood from the heart to variuos part of body uniformly.
This is generated by property of the Heart and blood vessel tensile strength.
it is controlled by varoius known and unknown factors in the blood and blood vessels.
It usually increases while doing physical activity, during cold season, hightened emotional states but immeditely is controlled automatically by the body.
But when these controlling mechanism fail there is a steady increase in blood pressure.
This increase in blood pressure if mild early may not cause any external symptoms for the patient who may not have any problem. outside But will develop problem in long run.
Because our body has ability to bear this increased tension to some extent but the organs like heart, kidneys, eyes and brain get slowly affected.
The normal blood pressure range is 90-130 for the systolic(upper) blood pressure and 60-80 for diastolic ( lower) blood pressure. When ever any doctor tells you about blood pressure he mentions to values upper and lower in simple langauge. Both are equally important. By increase in blood pressure it means systolic above 130 and diastolic above 80. When it reachs above 140/90 we call them hypertensive. But the target changes if patient has both diabetes and hypertension then above 130/80 is considered as hypertension.
Myth: with age, blood pressure increases and we dont have to treat it.
Truth: Any increase of blood pressure at any age has to be treated by doctor.
Well for the reason why it happened to you it is a very difficult question there is interplay of various genetic/polygenetic and environmental factors, the environmental factors consist of the stress related to work family for long duration, excess salt intake, smoking, excess alcohol intake, improper sleep due to work or snoring etc. The genetic factors are equally myraid and are still be explored. If family history is positive in one or more family members first degree that is father, mother, siblings then more likely to have it. Its the loss of balance between the protective and increasing factors. Like in your case smoking could be the cause.
Mr Vijay: How can I treat it?
Dr: As we talked yesterday about the circle approach (Refer to the contents ---blog post)
you should know about the disease, exercise, diet and drugs this four pronged method can help you.
Mr Vijay: Which drugs are best?
Dr: There is no fixed receipe , it has to be taken with consultation of cardiologist or Internal medicine consultant i.e MD Physician.
Usually few test will required before start of treatment. I
f the problem is mild that is 140-160 systolic then you doctor might ask
life style modification ( to be elaborated in coming blogs ) and see for next two three months
if the blood pressure is controlled then viola no need of medication
if not controlled then we have to start some medication.
we are starting medication in your case because your admission blood pressure was very high and its persisting to be high we have started two medication for you. Now your blood pressure is controlled.
Mr Vijay: What should I do prevent further problem?
Dr: This is best question you have asked.
Because this suggest that you are motivated
as motivation on the part of the patient is of utmost important for successfull treatment.
The first and fore most advice is stop smoking
and follow the instruction given by the doctor.
Check your blood pressure first every 15days for first 6mnths
so that if it is more than you report to your physician and make changes.
Once your blood pressure is controlled then a monthly blood pressure log would be good
always make it a note in you treatment book or separate notebook.
Mr Vijay : Thank you doctor
Dr: My pleasure
Recent population based studies have shown of the three poeple walking on road in th productive age group(20-60years of age ) one has hypertension i.e 1/3 . That figure increases to one in two as the age advances above 40years and ahead. (http://www.whoindia.org/LinkFiles/NMH_Resources_National_CVD_database-Final_Report.pdf)
Story:
I would like to introduce all the blogs with story of one my patients and questions they asked me, so that even you may find your answers.
Mr Vijay(Name changed for privacy) , 42 years old gentleman works for a reputed MNC at administrative post. He was apprently well 4days back when he developed sudden episode of inability to speak or write and mild paralysis/weakness of the right hand which improved completely over a period of 30minutes. He was seen by us on the same day, investigated. He was told that he had minor stroke as his MRI was showing some lesion. He did not have family history of similar events. He was smoker and noted to have hypertension. His rest of investigation were reported to be normal. He was discharged after 3days. While discharge we had chat with him to know his views and doubt. We allied his fears of recurrence.
Mr Vijay: what is hypertension? why did i developed it ?
Dr: here the word tension means the pressure in the blood vessels,
some amount of pressure is reqiured to push the blood from the heart to variuos part of body uniformly.
This is generated by property of the Heart and blood vessel tensile strength.
it is controlled by varoius known and unknown factors in the blood and blood vessels.
It usually increases while doing physical activity, during cold season, hightened emotional states but immeditely is controlled automatically by the body.
But when these controlling mechanism fail there is a steady increase in blood pressure.
This increase in blood pressure if mild early may not cause any external symptoms for the patient who may not have any problem. outside But will develop problem in long run.
Because our body has ability to bear this increased tension to some extent but the organs like heart, kidneys, eyes and brain get slowly affected.
The normal blood pressure range is 90-130 for the systolic(upper) blood pressure and 60-80 for diastolic ( lower) blood pressure. When ever any doctor tells you about blood pressure he mentions to values upper and lower in simple langauge. Both are equally important. By increase in blood pressure it means systolic above 130 and diastolic above 80. When it reachs above 140/90 we call them hypertensive. But the target changes if patient has both diabetes and hypertension then above 130/80 is considered as hypertension.
Myth: with age, blood pressure increases and we dont have to treat it.
Truth: Any increase of blood pressure at any age has to be treated by doctor.
Well for the reason why it happened to you it is a very difficult question there is interplay of various genetic/polygenetic and environmental factors, the environmental factors consist of the stress related to work family for long duration, excess salt intake, smoking, excess alcohol intake, improper sleep due to work or snoring etc. The genetic factors are equally myraid and are still be explored. If family history is positive in one or more family members first degree that is father, mother, siblings then more likely to have it. Its the loss of balance between the protective and increasing factors. Like in your case smoking could be the cause.
Mr Vijay: How can I treat it?
Dr: As we talked yesterday about the circle approach (Refer to the contents ---blog post)
you should know about the disease, exercise, diet and drugs this four pronged method can help you.
Mr Vijay: Which drugs are best?
Dr: There is no fixed receipe , it has to be taken with consultation of cardiologist or Internal medicine consultant i.e MD Physician.
Usually few test will required before start of treatment. I
f the problem is mild that is 140-160 systolic then you doctor might ask
life style modification ( to be elaborated in coming blogs ) and see for next two three months
if the blood pressure is controlled then viola no need of medication
if not controlled then we have to start some medication.
we are starting medication in your case because your admission blood pressure was very high and its persisting to be high we have started two medication for you. Now your blood pressure is controlled.
Mr Vijay: What should I do prevent further problem?
Dr: This is best question you have asked.
Because this suggest that you are motivated
as motivation on the part of the patient is of utmost important for successfull treatment.
The first and fore most advice is stop smoking
and follow the instruction given by the doctor.
Check your blood pressure first every 15days for first 6mnths
so that if it is more than you report to your physician and make changes.
Once your blood pressure is controlled then a monthly blood pressure log would be good
always make it a note in you treatment book or separate notebook.
Mr Vijay : Thank you doctor
Dr: My pleasure
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