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Jan
08

Hypertension (High Blood Pressure): Part 1 of 2

This column is a monthly feature of “Health & Exercise Forum” in association with the students and faculty of Geisinger Commonwealth School of Medicine (formerly The Commonwealth Medical College).

HYPERTENSION (High Blood Pressure): Part 1 of 2

 

Guest Authors: Michael Ambrose and Christian Bohan
3rd Year Medical Students at Geisinger Commonwealth School of Medicine (GCSOM) collaborated on this column.

Michael Ambrose, MD3, is from Coopersburg PA and attended college at the University of Scranton and is now a 3rd year medical student at GCSOM. His future interests include Emergency Medicine and cardiology.

Christian Bohan, MD3, grew up in Danville, PA prior to pursuing a degree in Neuroscience at the University of Pittsburgh. He is currently interested in neurosurgery and continues to enjoy learning about the different fields of medicine. In his free time, Christian can be found pursuing his interests of travelling and photography.

75 million people in the United States have been diagnosed with hypertension and hypertensive related diseases are the leading cause of death. Hypertension, otherwise known as high blood pressure, is defined as a constant elevation of blood pressure as opposed to a quick response to a stressful situation. A “normal” reading is 120/80 but can also be higher or lower based on an individual person’s body. A systolic pressure (top number) over 140 and a diastolic pressure (bottom number) over 90 is considered stage 1 hypertension. Usually, blood pressures below 140s/90s do not need to be treated medically, if you are less than 60 years old.

The purpose of this article is to bring awareness to the severe consequences associated with hypertension and the importance of regular checkups, early diagnosis, and treatment.
Perhaps the most obvious organ affected by hypertension is the heart but how exactly is it affected? There are two main diseases associated with the heart: coronary artery disease and congestive heart failure. Coronary artery disease is the narrowing of the vessels that supply the heart itself with blood. This can be caused by hypertension through turbulent blood flow which causes cholesterol to stick to the surface of the blood vessels. If one of these cholesterol plaques ruptures, it can cause a blockage in one of the coronary arteries, which would cause a heart attack. This is different from congestive heart failure, which is essentially the inability of the heart to pump enough blood to meet the energetic demands of the body (the heart gets tired). With increased blood pressure, the heart has to work harder to pump the same amount of blood through the system. Eventually the heart won’t be able to keep up, which will result in symptoms of fatigue and shortness of breath which gets worse with slight exercise such as walking up stairs.

Although not as obvious as the heart, the brain is also an organ that is severely impacted by hypertension. Although more blood to the brain may sound like a good thing, there are severe consequences involving the vessels. A stroke is caused when a part of the brain does not receive enough blood flow for a period of time. This can be caused by a blockage in an artery which prevents blood from getting to the tissue or it can be caused by a bleeding vessel which reroutes the blood away from the tissue that needs it. The first consequence is called an ischemic stroke, which means that part of the brain loses blood flow due to a blood clot causing an obstruction in the artery. This is associated with hypertension because turbulent flow is associated with clot formation. The second consequence is called a hemorrhagic stroke which occurs when the smaller arteries rupture (from increased pressure) causing bleeding within the brain. In both cases the result is the same: blood doesn’t reach its target and brain cells die.

The kidneys are another organ that can be affected by high blood pressure. This may not be obvious until you understand that the function of the kidney is to filter all of the blood in the body. In order to filter the blood effectively, the kidneys have a lot of tiny blood vessels that can be damaged from too much pressure. Over time, when high blood pressure is not kept in check these arteries can narrow, weaken or harden. When this occurs, the kidneys lose their ability to filter blood, leaving toxic substances in the body. What makes this even worse is that the kidney is also responsible for regulating blood pressure which can potentially make the hypertension worse.

High blood pressure also has adverse effects on the eyes. The eyes have small blood vessels and for the reasons we mentioned earlier, these vessels can be damaged with high blood flow. When the eye does not receive enough blood flow, the cells die causing blindness.

While this seems intimidating, there are steps you can take to decrease your blood pressure and lower your chances of developing these diseases. Perhaps the most important is regular monitoring of your blood pressure. You can do this by having regular checkups with your doctor, getting it checked at local pharmacies and there are even devices available for use in your own home. If you notice that your pressure is high, be sure to let your doctor know so you can come up with a plan to lower it. First and possibly the most important step in lowering blood pressure is diet and exercise. A low salt and low fat diet can help lower and keep it down at a manageable level. Aerobic exercise for 30 mins a day for at least 4-5 days a week is recommended to keep your heart healthy which further helps with maintaining a good blood pressure. Other steps you can take include limiting use of tobacco products and alcohol. If these methods aren’t adequate to lower your blood pressure, talk to your doctor about including medication into your care plan.

In conclusion, hypertension has a lot of widespread consequences but with diligent care, it can be easily

Visit your doctor regularly and listen to your body.

NEXT MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!” Part 2 “Hypertension”

This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com

Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at Geisinger Commonwealth School of Medicine (formerly The Commonwealth Medical College).