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Re: Need answers...
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Re: Need answers...

Posted By V. Talley on August 03, 1999 at 13:09:49
I am a 19 year old female and have just recently started having problems with my blood pressure.  I was taked to the emergency room a few days ago- my blood pressure was 175/120 - I was given several medicines and it took several hours for any of them to be effective.  The ER Doctor put me on 60mg procardia once a day.  I put a call in to my regular physician but she was out of town and one of the other doctors that works with her wanted to see me right away.  He was a young doctor and seemed somewhat unsure of himself.  He offered no reasons why I might be having this trouble nor did he tell me any ways that this could be regulated- ie diet.  He simply changed my medicine to atenolol and had me go for a chest x-ray.  The medicine seems to be making me feel drained and like I have no energy and my blood pressure is still high.  I thought that after a visit to the doctor I would feel less concerned about this and maybe have some answers- but I don't.  Do you have any suggestions as to what could be causing this and should I seek further medical attention?  Thank you for any response you may be able to provide.




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Posted By CCF CARDIO MD - CRC on August 03, 1999 at 13:55:10
It is somewhat unusual for a 19 year old to have high blood pressure but it is possible.  I would ask your doctor to look for secondary causes of high blood pressure.  It is possible your medication could be making you feel tired.  This will also need to be addressed by your physician.  Here is some general information about high blood pressure.
High blood pressure, or hypertension (HTN) , is defined in an adult as a blood pressure
greater than or equal to 140 mm Hg systolic pressure or greater than or equal to
90 mm Hg diastolic pressure. Blood pressure is measured in millimeters of
mercury (mm Hg). High blood pressure directly increases the risk of
coronary heart disease (which leads to heart attack) and stroke (or brain
attack), especially along with other risk factors.
High blood pressure can occur in children or adults, but is particularly prevalent in
blacks, middle-aged and elderly people, obese people, heavy drinkers and women who are taking oral
contraceptives. Individuals with diabetes mellitus gout or kidney disease have a higher frequency of
hypertension.  
High blood pressure may be primary (essential) or secondary.   If the  hypertension is secondary there may be a treatable cause.  Most of these causes are relatively rare (i.e. renal artery stenosis, pheochromocytoma).  If no secondary cause is found then the high blood pressure is said to be primary.  The vast majority of cases of HTN are  primary.  The main cause of primary HTN is genetic.

Q: I am hoping to get pregnant in the future and I am wondering if this will effect things?
A: Blood pressure may be elevate during pregnancy and if you have a predisposition to high blood pressure it should be closely monitored during pregnancy.
Q: I believe the higher blood pressure is directly related to anxiety which may be OK for the "normal"
person, however with me having this disorder I deal with anxiety A LOT and I often endure it without my medication.
A: It is important to take the medication you need for anxiety.  In addition you may need blood pressure medication if your high blood pressure continues.

Q: How do salt and sodium affect high blood pressure?
A: Most Americans consume far more salt (sodium) than their bodies need. Heavy sodium consumption increases blood pressure in some people, leading to high blood pressure. People who are diagnosed with high blood pressure are often placed on restricted-sodium diets.
Reducing sodium (or salt) consumption may help lower blood pressure in some people. Your doctor may
recommend a sodium (salt) restricted diet. This will mean you'll have to avoid salty foods and cut down on the amount of salt you use in cooking and at the table.
Q: How does being overweight affect high blood pressure?
A: Studies have shown that body weight, changes in body weight over time, and skinfold thickness are related to changes in blood pressure levels. These factors have been linked to the subsequent rise and development of high blood pressure. People who are overweight are more likely to have high-normal to mild high blood
pressure.
Physical inactivity is a risk factor for heart disease. In addition, a sedentary or inactive lifestyle tends to
contribute to obesity, a risk factor for both high blood pressure and heart disease. Regular exercise helps
control weight and lower blood pressure. Don't be afraid to be active  exercise should definitely be part of your daily program. Besides helping to reduce your risk of heart attack, it can also help you lose weight or maintain a healthy weight.
Statistics show that many people who have high blood pressure are also overweight. If you are overweight or have gained weight over time, you'll be advised to cut down on calories and lose weight. Your doctor can prescribe a diet that's right for you.
If you're given a diet, follow it closely, including any recommendations about reducing your consumption of alcohol. Alcoholic drinks are high in non-nutritious calories, so if you're trying to lose weight, avoid alcoholic beverages. Often when people lose weight, their blood pressure drops as well.
Q: How does medicine help control high blood pressure?
A: For some people, weight loss, sodium reduction and other lifestyle changes won't lower high blood pressure as much as it needs to be lowered. If that's your situation, you will probably need to take medication. Many medications are available to reduce high blood pressure. Some get rid of excess fluid and sodium (salt). Others relax constricted blood vessels. Others prevent blood vessels from constricting and narrowing. Because there is usually no cure for high blood pressure, treatment generally must be carried out for life. If treatment is stopped, the pressure may rise again.

Q: Will I have to take medications for my hypertension the rest of my life?
A: Generally, someone with high blood pressure will be on lifelong medication.
Q: At what point do I need to see a heart specialist for this condition?
A: Usually hypertension can be managed by an Internal Medicine doctor.
Q: Will there ever be a right combination (of medication) to treat this condition?
A: It may take several trials to find the right combination of drugs.   There are many different medications and new ones are coming out each year.
Q: My parents both had heart attacks and strokes and father had a bypass in Sept. 97 (age 74), mom had her stroke at age 49. They still take meds for hypertension. With this history is there a possibility I might have a heart attack in my later years?
A: Heart disease tends to run in families.  Those who have a family history of heart problems shoud take extra care of themselves (i.e. weight loss, high blood pressure control, exercise, etc.).

http://www.amhrt.org/Heart_and_Stroke_A_Z_Guide/hbp.html
http://www.ihr.com/medreprt/articles/bloodpr.html
http://www.musc.edu/iash/
http://www.am-osteo-assn.org/ccoop/hibldprs.htm
http://www.mco.edu/whl/know.html
http://www.bloodpressure.com/
http://www.mediconsult.com/hypertension/
http://www-med.stanford.edu/school/DGIM/Teaching/Modules/HTN.html
http://www.merck.com/!!uYfKE0uiyuYfKE0uiy/pubs/mmanual/html/khgnjgcd.htm
http://www.aafp.org/afp/091596/special.html
http://pharminfo.com/disease/cardio_db.html
http://www.pslgroup.com/HYPERTENSION.HTM
I hope you find this information useful.  Information provided in the heart forum is for general purposes only.  Only your physician can provide specific diagnoses and therapies.  Please feel free to write back with additional questions.
If you would like to make an appointment at the Cleveland Clinic Heart Center, please call 1-800-CCF-CARE or inquire online by using the Heart Center website at www.ccf.org/heartcenter.  The Heart Center website contains a directory of the cardiology staff that can be used to select the physician best suited to address your cardiac problem.






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Posted By V Talley on August 03, 1999 at 15:49:51
I knew it was unusual to have high blood pressure so young- and that is why I was concerned that the Doctor I saw did not probe deeper into the potential cause.  So you reccomend that I see another Doctor?  My diastolic (bottom number) pressure has been above 105 for the past few days that I have been watching it- that is why I am concerned.  I am a nursing student and I know that is not normal so I would like to know the "why" part.  Thanks for your response










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