My 36 year old sister began having episodes of extremely high blood pressure
on Monday. It was recorded as 210 over 130 at 5 pm. The clinic she went
to wanted to admit her to the hospital but she was scared and refused.
She began to get sick again at work Tuesday and then went to the ER.
She now has an appointment set with an internist next week. Can you give
us some insight on what might cause uncontrollable high blood pressure in
some one her age? She is 5'5" weighs 115 lbs, no smoking, social drinker,
takes birth control pills and just had some varicose veins removed. All her
hospital tests; ekgs, x-rays, echos and blood were all negative. Any clues
while we wait for her dr. appointment? Thanks!
Of all cases of hypertension, there is a limited number where the cause is found-and is
termed secondary. Those patients who undergo testing as I will speak of later and nothing
is found are given the diagnosis of essential hypertension ( the old term for without a specific
cause). The first thing that came to mind is the birth control pills which are notorious for
causing high blood pressure in women her age. Other possibilities we as physicians consider in
patients with newly diagnosed hypertension are 1)blockages in one or both renal arteries (that
which supplies the kidneys)or any disease of the kidney itself, 2)other medications and or some herbal diets and supplements, 3)an endocrine
abnormality which is the system of hormones throughout our bodies that regulates metabolism, especially
the thyroid and adrenal glands (there are some foods that contain hormone like substances), an abnormality of the aorta named
coarctation, various abnormalities of the brain (of course signs and symptoms of the primary brain disorder are often apparent
at the time the hypertension is discovered),and various asundry disorders that are quite rare (examples include lead poisoning, severe vitamin
deficiencies, paget's disease-an abnormality of bone, etc. The secondary causes
of hypertension (elevated blood pressure) that I speak of early on in the above paragraph are the most common, keeping in mind as I said
that often the cause is sought and not found. This leaves the treatment of the patient, which almost always requires medications, especially at the
levels that your sister has had. It is actually very important to know the pattern of the rise of the blood pressure, for instance does it get very high only
at night, or is it high all the time, and additionally, is it the same in both arms? I hope that this information gives you something
at least to ponder if not help you to better understand the evaluation by the physician. Good Luck and feel free to enter more questions regarding the work-up if you have any.
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