Nephrology & Hypertension Specialist
Williamson Medical Center
High blood pressure, or hypertension, is a common condition that becomes more common as people grow older. Among people over age 60, hypertension occurs in 65 percent of African-American men, 80 percent of African-American women, 55 percent of white men, and 65 percent of white women. According to a national survey, hypertension was only under good control in 25 percent of African Americans and whites and 14 percent of Mexican Americans. This means that for most people, blood pressure management remains a challenge.
Out of control
The benefits of having blood pressure under control are many. Numerous studies have concluded that blood pressure reduction is the major determinant of reducing our risk of death due to heart attacks and strokes, in both younger and older patients.
If not controlled, it can also put a strain on your heart, causing the heart muscles to become weaker over time, which then leads to heart failure. Heart failure itself can cause many problems, including sudden cardiac death. Our kidneys can also be affected by prolonged periods of uncontrolled high pressure, which causes these to spill protein into the urine that eventually makes our kidneys stop working.
When our kidneys no longer work, we have to rely on dialysis to do their job. Damage to our blood vessels can also be a risk of uncontrolled high pressure. The main blood vessel in our body is called the Aorta. When it continuously has blood pressure within high ranges inside it, it can develop tears in its walls. These tears can eventually cause a rupture or Aortic Dissection, which can lead to sudden death. As a rule, the higher the blood pressure, the greater these risks are.
Change your life
Treatment includes a change in lifestyle such as losing weight if you are overweight, regular physical activity, a healthy diet, cutting back if you drink a lot of alcohol, stopping smoking, and a low salt and caffeine intake. These measures should be tried first for some time. However, if our blood pressure continues to be high despite these changes, medications can be used to help lower blood pressure.
Be careful with medications
Not all blood pressure medications were created equal and many patients will respond well to one drug but not to another. A good response to one medication versus another can be predicted by certain clinical parameters, including race, presence of other medical conditions, such as sleep apnea and snoring.
Also, certain drugs may be expensive while others can actually be free at certain stores. Some are often associated with side effects, which could be muscle cramping due to a low potassium level. Other medications could even increase your cholesterol and blood sugar levels. For this reason, it is important to take the time to discuss what are the advantages and disadvantages of the medication, before starting therapy.
Read the fine print
It is also important to watch out for certain medications that can increase our blood pressure, in order to try and avoid these. These include, but are not limited to non-steroidal anti-inflammatory agents (NSAIDs), such as Ibuprofen, Naproxen, among others. NSAIDs lead to salt and water retention, which will cause blood pressure to become elevated. Some over-the-counter cold and sinus remedies can also lead to high blood pressure by stimulating our nervous system. When shopping for one of these it is important to read the labels on the box that should indicate whether a particular medication could increase your blood pressure. Other drugs that can increase blood pressure are certain birth control, depression, and diet pills.
In conclusion, high pressure can remain elevated for a large number of reasons, such as lack of lifestyle changes, underlying medical conditions, concomitant use of other medications that increase blood pressure and not using the ideal blood pressure medications.
Jennifer Santana, M.D., is board-certified in nephrology and internal medicine. She is part of Franklin Kidney Clinic and is a credentialed physician at Williamson Medical Center. She can be reached at 615-628-8064.