Friday, December 14, 2018

Dr. Matthew Bogard, Iowa Doctor - Hypertension: Detecting the Silent Killer – Part 1


Hypertension: Detecting the Silent Killer – Part 1


Our house had low water pressure when I was a child.  We had a well and the pressure tank never pushed water out of a faucet or hose with much force.  On the other hand, I had a friend who lived in town in a low-laying neighborhood and you could almost strip paint with his garden hose.  It's a good illustration that too much or too little of a good thing isn't a good thing.  Such is the case with your blood pressure.

Blood pressure refers to the pressure your blood places on the inner walls of your arteries, which are the vessels that carry oxygen-rich blood from the heart out to the other organs in the body.  Blood pressure is defined by two separate measurements.  The systolic pressure is the pressure in the arteries when the heart contracts (or beats) and the diastolic pressure is the pressure during the relaxation of the arteries between heart beats.  We typically report these as the systolic pressure over the diastolic pressure (120/80 for instance). 

More often than not, the problem is high blood pressure, or hypertension in medical terms.  Untreated high blood pressure increases the strain on the heart and arteries and eventually causes damage to your body's organs.  It also increases the risk of having a stroke, heart attack, heart failure, or kidney failure.  According to a recent study, hypertension is controlled in only about 25% of people with the disease.

Hypertension is a common health problem. In the US, approximately 25% of the overall population has hypertension.  It is more common as people grow older: among folks over age 60 years, 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.  Unfortunately, there are typically no symptoms of this silent killer so many people with the disease do not know they have it.  This is why we check your blood pressure at every doctor’s visit even if you’re just in for a runny nose or sprained ankle: we want to catch this chronic condition as soon as it hits and act early to prevent complications.

Next week I will discuss what specific blood pressures warrant this diagnosis, things you can do to lessen the chances of having hypertension, as well as the ways we treat it by lowering your blood pressure.

References:
Blog: https://matthewbogardmd.blogspot.com/
LinkedIn Profile: https://www.linkedin.com/in/matthewbogard/
https://attorneygazette.com/matthew-bogard%2C-md#7244cab0-d3fa-44b9-8632-6f83b0524da4
News: https://hype.news/dr-matthew-bogard/
News: https://attorneygazette.com/matthew-bogard%2C-md#7244cab0-d3fa-44b9-8632-6f83b0524da4

 
*** Dr. Matthew Bogard, Iowa doctor, is an emergency medicine doctor primarily at the Lucas County Health Center in Chariton, Iowa. Presently, he is Board Certified in Family Medicine by the National Board of Physicians and Surgeons and the American Academy of Family Physicians.

Dr. Matthew Bogard, Iowa Doctor - Hypertension: Detecting the Silent Killer - Part 2


Hypertension: Detecting the Silent Killer - Part 2

Last week I discussed the mechanics of hypertension, or high blood pressure, including the additional risks it confers to patients with this condition.  People with high blood pressure are at increased risk of having a stroke, heart attack, heart failure, or kidney failure.  About 25% of Americans have hypertension, and only about a quarter of them have it under control.

Normal blood pressure is anything less than 120 over anything less than 80 (120/80).  Prehypertension is when pressures run 121 to 139 over 81-89.  If you are diagnosed with prehypertension, you have about a 50% chance of developing hypertension and cardiovascular complications.  However, multiple studies have shown that medications to lower blood pressure are not beneficial for folks with prehypertension.

The formal diagnosis of hypertension is made with blood pressure of 140 or greater over 90 or greater (140/90) and this is even more concerning as pressures approach 160 over 100.  Most people have primary or "essential" hypertension, the cause of which is typically unknown.  A minority of people experience hypertension caused by an endocrine disorder or kidney abnormality that is potentially treatable; this is termed "secondary" hypertension.  We screen for this at diagnosis.

          Treatment of hypertension usually begins with lifestyle changes. Making these lifestyle changes involves little or no risk and is also a good idea for people with prehypertension. Recommended changes often include:

·       Reduce the amount of salt in your diet, especially by limiting packaged, frozen, and processed foods and be wary of the amount of salt in restaurant foods
·       Lose weight if you are overweight or obese
·       Eat more fruits and vegetables, more fish, and more fiber
·       Avoid drinking more than two alcoholic beverages daily (1-2 drinks daily appears to benefit the heart in patients over 40)
·       Avoid excess caffeine - limit yourself to two caffeinated drinks daily
·       Stop smoking
·       Exercise at least 30 minutes per day most days of the week

When these lifestyle changes are not enough, we often recommend beginning medication for hypertension.  There are many different medications available that work by different mechanisms; we try to individualize treatment based on a person's other risk factors, diseases, age, and the severity of their hypertension.


References:
Blog: https://matthewbogardmd.blogspot.com/
LinkedIn Profile: https://www.linkedin.com/in/matthewbogard/
https://attorneygazette.com/matthew-bogard%2C-md#7244cab0-d3fa-44b9-8632-6f83b0524da4
News: https://hype.news/dr-matthew-bogard/
News: https://attorneygazette.com/matthew-bogard%2C-md#7244cab0-d3fa-44b9-8632-6f83b0524da4


*** Dr. Matthew Bogard, Iowa doctor, is an emergency medicine doctor primarily at the Lucas County Health Center in Chariton, Iowa. Presently, he is Board Certified in Family Medicine by the National Board of Physicians and Surgeons and the American Academy of Family Physicians.