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Professor Dr. Dale Adler MD, prominent cardiologist and medical heart disease treatment expert, and Dr. Anton Titov MD PhD MBA / Exclusive interview on medical therapy for coronary heart disease, high cholesterol and hypertension treatment, and sudden death prevention and treatment.
- Hypertension is often silent. People are not aware of their high blood pressure until stroke or heart attack happens. What is the best way to treat hypertension? What principles of high blood pressure treatment do you apply in your medical practice? Yes. You are right. People often do not have good control of their blood pressure. We have so much data linking high blood pressure especially to stroke. Hypertension also causes kidney problems. Hypertension is linked to definite heart attacks a little bit less. But high blood pressure causes hypertensive heart disease, where the heart muscle gets thicker. In patients with hypertension heart muscle becomes more rigid and less compliant. It is always remarkable that even today in the United States 25% of people with hypertension do not have good control of their high blood pressure. Treatment of hypertension is so basic but many people do not succeed in its treatment. What is the best way to treat hypertension? First step is to know how high is your blood pressure. We live in era when everyone has equipment to measure blood pressure. It's very easy for patients to check their blood pressure. I always tell my patients: don't go crazy checking blood pressure Check your blood pressure about three times per week. Check blood pressure in different circumstances. Sometimes you have been very busy and active. Sometimes you are under stress. Check it once. Is it useful to check blood pressure on both arms? Difference of blood pressure results between two arms has been linked to higher risk of death. A large difference in blood pressure results between two arms can indicate a problem in the aorta or blockage in different blood vessels. So absolutely, check blood pressure in both arms at the same time at least the first time you take blood pressure measurement. We also want people to check their blood pressure in the morning when they wake up. People also should check blood pressure when they are under stress. Check your blood pressure also when you are relaxed. Blood pressure is similar to LDL cholesterol. The lower level of blood pressure - the better for your health. Same is true with LDL cholesterol levels. So lower blood pressure results mean lower risk of stroke. It is important not to make blood pressure so low that people have symptoms. If the blood pressure is too low, people may feel dizzy or they may have blurred vision. Or they feel they are about to pass out. We don't need to make blood pressure very low by using medications. People should be really mindful of how they eat. They should keep their weight in good order. People also should be really fit. By doing these three things they can help themselves a huge amount. I always tell my patients a sad story. It is a story about a man who always had very high blood pressure. His hypertension was very difficult to treat. And I always said to him: "I am worried about your diet." And he always replied: "My diet is great." Then unfortunately one day this man had a stroke. After stroke he could not eat on his own. His hand was paralyzed. Since that time we never had a problem with his blood pressure. Never. Not once. It is possible that stroke changed something in his brain. But there is a better explanation of his normal blood pressure after stroke. What he ate after stroke was controlled by others and the food became more healthy. So often there is a strong dietary component to hypertension. We have strong medications at our disposal to treat hypertension. In some people with resistant hypertension we need to use three and four medications. But almost always we can get patient's blood pressure under control. What are examples of medicines we use today to treat hypertension Carvedilol is a nonselective beta blocker and also an alpha blocker.
Hypertension Treatment: How to Find Best Approach to High Blood Pressure? (9) top doctors washingtonian | |
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| Science & Technology | Upload TimePublished on 14 Jul 2018 |
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