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Medicine & Health Education
The Story of High Blood Pressure
Lifestyle Modifications for a Healthy Body, Mind and Spirit
Bala N. Aiyer, M.D.
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Understanding Hypertension - Part - 2
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What can be done to control it?

Don't let high blood pressure sneak up on you. Have it checked periodically, especially if you have a family history of hypertension or heart disease or stroke or if you have diabetes, kidney problems, high cholesterol or if you are overweight. An early diagnosis, proper diet, regular exercise and medical treatment is essential to control and prevent complications.
Diet : Diet may be the most important change you will have to make. Loosing weight, if you are overweight is very important. Low salt diet often delay the occurrence of hypertension. It can control mild hypertension without medication. Even in moderate to severe cases, it is easier to control with a low salt diet. Life style modification with regular exercise, maintaining ideal body weight along with low fat, no cholesterol and controlled calorie diet is essential.
Excessive alcohol, coffee, and other forms of caffeine should be avoided, though in moderate amounts they do not seem to affect it. Cigarette smoking increases the blood pressure and doubles the risk of heart diseases and stroke. If life style modification program alone does not control hypertension, Medical Treatment will have to be added.
 
 

Will regular exercise help?

Exercise : Exercise is the most important second step. Exercise alone will not lower blood pressure, but it will help control body weight and make heart and circulation stronger. Walking, light jogging, bicycle, swimming or playing games like tennis daily for 30 minutes, can all help.
"Warning" : Be sure to check with your physician before starting any exercise program. Many people, especially older ones, will need a complete checkup, an ECG and sometimes a stress test. Start out exercise slowly and build up gradually. Rest when you feel tired. Allow plenty of time for warm up and cool down. Do not perform any isometric, muscle building or weightlifting exercise, which can often raise the blood pressure temporarily.
 
   

How long medications is to be taken?

Essential hypertension can be controlled but not cured. So, the medication need to be taken regularly and indefinitely along with life style modifications. One should not stop the medicines just because they feel good, or they do not feel "heavy in the head" or "they know" that the pressure must be normal. It is important for your physician to see you to plan the correct medicines, to reduce or stop any medicines. They also need follow-ups with tests to avoid complications from the disease and from the medicines. Every blood pressure medicine can cause some side effects and you may need lower or higher dose or change in medicines some times.
 
   

Medicines commonly prescribed :

There are four major categories of medicines used in the treatment and each one may have some side effect in some people and not in others. Most of these medicines have certain side effects that can make some people sick or ontplerant of the medicines.
1. Diuretics or water pills remove water from the body and reduce the blood volume.
2. Beta blockers work by blocking the impulses of the nervous system or act on the heart or blood vessels or work by other methods to lower blood pressure.
3. Vasodilators, Calcium channel blockers and Nerve blockers act directly on the smooth muscles of blood vessels and relax them.
4. Renin axis blockers or ACE inhibitors and Angiotensin-II Receptor blockers are the newest class of drugs in the market. They block certain chemicals formed in the kidneys that causes contraction of blood vessels and retention of salt.
 
   

Side Effects of medicines:

Usual side effects of these drugs include tiredness, dry mouth, dizziness on standing, sleepiness and in some cases, impotence which may require change of medicines. Sometimes, many individuals may feel some symptoms of discomfort while taking the medicines than when they were not taking any treatment, which often leads to non-compliance of medical treatment. For example, the Diuretics can often cause weakness, potassium loss, impotence, dizziness or postural hypotension [low blood pressure on standing up]. Beta-blockers can also make a person feel weak, have difficulty breathing or worsen heart failure or Bronchial Asthma. Vasodilators can cause swelling of legs. Calcium channel blockers can often cause head ache, fast heart rates or slow heart rates and constipation. They may also cause swelling of the legs. Ace inhibitors can cause a dry cough, worsen asthma or causse swelling of face. If the problem is too much, there may be a need to change the medicine. The new Angiotensin-II receptor blockers are similar to ace-inhibitors but cause much less problems. Both Ace inhibitors and A-II blockers can elevate the blood potassium levels. Most of these medicines also have other effects on the body which can be used to some therapeutic advantage in the treatment of the person as a whole. Smaller doses of more than one medicine [2 or 3 or more] is used to minimize these side effects, and sometimes to balance these efects.
All these drugs will keep the pressure under control, but they do not cure the disease. If the drugs are stopped suddenly, the pressures will return to previous levels or my go even higher. It is particularly important to follow your doctors' instructions, must continue proper diet and exercise, continue to take all medicines regularly every day and must return for periodic checkups.
 
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Now that we have discussed about Diabetes, Cholesterol & Fat and Hypertension :
 
 
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-- This is called Behavior Modification --
Essential Changes -- for a healthy Heart and General Health0
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