Hypertension - Dr. Winsome Christie

Dr. Winsome Christie
President
Pharmaceutical Society of Jamaica

High blood pressure is a condition that puts you at risk for heart attack, stroke, and kidney disease. There are two types of hypertension.

Primary or essential hypertension and Secondary Hypertension. When the cause of hypertension is unknown it is referred to as essential, or primary hypertension. When a cause can be found, the condition is called secondary  hypertension. Uncrontrolled hypertension puts you at risk for heart attack, stroke, and kidney disease.

Malignant hypertension is an illness where the pressure in your blood vessels is very high. The blood pressure is so high that it starts to harm organs of the body. This illness most often happens in people with kidney and blood vessel problems, and during pregnancy.

Below are some secondary hypertension conditions involving some major body organs, they are:

• Pulmonary hypertension, 
• Renovascular hypertension and 
• Idiopathic intracranial hypertension.

Pulmonary hypertension is a condition that causes high blood pressure in the blood vessels that carry blood to the lungs. When this happens, the heart has to work harder. This causes people to have trouble breathing and to feel very tired.

Symptoms of pulmonary hypertension include:

• Trouble breathing when moving around
• Feeling very tired

Over time, you might get other symptoms, including:

• Swelling of the legs and feet
• Chest pain
• Fainting
• Not feeling hungry
• Belly pain
• Ankle swelling

Rare symptoms include:

• Cough
• Spitting up blood

Pulmonary hypertension is a serious illness. Even with treatment, there is no permanent cure. For adults, the disease gets worse over time and is likely to make it hard for you to do everyday things, like bathing and dressing. For children, the disease might improve with time or it might get worse over time. Talk to your doctor to find out what to expect with your type of pulmonary hypertension.

Medicines and oxygen might make you feel better and live longer. You will need to see your doctor often to check if you need to change the dose of the medicines you take.

 

Renovascular hypertension is a type of high blood pressure that affects the renal arteries, the blood vessels that carry blood to the kidneys, these become narrow.

Symptoms include:

• A very bad headache
• Chest pain
• Severe pain in your upper back
• Problems breathing
• Weakness on 1 side of your body and not the other
• Problems speaking
• Nausea or vomiting
• Confusion
• Vision changes
• Blood in your urine

You can reduce your chances of getting renovascular hypertension by keeping your blood vessels healthy. To do that, you should:

• Quit smoking, if you smoke.
• Walk, or do some form of physical activity on most days of the week.  Lose weight, if you are overweight.

Idiopathic intracranial hypertension results in elevated pressure within the skull. It is also  called "pseudotumor cerebri."

Idiopathic intracranial hypertension causes headaches and vision loss.

Doctors do not know the cause. But idiopathic intracranial hypertension is more common in women and people who are obese.

 

Symptoms of idiopathic intracranial hypertension include:

• Dimming of vision
• Trouble seeing things at the edge of your line of sight
• Double vision
• Seeing flashing lights
• Noises inside your head – The noise might sound like rushing water or wind. It often pulses in time with your heartbeat and can come and go.

Idiopathic intracranial hypertension the Treatments include:

• Weight loss – If you are overweight, your doctor will recommend healthy ways to lose weight. If you are very overweight and cannot lose weight through changing your diet and exercise habits, your doctor might recommend medicines or weight-loss surgery.
• Medicines – Your doctor might prescribe medicines that help lower the amount of spinal fluid your body makes. Spinal fluid is the fluid that surrounds the brain and spinal cord. They might also recommend medicines used to prevent and treat headaches.
• Surgery – Doctors only do surgery if losing weight and taking medicines don't help enough. The kinds of surgery include:
• Shunting – In this surgery, a doctor puts a device called a "shunt" into a fluid-filled space inside your brain. The shunt is connected to a tube that is placed under your skin and that empties into your belly. The shunt helps drain the extra spinal fluid from your brain and can relieve the pressure.
• Optical nerve sheath fenestration – In this surgery, a doctor cuts a tiny, window-like hole in the tissue that covers the optic nerve. This helps lower pressure on the nerve to help save your vision.

It is important, therefore to keep blood pressure under control by doing frequent blood pressure checks , lifestyle modifications, having periods of relaxation, stress reduction, dietary adjustments to include healthy fats, reduced processed foods, less salt intake, less fast foods more fruits and vegetables. Have regular checks with your doctor and consult a nutritionist/dietician for dietary advise.

 

Dr. Winsome B. Christie

President

Pharmaceutical Society of Jamaica