Archive for October, 2013

High Blood Pressure

Hypertension is the medical term for high blood pressure. Blood pressure refers to the pressure that blood applies to the inner walls of the arteries.  Arteries carry blood from the heart to other organs and parts of the body.

Blood pressure is measured by two values:

  • Systolic pressure refers to the pressure in the arteries as the heart contracts (beats) and,
  • Diastolic pressure refers the pressure in the arteries as the heart relaxes between beats.

This is read as systolic pressure over diastolic pressure (e.g., 120 over 70).

Blood pressure normally changes over a person’s lifetime (usually increasing with age) as well as over the course of a day. In addition, activity affects blood pressure, which rises as a normal response to physical activity and stress. However, patients with hypertension have high blood pressure even at rest.

Untreated hypertension increases the strain on the heart and arteries, eventually causing organ damage. Hypertension increases the risk of heart failure, heart attack (myocardial infarction), and stroke.

A person is considered to have high blood pressure after three to six elevated blood pressure measurements over several months. These definitions apply to adults who are healthy and not using medication for high blood pressure. If the two pressures fall in different categories, the higher one is used to determine the severity of the hypertension.

Normal blood pressure — Systolic under 120 and diastolic under 80.

RISK FACTORS — Hypertension is a common health problem.  In the United States, approximately 32 percent of African-Americans and 23 percent of white people and Mexican-Americans have hypertension.

Keep in mind that hypertension is more common as people grow older. As an example, 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

Treatment options

Lifestyle changes — Treatment of hypertension usually begins with lifestyle changes.  Making these lifestyle changes involves little or no risk.  Recommended changes often include a moderate restriction on salt in the diet, weight loss in those who are overweight or obese, avoiding excessive alcohol intake, stopping smoking, and regular aerobic exercise.

Medication — Antihypertensive medication is usually recommended when the blood pressure is consistently at or above 140/90, with no or minimal changes with diet and exercise.

WHERE TO GET MORE INFORMATION — Your healthcare provider is the best source of information for questions and concerns related to your medical problem. Because no two patients are exactly alike and recommendations can vary from one person to another, it is important to seek guidance from a provider who is familiar with your individual situation.

Upper Endoscopy

An upper endoscopy is a test that looks inside the body.  The endoscope is a long flexible tube that can be swallowed.  It has a camera and light inside it. An upper endoscopy enables the physician to look inside the esophagus, stomach, and duodenum (first part of the small intestine). The procedure might be used to discover the reason for swallowing difficulties, nausea, vomiting, reflux, bleeding, indigestion, abdominal pain, or chest pain. Some doctors call it a telescope.  Also through the endoscope, the doctor can take samples (biopsies) of any abnormal looking tissues.

You can have this test as an outpatient.  You can’t eat or drink for about 8 hours before the test so that your stomach and duodenum are empty. Your doctor will give you written instructions about this beforehand, or they may arrive with your appointment letter.

When you get to the Endoscopy Suite, you may be asked to take your upper clothing off and put on a hospital gown.  Some hospitals prefer to use gowns because your clothes won’t get messy.  Once you are ready, you get onto the bed or a stretcher.  Right before the procedure the physician will spray your throat with a numbing agent that may help prevent gagging. You may also receive pain medicine and a sedative to help you relax during the exam.

Once the sedative and throat spray have been given, the doctor will pass the endoscope tube down your throat to the area being investigated.  Your doctor will ask you to swallow as the tube goes down.  If there are any abnormalities, the doctor will take pieces of tissue from the abnormal looking area to send to the laboratory for closer inspection under a microscope.  These tissue samples are called biopsies.

The procedure takes 20 to 30 minutes. Because you will be sedated, you will need to rest at the endoscopy facility for 1 to 2 hours until the medication wears off, before being able to go home. You should also bring someone with you or arrange to be picked up.