High blood pressure

[aggle_rithm]

In another thread, someone mentioned a symptom of high blood pressure.

It's my understanding that the only symptom of high blood pressure is that one's blood pressure is high. However, I know several people that claim to be able to "sense" when their pressure is high.

My mother-in-law believes her pressure is high when she feels stressed -- she's probably right, but I think she has cause and effect confused. Anyway, it's impossible to tell because she never checks her hypothesis by actually measuring her blood pressure.

My own mother says that she can hear blood pounding in her ears when it's high. This sounds a little more reasonable, but I don't know how reliable it is.

 

[Jon_in_london]

Chest pains?

BTW, is it true that hypertension can cuase kidney damage?

 

[richardm]

Chest pains?

BTW, is it true that hypertension can cuase kidney damage?

Yes to the Kidney damage, No to the chest pains.

My doc told me that one of the main difficulties with high blood pressure is that it doesn't usually show any side effects. Consequently it's only discovered when you have your blood pressure checked - which many people don't bother to do if they have no other reason to visit the doctor.

Certainly I only found out about mine when I visited to see if they could recommend something industrial-strength for my hayfever. I was a new patient and got the once-over - and there it was.

 

[Paul C. Anagnostopoulos]

Richard said:

... which many people don't bother to do if they have no other reason to visit the doctor. ...
Certainly I only found out about mine when I visited to see if they could recommend something ...

Huh? Don't people have physical exams every year?

~~ Paul

 

[arcticpenguin]

Richard said:
Huh? Don't people have physical exams every year?

~~ Paul

No, not in the real world of 'managed care'. It's all about managed money, I think.

 

[richardm]

Richard said:
Huh? Don't people have physical exams every year?

~~ Paul

It's recommended that you do once you get above a certain age, but you're not obliged to in the same way as you might if, for example, you have health insurance.

Now I have new and exciting blood pressure, I'm in there once a quarter.

As ArcticPenguin said - there's a lot of money management going on. Most GPs can't cope with the number of ill people they have coming in, without dealing with healthy ones as well.

Of course, the upshot of it all is that many people give real problems time to develop undiscovered, which costs more money in the long term. Great, isn't it?

 

[Jon_in_london]

Yes to the Kidney damage,

Why does hypertension damage kidneys?

 

[richardm]

Why does hypertension damage kidneys?

As I understand it, it's simply that the high pressure causes damage to the numerous small blood vessels in the kidneys. Once enough of these are damaged, the kidneys start to fail.

 

[Dr. Imago]

Why does hypertension damage kidneys?

The increased pressure in the small vessels causes deposition of proteinaceous material, by extravasation, outside the vessel into the interstitial space. This further blocks the blood flow downstream in the filtering apparatus, the glomerulus, inside the kidney. This then causes the kidney to release more substances (renin) into the circulation in an attempt to further raise the pressure and overcome the diminished flow, all in an attempt restore proper flow through the glomerulus. It's a vicious cycle.

The kidney is actually the major organ that regulates your blood pressure. ACE inhibitors act to lower blood pressure by interfering with this kidney based renin-angiotensin system.

-TT

 

[Jeff Corey]

Is Cozaar TM an acetylcholine inhibitor? That might explain some sleep and memory disturbances.

 

[Dancing David]

Some people experience head aches from thier hypertension, others get tired, but as mentioned before you casn't really tell except by measuring it.

Whats really wierd is that not every one is sodium sensitive, I am, if I go over three grams daily then there goes my bottom number, in others they can eat all the salt they want.

 

[Dr. Imago]

Is Cozaar TM an acetylcholine inhibitor? That might explain some sleep and memory disturbances.

Well, actually "ACE" stands for "angiotensin-converting enzyme". In medical parlance, acetylcholinesterase is abbreviated AChE. Most AChE inhibitors, such as neostigmine (used to treat Myasthenia Gravis), do not actually cross the blood-brain barrier. They indirectly increase the amount of acetylcholine at the neuro-muscular junction by inhibiting the enzyme, AChE, that breaks down ACh into acetyl-CoA and choline in the synaptic cleft.

Also, you (perhaps unwittingly) expertly show the dangers of medical abbreviation. Mea culpa for using the shorthand before.

As far as Cozaar (losartan) goes, this is actually an ACE II inhibitor that blocks the angiotensin II receptor, and not the actual conversion of angiotensin I to angiotensin II like the typical ACE inhibitors do. So, to answer your question, it shouldn't have any effects on the CNS.

-TT

 

[Jeff Corey]

Mea culpa, also. I should have remembered that ACh (which is the way my psych text abbreviates it) is the neurotransmitter that mediates motor action.

 

[Always Free]

I recall reading or being told a long time ago, that once one is on high blood pressure medication you are on it for life.

Does anyone know if this is true?

 

[Interesting Ian]

Some people experience head aches from thier hypertension, others get tired, but as mentioned before you casn't really tell except by measuring it.

Whats really wierd is that not every one is sodium sensitive, I am, if I go over three grams daily then there goes my bottom number, in others they can eat all the salt they want.

There's no way you can tell if you're sodium sensitive? What about if you use something like "lo-salt"? (2/3 potasium chloride, 1/3 sodium chloride)

 

[Phaycops]

I had high blood pressure resulting from my thyroid condition (Grave's Disease -- sounds scary, donnit?), and I could definitely tell when I forgot to take my beta blockers back when I was first getting treated. I don't need them so much now that my thyroid is coming under control, but way back when, I would get weird headaches and shortness of breath, especially when trying to excersize. Blecch. I would venture to say that it's not that there's NO symtoms (signs?) of high blood pressure, more that they're so common that most people never notice. It's not like you get a headache and think "Oh, I must have high blood pressure!" Just my two cents.

 

[Paul C. Anagnostopoulos]

Arctic said:

No, not in the real world of 'managed care'. It's all about managed money, I think.

Hmm. My HMO pays for a physical once a year, minus copayment.

Free said:

I recall reading or being told a long time ago, that once one is on high blood pressure medication you are on it for life.

My father has reduced his blood pressure medicine to about 25% of what it was at the highest level. He's 80 now.

~~ Paul

 

[Dr. Imago]

I recall reading or being told a long time ago, that once one is on high blood pressure medication you are on it for life.

Does anyone know if this is true?

It depends on the cause. Contrary to what a lot of the woo-woo alternative medicine practitioners would have you believe, doctors do indeed try to treat and correct the underlying cause of medical problems - not just the signs and symptoms of the problem at hand. Often with hypertension, though, the lifestyle modifications that are necessary to fix the problem (losing weight, exercising, quitting smoking, etc.) are things that patients are just unwilling to do. So, your only option is to give them a drug and hope they take it.

More directly, to answer your question: in some cases, "no", you do not need to be on blood pressure medication for the rest of your life. Some examples have been given above (such as hyperthyroidism that is ultimately corrected, etc.) and others such as pheochromcytoma, which is a benign tumor that eratically releases pressure-raising substances into the bloodstream, can be treated with surgical resection and the problem will be solved.

In many cases, however, such as when the diagnosis is "benign essential hypertension" (which is the most common diagnosis) and/or diet and lifestyle modifications don't work, then you will probably have to be on it for life.

-TT