Dr Vinod Wadhwa - Your Family Doctor to High Blood Pressure

Dr Vinod Wadhwa, 2006

ISBN 81-8328-030-7

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Dreams, books, are each a world,

and books, we know

are a substantial world, both pure and good.

Round these, with tendrils strong as flesh and blood,

our pastime and our

happiness will grow.

William Wordsworth

To all the books in the world which give you the knowledge

to make you a complete human being.

Contents

Preface

Acknowledgements White-coat hyptertension Does the heart take a break? Gizmos for checking heart beats When are you hypertensive? Meaning in medical parlance Are you one of them? Understanding hypertension Role of medicines Self-treatment

Preface

No friend like health abounding and like disease no foe.

Panchatantra

How very true this is. Disease is a foe, a collective foe, which we must fight collectively with knowledge, alacrity and all our resources. Of all the foes, big and small, hypertension is an easy foe that can be fought and won over. Raised blood pressure does not directly cause a problem but does so by damaging important body parts like the kidney, heart, brain, eyes and literally the entire body. Thus, if allowed to go unchecked, it could devastate the whole being but if taken care of early, it can be tamed. Good eating habits, salt restriction, exercise, obesity control and adequate mental and physical rest are required;

Your family doctor to high blood pressure

medicines, if needed, can be added to help the system. The disease assumes significance as it is a common condition all over the world, sparing no race, no creed.

In this small book, the authors endeavour is to make one aware of blood pressure and its causes. Managing on our own, by lifestyle modifications and correct medication, finds a mention in this self- help book (if we may call it so). The need for this book is to make a person with high blood pressure understand why and how he is suffering and what he needs to do about it.

Yes, hypertension (or high blood pressure) is a very commonly used term in medical parlance all over the world. It tells us that the person is suffering from raised blood pressure. It does not qualify what is the status on other related issues.

Acknowledgements

I would like to thank all the patients who have

contributed, though unknowingly, in increasing my

understanding of the psyche of the people with hypertension (high blood pressure). No matter how much literature we scan through, information gathered is useless till it is utilised in a practical setup. Also, information has been collected and utilised from Mayo Clinics Heart Book, Hot TopicsHypertension and many other information leaflets.

Your family doctor to high blood pressure

CHAPTER ONE

White-coat hypertension

God made doctors because he cannot be present everywhere at the same time, is the usual quip of most medical representatives when they meet doctors, especially on Doctors Day. This often sets me wondering, Doctors make mistakes. Does God also make mistakes? So, to prove my point, Ill relate an interesting incident that has made me change my perspective on blood pressure and on understanding of the elusive problem.

It was a bright, rather pleasant summer morning, when a gentle,

Your family doctor to high blood pressure

well turned-out banker walked into my chamber. In measured words (remember, he was a banker), he discussed how he had been on treatment for control of high blood pressure for almost three years. He took very little salt, went for walks religiously and led a saintly life as far as possible in todays world. The only sore point was his office- stress that, I felt, he was managing pretty well; yet, his blood pressure refused to return to normal. It seemed to have got stuck at 150/90. The whole thing did not make sense. Here was an easy-going, affable person taking all the possible precautions and had no family history of hypertension. He was on regular medication, yet his blood pressure refused to reach normal. I told him to buy a digital blood pressure apparatus (though I feel, these things cause more harm than good). He was a meticulous person and he was back to me in a weeks time with a tabulated blood pressure monitoring of the previous week. I could not believe my eyes when I saw the figures on the paper.The domiciliary blood pressure readings were all in the range of 120/70. I checked his blood pressure in the clinic and the readings were still stuck at 150/90. We checked up his blood pressure on his machine in the clinic and

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White-coat hypertension

this too showed the same reading. That meant his apparatus was okay.

This scenario fitted into a new-found disease, called white-coat hypertension. This is a medical condition (not a disease really) in which the patient shows a higher reading at the clinic but at home reveals a very normal reading. Erroneously, the patient is described as hypertensive and his treatment is commenced. Every now and then, medicines are changed because the blood pressure recording remains high. The banker-gentleman is now off medication but still monitors his blood pressure regularly. He has since been allowed to have his regular cup of coffee that he really relishes. This event made me sit up and think,Why shouldnt we educate our patients about hypertension, its causes and management? Hence, this small book as a mark of respect to all the white-coat hypertensives who have been advised by their well-meaning family physicians to keep consuming medicines for hypertension (which in reality they dont suffer from) and to all those good souls who carry the burden of being labelled as high BP patients all their lives.

Your family doctor to high blood pressure