Common Questions - About Hypertension Treatment
Common Questions - About Hypertension Treatment
Here are some of the common questions I frequently get asked by my patients ( and my answers) regarding treatment for Hypertension…
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#HearttoHeartwithDrYee #Hypertension #QnA
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The Video Content has been made available for informational and educational purposes only. The information contained in the multimedia content (“Video Content”) posted represents the opinions and views of Dr Yee Kok Meng. Owning to each person’s varying health needs, a physician should be consulted before acting on any information provided in this material. Although every effort is made to ensure this multimedia content is accurate, neither Dr Yee Kok Meng nor the team shall be responsible for any errors, inaccuracies or other defects in the information contained.
Content
12.559 -> One of the commonest questions I get asked when patients are put on blood pressure pills,
17.68 -> they always ask me once i start this, does it mean that i need to take these pills for life, doc?
22.102 -> Well, the answer to that is.....not necessarily.
25.484 -> High blood pressure can sometimes be caused or accentuated by stress; anxiety, or by external factors.
32.377 -> And, sometimes if we change our lifestyle.
34.801 -> As I said before if you reduce your weight and change your lifestyle - if you have a healthier diet, if you have proper rest and sleep
43.003 -> your blood pressure can come down naturally by 5-10%.
45.92 -> If your blood pressure comes down, it is possible to come off these tablets.
50.48 -> However, there's a good number of patients where the blood pressure may be persistently high and in this group of patients,
57.039 -> it may not be possible or it may not be possible to reduce entirely all the blood pressure medications, you might reduce a little but not all.
66.156 -> Only for some patients where the blood pressure is mild or moderate with the adequate lifestyle changes
71.04 -> you might be able to come off the blood pressure medications eventually.
74 -> So, I have hypertension. I need to see a doctor. What tests should I do, doctor?
78.72 -> That's another common question that i get asked.
81.529 -> When you see a cardiologist these are some of the possible tests that the doctor may want to carry out.
86.537 -> He would want to find out whether you have primary hypertension or secondary hypertension.
90.621 -> Hence, he would want to do a series of tests to exclude a secondary cause for your high blood pressure.
95.795 -> This may include a series of blood tests and urine tests to exclude kidney disease or hormone imbalance.
104.195 -> He may also wish to carry out an ultrasound of the kidneys to look for conditions such as
109.439 -> renal artery stenosis which is a rare but not uncommon cause of secondary hypertension.
114.879 -> In addition to looking for a cause secondary hypertension, your doctor may also wish to
121.89 -> look for evidence of end-organ damage meaning damage caused by the high blood pressure.
126.887 -> He may do an ECG or echocardiogram to assess the heart function eg. whether there’s enlargement of the heart muscles.
135.515 -> He may also wish to assess the eyes to look for any retinopathy which is damage to the retinas caused by the high blood pressure
143.9 -> and also assess the kidney function again to look for any signs of kidney damage.
147.792 -> So, these are some of the tests that your doctors may do and depending on the results of these tests then
153.568 -> your doctor would be able to advise you on what the cause of the hypertension is and
159.449 -> therefore decide on what the best form of treatments are available and will be able to treat you appropriately.
166.067 -> Another common question I often get asked when I start somebody on high blood pressure medication is
170.867 -> will the medication be too strong for them?
173.101 -> Many patients are worried whether their blood pressure will come down too low.
177.131 -> How low is low?
178.729 -> Well, based on the guidelines blood pressure medications are often given
182.4 -> when the blood pressure readings are above 140/90 mm/Hg.
186.159 -> And the aim is to get them down to an optimal blood pressure which is often below 120/80 mm/Hg
192.381 -> There are many patients whose blood pressure are much lower than that
195.289 -> and they are fine even with a blood pressure of 100 systolic or 110 systolic over 50 or 60 mm/Hg diastolic
202.837 -> Blood pressure is too low when patients become symptomatic.
205.743 -> That's when blood doesn't get to the brain, causing giddiness or
209.267 -> it doesn't supply enough blood to the vital organs....
211.975 -> ...such as the kidneys causing end-organ damage.
216.56 -> In effect, there is a J-curve to the cardiovascular benefits of blood pressure lowering in hypertension.
221.44 -> The greater you lower the blood pressure, the greater is the cardiovascular benefit.
225.761 -> However, there is a threshold where below which when the blood pressure lowering is too much,
230.545 -> when the side effects of blood pressure lowering starts to outweigh the potential benefits of protecting the heart.
236.609 -> For most people, this would mean a systolic blood pressure of below 100 mm/Hg or diastolic blood pressure of 50 mm/Hg or below.
245.221 -> This is an important point particularly, in the elderly patients, where we do not want to lower the blood pressure too aggressively
252.075 -> as these may be potentially dangerous leading to falls and fractures.
256.8 -> Thank you for watching.
258.041 -> I hope you liked the video.
260.041 -> If you do, please don't forget to like, share and comment.
264.049 -> Thank you.
Source: https://www.youtube.com/watch?v=kczGfay4cM4