Symptoms We Treat

High Blood Pressure

High blood pressure, also known as hypertension, occurs when the pressure of the blood flowing against the artery walls is above the normal range. Blood pressure is determined by the amount of blood the heart pumps and the blood flow resistance in the arteries. If the heart pumps more blood than normal, and the arteries are narrower than normal, the result is high blood pressure. Untreated high blood pressure can cause serious health problems, including heart attack, kidney failure and stroke. There are two types of high blood pressure: primary and secondary. Primary hypertension is high blood pressure that develops gradually over the course of time, and secondary hypertension is high blood pressure that results from an underlying medical condition.

Blood Pressure Diagnosis and Measurement

Blood pressure is commonly measured during a physical exam. An inflatable arm cuff is fit around the arm and measures the blood pressure using a pressure-measuring gauge. This gauge yields two sets of numbers. The first number is the systolic reading, which is the pressure when the heart is beating. The second number is the diastolic number, the pressure when the heart is resting. High blood pressure occurs when the systolic reading is at 140 or higher and the diastolic reading is 90 or above.

High Blood Pressure Treatment

High blood pressure is often initially treated with lifestyle changes that may include:

  • Losing weight
  • Eating a healthy diet that is low in salt and fat
  • Limiting alcohol intake
  • Exercising and staying physically active
  • Quitting smoking

Hypertension that does not respond to lifestyle changes alone, is often treated with medication that may include alpha blockers, vasodilators, aldosterone antagonists, and central-acting agents. Treating any underlying conditions can also help to control high blood pressure.

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High Cholesterol

Cholesterol is produced by the liver, the intestines and nearly all tissues in the body. Cholesterol is needed for the production of hormones, vitamin D and the bile necessary to digest the fats in food. Cholesterol also protects cell membranes from changes in temperature. While a certain amount of cholesterol is needed, too much cholesterol is unhealthy. An excessive amount of cholesterol can block blood flow in the arteries. This lack of blood flow can lead to a stroke. While there are no symptoms of high cholesterol, a simple blood test can provide patients with results. Cholesterol levels can be controlled or reduced with an active and healthy lifestyle. In some cases, medication may be necessary to control high levels of cholesterol.

Types of Cholesterol

There are three different types of cholesterol. Different blood tests are performed to individually measure each type of cholesterol.

High-density Lipoprotein

High-density lipoprotein (HDL) is the “good” cholesterol because elevated HDL levels may reduce the risks for heart disease or stroke. It is believed that HDL returns excess cholesterol to the liver for elimination from the body.

Low-density Lipoprotein

Low-density lipoprotein (LDL) comprises the majority of the body’s cholesterol. It is considered to be the “bad” cholesterol because it builds up in the walls of the arteries causing them to narrow, blocking blood flow and leading to heart disease or stroke.

Very-low-density Lipoprotein

Very-low-density lipoprotein (VLDL) is composed of cholesterol, triglycerides and proteins. VLDL contains the highest amount of triglycerides than any other lipoprotein and is considered to be a “bad” type of cholesterol.

A total cholesterol test measures all types of cholesterol in the blood and the results indicate whether the bad cholesterol levels are too high.

Treatment of High Cholesterol

A low-fat diet and losing weight in general may help lower LDL and triglyceride levels. While these lifestyle changes are usually effective in treating high cholesterol, they may not be enough. If lifestyle changes have been made and the total cholesterol levels remain high, the following medication may be suggested:

  • Statin medication to reduce LDL cholesterol levels
  • Niacin, or nicotinic acid, to raise HDL levels and lower LDL levels
  • Fibrates to reduce triglyceride levels
  • Bile acid sequestrants to eliminate bile acids

Many medications do have side effects, so it is important to discuss any potential risks with a doctor before taking any medication.

Hypertrophic Cardiomyopathy

Hypertrophic cardiomyopathy is a disease in which the heart muscle, or myocardium, becomes thickened. This condition makes it difficult for the heart to pump blood. In some cases, it can also cause damage to the heart’s electrical system.

Hypertrophic cardiomyopathy is typically caused by a gene mutation that causes the heart muscles to thicken beyond their normal size. In some cases of hypertrophic cardiomyopathy, the heart muscle fibers are arranged in an abnormal fashion. This abnormal arrangement of heart muscle fibers can result in an irregular heartbeat, or arrhythmia.

Types of Hypertrophic Cardiomyopathy

The condition can be further classified into two subcategories, hypertrophic obstructive cardiomyopathy and hypertrophic nonobstructive cardiomyopathy.

Hypertrophic Obstructive Cardiomyopathy

Hypertrophic obstructive cardiomyopathy, or cardiomyopathy with obstruction, is present in roughly 70 percent of people suffering from hypertrophic cardiomyopathy. In this version of the condition, the wall between the ventricles becomes enlarged which blocks blood flow.

Hypertrophic Cardiomyopathy without Obstruction

Hypertrophic cardiomyopathy without obstruction, also known as nonobstructive hypertrophic cardiomyopathy, is the hardening of the left ventricle. While slightly less severe than hypertrophic obstructive cardiomyopathy, this version of the condition reduces the amount of blood the ventricle can process.

Treatment of Hypertrophic Cardiomyopathy

Treatment of hypertrophic cardiomyopathy focuses on easing symptoms in three possible ways. Medications to relax the heart muscle, and blood thinners to reduce the risk of blood clots, are often prescribed to allow the heart to pump at a normal rate. Surgery to remove part of the hardened heart muscle, known as a septal myectomy, or valve replacement or repair, may be necessary. Alternatively, a pacemaker or an implantable cardioverter defibrillator (ICD) may be implanted to help control arrhythmia.

Long QT Syndrome

Long QT syndrome (LQTS) is a genetic heart rhythm condition that can potentially cause fast, dangerous heart rhythms. It is usually caused by a genetic abnormality in one of the potassium or sodium channels of the heart’s electrical system. These irregular heart rhythms can cause fainting spells or seizures. In some cases it causes sudden death. Long QT syndrome is treatable, usually with just medications In some cases, treatment for long QT syndrome involves getting a defibrillator. You’ll also need to avoid medications known to worsen prolonged QT intervals. The diagnosis is made by EKG and sometimes genetic testing. Certain physical activities or sports may need to be avoided.

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