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Old 07-21-2018, 05:34 PM
 
8,708 posts, read 4,954,360 times
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Quote:
Originally Posted by oldgardener View Post
You can read about the reasons to give some patients a certain med and other patients other meds, at this link.

https://bpac.org.nz/BPJ/2010/october...ertensive.aspx
Great link. Thanks
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Old 07-21-2018, 05:34 PM
 
Location: SW Florida
14,859 posts, read 11,990,498 times
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Quote:
Originally Posted by UNC4Me View Post
Yes, some can be fixed with time. And some like older age, genetics, family history of high blood pressure, chronic kidney disease, adrenal/thyroid disorders and sleep apnea are outside ones control.

The point is to take the medication to lower BP while concurrently working on correcting the risk factors within your control so you may be able to stop the medication. Given the life threatening issues that can arise from high blood pressure, I would take the meds. I would encourage anyone I love to do the same.

BTW, high blood pressure is a possible sign of Metabolic Syndrome not the other way around. Although, you can have HBP without having metabolic syndrome or can have metabolic syndrome without having HBP.

What are the signs of metabolic syndrome?

A person with metabolic syndrome has three or more of the following:

Obesity: a waistline of 40 inches or more for men and 35 inches or more for women
Blood pressure: 130/85 or higher
Triglyceride (part of "bad" cholesterol) levels: 150 mg/dl or above
HDL cholesterol ("good" cholesterol) levels: 40mg/dl or lower in men and 50mg/dl or lower in women
Fasting blood glucose (blood sugar) levels: 110 mg/dl or above

Well, according to those criteria I don't have metabolic syndrome, but I do have high blood pressure. I have a strong family history of hypertension, with family members having it at an early age and not being overweight (as was the case with me when I first had problems with it). I use both medication and life style practices to keep the blood pressure under control, but it still gets the best of me once in a while-mostly under stress or illness.

I have to assume that I jumped into the wrong gene pool to ever think I could stop having to deal with high blood pressure, either by stopping the medication for it, or skipping the exercise, healthy diet and so on.
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Old 07-21-2018, 06:15 PM
 
385 posts, read 320,978 times
Reputation: 1578
Quote:
Originally Posted by Good4Nothin View Post
Most of the causes, aside from a genetic defect, can be fixed.

Also, you didn't mention metabolic syndrome, probably the most common cause these days. And caused by the typical modern lifestyle.
Metabolic syndrome does not cause hypertension. Rather, metabolic syndrome describes a constellation of symptoms, of which hypertension may be included.

If you look in medical textbooks, hypertension (hereafter HTN) is divided into two main categories:
1) essential HTN
2) secondary HTN

95% of hypertensive patients have essential, and only about 5% have secondary.

In secondary HTN, a patient may develop HTN early in life without any family history. Secondary HTN has specific causes (there is a whole list). E.g., if you have a pheochromocytoma (extremely rare), your secondary HTN is caused by excessive plasma levels of norepinephrine. Renal artery stenosis is another possible cause.

The biggest category is called essential HTN, and no (specific) cause can be identified. The pathogenesis is considered to be multifactorial. Genetic factors play a role, and obesity is often an exacerbating factor. BTW, smoking is one of those factors, because it raises plasma levels of norepinephrine.

Anti-HTN meds have a host of differing mechanism, and sometimes today patients take one pill that combines two differing mechanisms of action.

A long time ago, I used to remember the dominant types by the acronym ABCDE:
alpha blockers, beta blockers, calcium channel blockers, diuretics, and ACE inhibitors (ok, it almost worked). And then they came out (probably a decade ago) with ARBs -- angiotensin receptor blockers. There are some some shortcuts to the naming conventions: meds ending in -ol are normally beta blockers (e.g., propanolol, metroprolol), meds ending in -il are ACE inhibitors (lisinopril), etc.

First thing to remember is that patients with essential HTN are normally asymptomatic (unless the elevation is extreme). They normally don't feel a thing.

However, the heart (a brilliant pump with four chambers, two atria and two ventricles) is really working hard to pump out blood against a pressure gradient. If this continues for decades, the shape of the heart will gradually remodel. Where there was once a perfect symmetry between four chambers, this symmetry breaks down as chamber sizes differ. Then you get cases where a little blood may not evacuate to the next chamber as "cleanly" as before. If fact, some blood may pool in one or more chambers.

This gets worse and worse as one passes through four different classifications of congestive heart failure. Today, it usually is just called "heart failure". There are medications to help this, but it can't be cured. I watched a patient die in the hospital in Temple, TX of this many years ago. His treating doctor had tried every combination of meds he had at his disposal. The doctor was very compassionate and switched to palliative care -- trying to make the patient as comfortable as possible.

At 72 years old, my father was obese, had hypercholesterolemia, HTN, and heart failure. Every so often, he would "decompensate," blood that hadn't cleared his heart would back up into his lungs, and he would have to be admitted to the hospital to be "dried out." Finally, it took his life (1992).

Folks, these medications work well, and cardiologists are well equipped to treat HTN. Take your meds, and avoid the exacerbating factors -- obesity, smoking, etc.
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Old 07-21-2018, 06:17 PM
 
Location: Georgia, USA
36,974 posts, read 40,978,179 times
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Quote:
Originally Posted by Good4Nothin View Post
So you have not considered that your lifestyle might be causing it? You find it simpler to take a drug?

Please try to understand that drugs interfere with intricate and poorly understood natural processes. They should not be used instead of lifestyle modifications. They should only be used if urgently needed.

If your BP is dangerously high in spite of a good lifestyle, and your doctors have not been able to find any reason for it, then you should take drugs. Otherwise, you could be damaging your health for no reason.
No, dear heart, as many CD posters have told you, hypertension is not always a result of a bad lifestyle, and a number of us have explained that our hypertension started and continued no matter what lifestyle changes were made. High blood pressure kills people. If the stroke does not kill you, it may cripple you and send you to a nursing home. Telling people to refuse medical treatment for high blood pressure is ill advised. You could cause someone to die. I have taken these medications for a Very Long Time. The "drugs" are not damaging my health.

I plan to be the first in a long line of women to not have stroke, like my mother, her mother, and her mother's mother.

Quote:
Originally Posted by Good4Nothin View Post
Most of the causes, aside from a genetic defect, can be fixed.

Also, you didn't mention metabolic syndrome, probably the most common cause these days. And caused by the typical modern lifestyle.
As you have been told before, metabolic syndrome is, well, a syndrome. Hypertension is one of the components of metabolic syndrome. Saying that metabolic syndrome causes high blood pressure is like saying metabolic syndrome causes metabolic syndrome.

Quote:
Originally Posted by Good4Nothin View Post
Most of the time hypertension is related to insulin resistance. The reason hypertension is so common now is because the typical lifestyle leads to metabolic syndrome (insulin resistance, etc.).

You are trying to make it sound like it's a big mystery, idiopathic, no idea why it happens, must resort to drugs.

When in fact it is very well known that metabolic syndrome is involved, and most likely somehow causes hypertension. None of this is completely understood. But it's not simply not known, that is just not true.

Again, it is primarily lifestyle. You will deny it and say it's genetic. But just because genetics is involved (it's involved in just about any disease) doesn't mean drugs are the answer.

Genetics can make one person more vulnerable than another. In rare cases, a person can do everything right and still have hypertension. Most of the time, lifestyle is the major contributer.
Before you continue to post about hypertension, you need to do some reading about it. If you are trying to convince your family and friends not to take "drugs" for hypertension you could do serious harm.

The most common form of hypertension is idiopathic. No one knows what causes it. That is right there in the link I gave previously. I even quoted it:

"Essential hypertension (also called idiopathic hypertension) may be attributed to multiple factors, including genetic predisposition, excess dietary salt intake, and adrenergic tone, that may interact to produce hypertension. Essential hypertension accounts for 90% of human hypertension and can evolve into secondary hypertension, as renal function decreases. Thus, the distinction between primary and secondary forms of hypertension is not always clear in patients who have had uncontrolled hypertension for many years."

Yes, insulin resistance can affect blood pressure. One way is through its effect on salt physiology. The magnitude of the effect is related to whether an individual is salt sensitive or not. This may be gift from our ancient ancestors as an adaptive response that favored survival. Yep, those pesky genes again.

https://dmsjournal.biomedcentral.com...1758-5996-6-12

A healthy lifestyle is important, but it does not treat the cause.
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Old 07-21-2018, 06:36 PM
 
8,189 posts, read 3,383,296 times
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Quote:
Originally Posted by suzy_q2010 View Post


The most common form of hypertension is idiopathic. No one knows what causes it. That is right there in the link I gave previously. I even quoted it:

"Essential hypertension (also called idiopathic hypertension) may be attributed to multiple factors, including genetic predisposition, excess dietary salt intake, and adrenergic tone, that may interact to produce hypertension. Essential hypertension accounts for 90% of human hypertension and can evolve into secondary hypertension, as renal function decreases. Thus, the distinction between primary and secondary forms of hypertension is not always clear in patients who have had uncontrolled hypertension for many years."

Yes, insulin resistance can affect blood pressure. One way is through its effect on salt physiology. The magnitude of the effect is related to whether an individual is salt sensitive or not. This may be gift from our ancient ancestors as an adaptive response that favored survival. Yep, those pesky genes again.

https://dmsjournal.biomedcentral.com...1758-5996-6-12

A healthy lifestyle is important, but it does not treat the cause.
So you post a quote, and assume it is the absolute undeniable truth.

A healthy lifestyle, most of the time, DOES treat the cause. The cause is insulin resistance, which is caused by the modern lifestyle.

Everyone knows this, except people who want to sell drugs.

And salt sensitivity is probably a result of metabolic syndrome. So correct the metabolic syndrome and you don't have to worry about salt.

And by the way, you never say anything about your own lifestyle. Your mother and grandmother had strokes, but you don't say anything about their lifestyles. If a thin and physically active person has a stroke at a relatively young age, then it probably wasn't lifestyle-related. But you never give the critical information.
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Old 07-21-2018, 06:46 PM
 
Location: Northern California
128,311 posts, read 11,839,430 times
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some people who reduce salt, actually increase their BP. Cutting salt only helps those who are salt sensitive. I am not one of them.

https://reason.com/blog/2013/05/15/o...ns-are-salt-se



And from the next link:

"One study found that less than 3,000 mg of sodium per day is linked to an increased risk of dying from heart disease, including from heart attacks and strokes (14)."

https://www.healthline.com/nutrition...ction#section2

Last edited by evening sun; 07-21-2018 at 07:07 PM..
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Old 07-21-2018, 07:11 PM
 
8,189 posts, read 3,383,296 times
Reputation: 6057
Quote:
Originally Posted by evening sun View Post
some people who reduce salt, actually increase their BP. Cutting salt only helps those who are salt sensitive. I am not one of them.

https://reason.com/blog/2013/05/15/o...ns-are-salt-se



And from the next link:

"One study found that less than 3,000 mg of sodium per day is linked to an increased risk of dying from heart disease, including from heart attacks and strokes (14)."

https://www.healthline.com/nutrition...ction#section2
And yet, the medical profession stubbornly continues to recommend low salt for everyone.

I just wish they would include a logic class in medical school.
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Old 07-21-2018, 07:18 PM
 
6,438 posts, read 6,877,340 times
Reputation: 8739
My numbers are perfect with medication. 200/115 when I was diagnosed. I'm very happy.

Metoprolol, amlodipine, losartan.
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Old 07-21-2018, 07:43 PM
 
3,211 posts, read 2,951,787 times
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Quote:
Originally Posted by Larry Siegel View Post
My numbers are perfect with medication. 200/115 when I was diagnosed. I'm very happy.

Metoprolol, amlodipine, losartan.

Wow!
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Old 07-21-2018, 07:59 PM
 
22,601 posts, read 24,409,835 times
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Some people need meds, some people need to make changes in their life, it really depends on the individual.

My BP used to run high, at times dangerously high.........have seen it as high as 155/100.

I started seriously cutting salt and my blood-pressure responded quite quickly. Now I take my BP and it will be 110/55 or something like that. The wonderful thing is, food, after the initial low-sodium shock, tastes brilliant. I do not add salt to anything and try to avoid as much from sources like canned-food, and other packaged-foods that have salt. Sure I cannot avoid added salt 100%, that is probably not necessary or healthy anyways.

My taste-buds are much improved without all that salt. I can cook 2 large chicken-thighs in water, until it is broken-down and soup-like, and it tastes so good. Leaving out the salt has made my
taste-buds much more attuned to the actual taste of what I am eating and not the added saltiness.

Last edited by tickyul; 07-21-2018 at 09:14 PM..
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