Diagnosis and Treatment of Primary and Secondary Hypertensio Posted: 01-14-06 15:43pm
My father lives in Hong Kong and has
hypertension for a few years. He did not
have any treatment since he followed a
very strict but balanced diet and
exercises regularly hoping that this would
help. However, his blood pressure seems to
spike at night recently, especially as
soon as he lays down. He saw many doctors
(even cardiologist & neurologist). At
first he thought his gallbladder stones
was the cause so he had it removed but
after that, and despites all the different
medications these doctors prescribed, none
of them works. The neurologist even
prescribed 3 MAOIs to him (which almost
landed him in the ER once again.) We all
puzzled, including the doctors in Hong
Kong, of what might have caused the blood
pressure to rise at night. His blood
work, stress test & EKG test all came out
normal. My father is very desperate for
any suggestion, especially for any
recommendation in medication since he is
very concern about his life right now.
Thanks.
|
DoctorAnswer
Doctor Answer
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High Blood Pressure, Hypertension, High Cholesterol Answer A Posted: 01-23-06 21:01pm
I can’t tell you anything about proper
therapy for your father because I need
more information about the level and type
of his hypertension (HTA). However, I can
first tell you that HTA has more unknown
than known causes. Roughly more than 95%
of all cases cannot be etiologically
traced (Primary, idiopathic, essential
hypertension). Various genetics, metabolic
rates, nutritive elements, life-style, and
psychic state (as well as other factors)
are most likely the root of its
pathogenesis. In less than 5% of all
cases of HTA, then, clinicians are able to
identify its cause: suprarenal tumors or
vascular disorders of the kidneys
(Secondary, symptomatic, non-essential
hypertension). Primary HTA is an incurable
life-lasting disease... BUT IT CAN BE
CONTROLLED by using a combination of
pharmaceutical medications and a
prescribed diet (less salt). Its treatment
is life-lasting, too. Putting the blood
pressure at normal levels is very
important to prevent atherosclerosis which
causes heart attacks, hypertensive heart
disease, cerebral insults, renal-vascular
disorders, hypertensive retinopathy…
Sometimes the HTA is very resistant to any
therapy (malignant hypertension) and the
complications mentioned above occur very
quickly. Treatment and prognosis of
Secondary HTA depends upon a number of
conditions. In your father’s case,
several biochemical blood analyses must
first be completed to identify the type of
HTA (Primary or Secondary). He also can
examine the prescence and varying levels
of the following: cholesterol (LDL and
HDL), triglycerides, glucose, urea,
creatinin, ions(Na+, K+), aldosterone,
adrenaline. An ultrasound of the kidneys
and suprarenal glands is also recommended.
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