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Anjali Dixit

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About Author — Dr. Anjali attended Stanford University and is continuing her training in anesthesiology at UCSF. She has a background in public health and an interest in how technologies can shape U.S. healthcare.

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Have you ever been told that you have high blood pressure? Just like diabetes (as we discussed in our last post, Who Cares About High Blood Sugar?), high blood pressure is a silent disease. Most people don’t have any symptoms for years, so they might wonder why they need to treat it. Plus, blood pressure can vary widely throughout the day — sometimes your blood pressure is higher in a doctor’s office because you’re nervous or you just rushed to the clinic. But if you’ve had multiple high blood pressure readings at doctors’ offices and/or with a home blood pressure machine, this is probably something that you should investigate and treat.

Blood pressure is the actual pressure in your blood vessels. If your blood pressure is too low, it doesn’t circulate well throughout your body and it can’t distribute oxygen and other vital nutrients to your cells. However, if your blood pressure is too high, it damages the walls of the blood vessels. Your heart also has to pump really hard against that high pressure to get blood out. Over many years, damage to the blood vessels and the heart leads to many serious conditions, such as the following:

• Kidney disease: If you have hypertension, a doctor will probably check your kidney function regularly with a blood or urine test. These tests are done to see how your kidneys are functioning. Long-term hypertension damages the blood vessels in the kidneys, a condition called hypertensive nephropathy. Kidney damage leads to many problems because the kidneys maintain the balance of electrolytes in your bloodstream and filter out toxins – functions that are vital for survival. Patients with extreme kidney damage eventually have to rely on dialysis machines to do the work of their kidneys for them, or they have to receive a kidney transplant.

• Heart attack or heart failure: Just like any other muscle, the heart will grow larger as it works harder. With high blood pressure, the heart pumps so hard against high pressures that it can enlarge a lot and require a huge amount of oxygen to keep working well. The heart’s oxygen demand will eventually outweigh what the body can provide, and the heart muscle will slowly start to die. This can lead either to a sudden heart attack or to a more gradual development of heart failure. Either way, one’s heart stops being able to circulate the blood through the body well, leading to symptoms such as swelling in the legs, difficulty breathing, trouble with exertion, and fatigue. Heart attacks and heart failure can also lead to death.

• Stroke: Patients with uncontrolled blood pressure can also develop damage to the blood vessels in their brain. Over time, this damage weakens the blood vessels and can lead to bleeding in the brain or a sudden loss of blood flow to the brain tissue — the two main ways that one can have a stroke. Strokes cause various symptoms depending on what part of the brain they affect, but common symptoms include sudden facial drooping, weakness on one side of the face or body, trouble speaking, and problems with walking or balance. Stroke can also lead to death.

While these complications sound severe and scary, they all take years to develop. All three of these complications are more likely if you have other medical conditions (like diabetes or obesity), if you smoke cigarettes, or if you don’t exercise regularly. This means that you have time to treat high blood pressure (also known as hypertension) with lifestyle changes and/or medications before it causes serious problems.

As always, PlushCare doctors are available for consultation about your blood pressure. Our doctors can order blood work to test your kidney function and can help you think through ways of modifying your lifestyle to prevent or treat hypertension. We can also provide prescription medications for the treatment of hypertension.

PlushCare’s top physicians will diagnose, treat, and prescribe you medication all from your phone. For more information or to book an appointment, visit plushcare.com.

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