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MISCONCEPTIONS ABOUT HYPERTENSION

Dr Himanshu Gul Mirani Emergency Physician and Centre Head UCC, Kalkaji
1. Hypertension cant be asymptomatic Hypertension is a silent killer. Its very much possible to have high BP and yet be asymptomatic. Symptoms like headache/ nausea/ vomiting/ chest pain/ shortness of breath may not be present at the very outset of disease. Its not a rule that BP is high only when you can feel it! Usually such patients present to ER upon decompensating into Hypertensive Crisis. 2. Anti-hypertensive medicines need to be discontinued once normal values are recorded Your normal values may well be because of the anti-hypertensive medicines itself. So dont discontinue them without a proper physician consult. Sudden discontinuation of these medicines without medical supervision can predispose the patient to rebound hypertension and precipitate Hypertensive Crisis. 3. Its OK to miss my doses of medicines anyways I take them every day, so some drug holiday is allowed Non drug compliance itself is thought to cause about 89000 pre mature deaths in USA per annum. These deaths are simply preventable by practicing drug regime adherence. So dont skip your doses. It would only undo the good.

4. Its been quite some time since I saw my doctor & I am continuing with my prescription which is ages old Its very much advisable to have a diligent follow up with your GP, although you may be having a good control of BP with your current medicines. Antihypertensive medicines have their own side-effects which need to be monitored, eg patients on ACE Inhibitors need Kidney Function Tests regularly at the commencement of therapy and continuation of therapy. Diuretics predispose a person to dyselctrolytemia. Maybe the cough for which you are gulping OTC cough syrups is a side effect of ACE inhibitor drug. So do keep visiting your GP as advised by him/her. Also maybe after implementing positive therapeutic lifestyle interventions you may need drug dose reduction! 5. I left exercising as it increases BP Exercising to the best of ones capability and capacity is advisable to even heart failure patients. It has been established that regular permissible exercise and weight management can only have positive impact on ones health. In fact for every 10kg weight loss SBP may fall between 5-20 mmHg and if one does regular exercise for about 30-45 mins on most days of a week, preferable 5 out of 7; this itself can bring a fall in SBP of 4-9 mmHg. Sedentary life style is one of the leading risk factor predisposing to hypertension. 6. High BP affects only oldies The disease has epidemically plagued the Gen Y and Gen Z and is no longer limited to the Baby Boomers. There is enough evidence to testify that the young are fast getting engulfed by hypertension. High stress levels, lack of physical activity, tobacco and alcohol addiction, excess salts in packaged and processed foods, fast foods all contribute immensely to increase the disease load. 7. Medicines are ineffective in old patients and they cant hit their goal BP With the multiple drugs in the armamentarium of your physician the drugs are very much capable to help you attain your target level of BP. These drugs act by varied mechanisms to help an individual attain the desired control of BP.

Target BP is determined based on ones other co-morbid conditions - more the co-morbidities like diabetes and chronic kidney disease the more stringent the control of BP. 8. Medicines are the only way to control BP Non pharmacologic methods to control BP have a very well established role in todays BP management methodology. They have variable effects depending upon individuals. The following are the suggested measures: Decrease sodium (salt) intake Regular exercise on most days of a week Weight reduction Moderation of alcohol consumption Quit smoking Follow DASH diet

For any feedback/ suggestions/ query regarding this article; contact the author on himanshu.mirani@urgentcare.co.in

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