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Hypertention & Bloodpressure from steroid usage..
What is blood pressure?
The heart pumps blood around the body and the brain. In order for the blood to reach the muscles and organs, it is pumped away from the heart through the arteries. When blood has permeated the body's tissues it travels back, through the veins, to the right side of the heart. From there, it is pumped into the lungs, where carbon dioxide (CO2) is exchanged for fresh oxygen. The blood then returns to the left side of the heart to be pumped via the arteries to the tissues once again.
The blood pressure depends on how forcefully the heart pumps the blood around the body and how narrowed or relaxed your arteries are. Hypertension occurs when blood is forced through the arteries at an increased pressure. Blood pressure is measured using two numbers. An example of this could be: 'the blood pressure is 120 over 80', which is written as '120/80'. The first figure is the systolic blood pressure - the pressure in the arteries when the heart contracts and pushes the blood out into the body. The second figure is the diastolic blood pressure. This is the pressure in the arteries when the heart is filled with blood as it relaxes between two beats.
What is hypertension?
There is a natural tendency for blood pressure to rise with age due to the reduced elasticity of the arterial system. The definition of hypertension is thus dependent on the age of the patient. For example, in a 60-year-old patient, hypertension occurs when the blood pressure is higher than 160/90 while the patient is at rest. Some patients have lower thresholds for the diagnosis of hypertension, in particular diabetic patients, for whom any persisting pressure above 130/80 causes problems. Even though hypertension itself rarely has any symptoms, it can cause many serious problems.
What causes hypertension?
In more than 90 per cent cases, the cause is unknown. This is called 'primary or essential hypertension'. In the remaining minority of cases, there is an underlying cause. This is called 'secondary hypertension'. Some of the main causes for secondary hypertension are: chronic kidney diseases, diseases in the arteries supplying the kidneys, chronic alcohol abuse, hormonal disturbances and endocrine tumours.
How is blood pressure measured?
A blood pressure cuff is placed around the upper part of the arm. The cuff is inflated and the doctor listens to the artery just below the cuff as the air is then released. When the doctor can hear the heart beat, they note the systolic pressure. When the sound disappears, they record the diastolic pressure. Blood pressure can also be measured in other ways, such as using an automatic blood pressure gauge, which can also be used at home.
When the doctor measures blood pressure, it sometimes increases slightly because the patient is nervous. This reaction is called 'white coat hypertension' and the doctor will usually perform several blood pressure readings to get a better idea of what your average level tends to be. Blood pressure can also be measured evenly over the course of a day using an automatic day and night pressure gauge, which the patient carries for 24 hours.
What are the symptoms?
Hypertension hardly ever causes symptoms and may not be noticed at all. However, serious and rare manifestations of severe hypertension can be: Headache, sleepiness, confusion or coma, Serious breathing difficulties, Nose bleeds
What factors increase the risk of hypertension?
Anyone can suffer from hypertension but certain factors can seriously aggravate hypertension and increase the risk of complications: A tendency in the family to suffer hypertension: Obesity, Smoking, Diabetes type 1 or type 2, Kidney diseases, High alcohol intake, Excessive salt intake, Lack of exercise, Certain medicines, such as steroids and certain kinds of diet pills.
What can I do?
Have regular blood pressure tests if there is a family tendency for hypertension. In this way, treatment can be started before any complications arise. Change your lifestyle: Stop smoking, lose weight if necessary and exercise regularly. Cut down on alcohol, eat a varied diet, try to avoid stressful situations and experiment with different relaxation techniques. If you suffer from hypertension, your blood pressure should be measured regularly so that any necessary treatment can be arranged. If your blood pressure requires medical treatment, you will probably have to take medicine on a regular basis. If so, never stop taking it without consulting your GP, even if you feel fine. Hypertension can lead to serious complications if left untreated.
What can your doctor do?
Pinpoint risk factors and help change your lifestyle in order to reduce blood pressure. If necessary, offer medication for the reduction of blood pressure and arrange regular monitoring Possible complications: Atherosclerosis (narrowing ofthe arteries) Strokes (CVAs) - cerebral haemmorhage or cerebral thrombosis, Thoracic aortic aneurysm - expansion of the main artery in the chest, Abdominal aortic aneurysms - expansion of the main artery in the abdomen, Heart attack, Heart failure (reduced pumping ability)Kidney failure, Eye damage,Probable developments: By treating the hypertension, complications can be avoided and average life expectancy will remain almost normal. Without treatment, life expectancy may well be reduced due to the risk of developing any number of the complications listed above.
What medications are used?
Diuretics help the body excrete superfluous fluids and salt through the kidneys, and in certain cases relax blood vessels and thus reduce the strain on the circulation. Diuretics can have different effects on your kidneys and can be divided into thiazides, loop diuretics, potassium-saving diuretics or a combination of these. Beta blockers block the effect of the hormone adrenaline and the sympathetic nervous system on the body. This relaxes the heart so that it beats more slowly, lowering the blood pressure and also opens up the circulation through a central action on the vasomotor control centre in the brain stem. Alpha blockers and beta blockers combined have a similar effect to Beta blockers but have a greater effect on the resistance in the circulation. Calcium channel blockers reduce the muscle tension in the arteries, expanding them and creating more room for the blood flow. In addition, it slightly relaxes heart muscle, thus reducing the blood pressure. ACE-inhibitors: These interrupt the formation of a hormone (called angiotensin II) that makes the blood vessels contract. As a result, the tension in the circulation is lowered, the vessels expand and the blood pressure is reduced. These are very useful drugs for the treatment of high blood pressure and, if your blood pressure is not easily controlled on simple medication, your doctor will probably use a drug of this type. Angiotensin II-receptor antagonists prevent the hormone angiotensin from working on the receptors which make the blood vessels contract. The vessels expand and the blood pressure is reduced.
The following drugs are used less frequently: Indapamide is a mildy diuretic preparation which also relaxes the peripheral arteries. Hydralazine relaxes the vascular walls in the peripheral arteries thereby reducing the blood pressure. Methyldopa stimulates the alpha receptors in the brain that relax the heart and vessels so that blood pressure drops. Moxonidine is another drug which reduces the effect of the involuntary part of the brain on peripheral resistance. Minoxidil relaxes the vascular walls so that blood pressure drops.
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