115, High Rd., Loughton. Essex IG10 4HJ Tel: +44 (0) 208 508 7741,
WebMaster: Dr David H. Dighton
WebMaster: Dr David H. Dighton
Registered
6. 2. 2012
CASE HISTORIES
There are many possible outcomes related to blood pressure.
Here two common outcomes illustrated in summary.
Here two common outcomes illustrated in summary.
Mr C was 45. His wife was a nurse and had been concerned about the occasional
high readings she had found. His GP too had been keeping under observation.
Examining him he appeared to have a forceful heart beat. His blood pressure was
‘borderline’ (150/90). A 24hr recording showed some highs and quite a few normal
readings. His echocardiogram showed very thickened heart muscle, typical of
long established high blood pressure (hypertension). We started him on treatment to
stop further growth of his heart muscle and the muscular walls of his small arteries.
TAKE HOME MESSAGE: Once the heart muscle becomes thick (hypertrophied) the patient
is in trouble, as far as his future risk of stroke is concerned. Not all drugs control this.
Just taking his blood pressure completely underrated his risk. Blood pressure is an effect
of artery changes, not a disease process or illness in itself.
Mrs Y was a very large lady (20 stones +). She was said to have high blood pressure.
As a nurse she was worried by her inability to take blood pressure lowering pills of any
sort. Taking her blood pressure in her forearm (no machine was big enough for her
upper arm) seemed normal off of all treatment. She had a normal ECG and her
echocardiogram (heart echo) was normal. She was, however, very short of breath
on minimal exercise. Exercise made her go blue! We concluded that she had a
normal blood pressure, thought to be abnormal because of using too small a cuff
on her upper arm. She was feeling unwell on blood pressure lowering tablets
simply because her blood pressure did not need lowering!. She was breathless
Because she had the equivalent of a lawn mower engine trying drive a Centurion tank!
TAKE HOME MESSAGE: Never judge a book by its cover!
high readings she had found. His GP too had been keeping under observation.
Examining him he appeared to have a forceful heart beat. His blood pressure was
‘borderline’ (150/90). A 24hr recording showed some highs and quite a few normal
readings. His echocardiogram showed very thickened heart muscle, typical of
long established high blood pressure (hypertension). We started him on treatment to
stop further growth of his heart muscle and the muscular walls of his small arteries.
TAKE HOME MESSAGE: Once the heart muscle becomes thick (hypertrophied) the patient
is in trouble, as far as his future risk of stroke is concerned. Not all drugs control this.
Just taking his blood pressure completely underrated his risk. Blood pressure is an effect
of artery changes, not a disease process or illness in itself.
Mrs Y was a very large lady (20 stones +). She was said to have high blood pressure.
As a nurse she was worried by her inability to take blood pressure lowering pills of any
sort. Taking her blood pressure in her forearm (no machine was big enough for her
upper arm) seemed normal off of all treatment. She had a normal ECG and her
echocardiogram (heart echo) was normal. She was, however, very short of breath
on minimal exercise. Exercise made her go blue! We concluded that she had a
normal blood pressure, thought to be abnormal because of using too small a cuff
on her upper arm. She was feeling unwell on blood pressure lowering tablets
simply because her blood pressure did not need lowering!. She was breathless
Because she had the equivalent of a lawn mower engine trying drive a Centurion tank!
TAKE HOME MESSAGE: Never judge a book by its cover!