FROM OUR EXPERTS
Sometimes we need to rely on our doctors. But checking our blood pressure isn’t one of those times.
If you are lucky, every time you see your primary care physician or endocrinologist, somebody in the office will check your blood pressure. If you are especially lucky, somebody will tell you what the numbers are and they will be pretty accurate. You will need that good luck. For several reasons you aren’t likely to get it. Many people have “ white-coat hypertension .” They become nervous at the doctor’s office and have higher readings that they normally would at home. The other problem is that medical people are a bit busy these days, and they often rush when they need to pause. I ran into that at my most recent visit to a doctor’s office. The nurse checked my blood pressure as soon as she came in the room. I’m sure that she knew as well as I did that patients are supposed to sit still for five minutes before the test. But she was too rushed, and my numbers were predictably too high.
Medications Several classes of drugs are used to treat hypertension. Diuretics Diuretics help the kidneys get rid of excess salt and water. They are the mainstays of anti-hypertensive therapy and are often the first type of drug selected for most people with hypertension. They are also especially helpful for treating patients with heart failure, patients with isolated systolic hypertension, the elderly, and African-Americans. (African-Americans are more likely to be salt-sensitive, so they respond well to these drugs.) They also work well for patients with diabetes. Diuretics are often used in combination with other antihypertensive drugs. There is strong evidence that diuretics work just as well as newer drugs in lowering blood pressure and are more effective in preventing heart failure, heart attack, and stroke. Diuretic Types and Brands. The three main types of diuretics include: Thiazide diuretics. These include chlorothiazide (Diuril), chlorthalidone (Hygroton), indapamide (Lozol), hyd...
Sickle cell anemia is an inherited blood disease which can cause episodes of pain, damage to vital organs, and for some, death in childhood or early adulthood. Its effects vary greatly from one person to another, and from one time to another in the same person. Most people with sickle cell anemia enjoy reasonably good health much of the time. Oxygen-carrying red blood cells are normally round and flexible. But under certain conditions, the red blood cells of a person with sickle cell anemia may change into a crescent or sickle shape within the blood vessels. Sickled cells tend to become trapped in the spleen and elsewhere and are destroyed. This results in a shortage of red blood cells which, when severe, can cause the patient to be pale, short of breath, and easily tired. People with sickle cell disease may be prone to certain infections which can worsen their condition, and their physical growth and development are often slower than normal. Sometimes certain conditions may worsen a patie...
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