When discussing blood pressure issues, the healthcare professional may ask questions about past medical history, family history, and medication use, including prescriptions, over-the-counter medications, herbal remedies, and food additives. Other questions may include lifestyle habits, including activity levels, smoking, alcohol consumption, and illegal drug use.
In “guessing” on the best initial single drug to try, most experts now recommend beginning either with either a thiazide diuretic (usually chlorthalidone or hydrochlorothiazide), a long-acting calcium blocker, or an ACE inhibitor. ARBs are generally thought of as substitutes for ACE inhibitors, and generally, are used only when ACE inhibitors are poorly tolerated.
For this reason, Dr. Alan Goldhamer and his colleagues at the Center for Conservative Therapy set out to carefully document the effectiveness of supervised water-only fasting and to report the results to the scientific community in a way that other doctors might find convincing. To assist him in this task, Dr. Goldhamer and his research staff at the Center sought the help of one of the world’s leading nutritional biochemists, Professor T. Colin Campbell of Cornell University.
‘White coat syndrome’ refers to elevated blood pressure due to nervousness or anxiety when clients have their blood pressure taken by a healthcare provider. This occurs in approximately 20% of clients. Key message: have the client take their blood pressure at home with an automatic home blood pressure cuff and compare the findings. Alternatively, you can ask the client to sit quietly and leave the room while an automatic cuff takes a client’s blood pressure. The automatic cuff can be programmed to take three measurements and the blood pressure documented is an average of the three readings.
Typically, more attention is given to systolic blood pressure (the first number) as a major risk factor for cardiovascular disease for people over 50. In most people, systolic blood pressure rises steadily with age due to the increasing stiffness of large arteries, long-term buildup of plaque and an increased incidence of cardiac and vascular disease.
Hydralazine has been used for the treatment of high blood pressure since the 1950's. It is believed that hydralazine reduces blood pressure, however there are concerns due to the potential for this drug to cause adverse effects. The aim of this review was to determine the extent to which hydralazine reduces blood pressure, the nature of hydralazines adverse effect profile, and to determine the clinical impact of its use for hypertension. Unfortunately, the search revealed no randomized controlled trials which compared hydralazine to placebo as monotherapy for primary hypertension, therefore we are unable to make firm conclusions regarding its effects on blood pressure, adverse effects, or clinical outcomes. Some of the adverse effects related to hydralazine and that have been reported in the literature include reflex tachycardia, hemolytic anemia, vasculitis, glomerulonephritis, and a lupus-like syndrome.