The JAMA study was an extensive chart review of over 38,000 patients at low risk for heart disease who had stage two hypertension (blood pressure between 149/90 and 159/99) and were treated with blood pressure medications. Over an average follow-up time of almost six years, they found no reduction in the risk of cardiovascular disease events or risk of death with medication use. They did, however, find an increased risk for low blood pressure, fainting, and acute kidney injury among those treated with medications.
High blood pressure often runs in families. Much of the understanding of the body systems involved in high blood pressure has come from genetic studies. Research has identified many gene variations associated with small increases in the risk of developing high blood pressure. New research suggests that certain DNA changes during fetal development may also lead to the development of high blood pressure later in life.
Be proactive and follow all medical advice received about how to manage hypertension. It is crucial to continue on any prescriptions given to treat hypertension. It is very dangerous to stop taking a medication for hypertension just because the symptoms seem to have lessened. Have frequent medical checkups and stay in touch with the doctor if any new symptoms arise.
Secondary hypertension results from an identifiable cause. Kidney disease is the most common secondary cause of hypertension. Hypertension can also be caused by endocrine conditions, such as Cushing's syndrome, hyperthyroidism, hypothyroidism, acromegaly, Conn's syndrome or hyperaldosteronism, renal artery stenosis (from atherosclerosis or fibromuscular dysplasia), hyperparathyroidism, and pheochromocytoma. Other causes of secondary hypertension include obesity, sleep apnea, pregnancy, coarctation of the aorta, excessive eating of liquorice, excessive drinking of alcohol, and certain prescription medicines, herbal remedies, and illegal drugs such as cocaine and methamphetamine. Arsenic exposure through drinking water has been shown to correlate with elevated blood pressure.
However, individuals will respond quite differently to these medications. Jim might respond quite nicely to a thiazide, but fail with a calcium blocker, and the case with Jane might be the exact reverse. There is generally no way ahead of time to predict which person will do well with which kind of medication. So, what doctors and patients are left with is an educated trial-and-error approach.
Once the diagnosis of hypertension has been made, healthcare providers should attempt to identify the underlying cause based on risk factors and other symptoms, if present. Secondary hypertension is more common in preadolescent children, with most cases caused by kidney disease. Primary or essential hypertension is more common in adolescents and has multiple risk factors, including obesity and a family history of hypertension. Laboratory tests can also be performed to identify possible causes of secondary hypertension, and to determine whether hypertension has caused damage to the heart, eyes, and kidneys. Additional tests for diabetes and high cholesterol levels are usually performed because these conditions are additional risk factors for the development of heart disease and may require treatment.
This study will assess whether minocycline, an antibiotic with anti-inflammatory effects, can improve blood pressure control in patients who do not respond to medicines in combination with lifestyle changes, such as physical activity, weight loss, and healthy eating patterns. To participate you must be at least 18 years old and have high blood pressure that does not respond to treatment with three different high blood pressure medicines even when used at the maximum doses. Please note that this study is in Gainesville, Florida.
Note – always consult your personal doctor if you are unsure whether your numbers are too high or too low. If symptoms are present you need to visit your doctor promptly. Often times, an underlying problem may affect your numbers. It is always best to first try and change your lifestyle (abandon smoking, more exercise, proper diet) to mitigate the problem, however in some circumstances drugs will be your only option to keep things under control.
Regular visits with your doctor are also key to controlling your blood pressure. If your blood pressure is well-controlled, check with your doctor about how often you need to check it. Your doctor may suggest checking it daily or less often. If you're making any changes in your medications or other treatments, your doctor may recommend you check your blood pressure starting two weeks after treatment changes and a week before your next appointment.