You Shouldnt Ignore White Coat Hypertension
Some people experience white coat hypertension, when blood pressure is elevated in the doctors office but not in other settings. These patients need to monitor their blood pressure at home or wear an ambulatory blood pressure monitor that takes your blood pressure every 30 minutes for 24 hours.
While white coat hypertension was formerly considered simple nervousness, recent research suggests otherwise.
A study published in the journal Hypertension found that people with white coat hypertension are at a significantly greater risk for developing sustained high blood pressure than people who have normal blood pressure. One possible explanation is that people with white coat hypertension have a harder time managing stress and anxiety.
What Is Considered High Blood Pressure
The American Heart Association and the American College of Cardiology have recommended guidelines to define normal and high blood pressure .
Guidelines to define normal and high blood pressure stages chart
| > 139 | > 89 |
Based on these new 2017 guidelines defining high blood pressure, as many as half of all Americans will have this disease . Uncontrolled high blood pressure is responsible for many cases of death and disability resulting from a heart attack, stroke, and kidney failure.
According to research studies, the risk of dying of a heart attack is directly linked to high blood pressure, particularly systolic hypertension. The higher your blood pressure, the higher the risk. Maintaining lifelong control of hypertension decreases the future risk of complications such as heart attack and stroke.
About 1% of people with high blood pressure do not seek medical care until the high blood pressure is very severe, a condition known as malignant hypertension or a hypertensive emergency.
Antibiotic And Combination Drug Regimens For The Treatment Of H Pylori
The established treatment for H pylori infection is a combination of antibiotics plus a PPI. Current standard therapy includes three medicines, two antibiotics plus a PPI, called triple therapy. Quadruple therapy refers to four medicines, in various combinations. For any of these regimens, the medicines may be taken in stages, one after another. This is called sequential therapy. Medicines may also be taken at the same time. This is called concomitant therapy. Due to the growing resistance to certain antibiotics and areas where standard therapy cure rates are somewhat low, various combinations and timing of medications are now under study.
Reported cure rates for H pylori range from 70% to 90% after triple therapy regimen treatment. Eradication rates are higher for when bismuth subsalicylate is added to the regimen. The standard treatment regimen uses two antibiotics and a PPI:
Patients typically take combination treatment for 10 to 14 days. A 7-day regimen is another option, but some research suggests that 14 days of therapy with antibiotics and PPIs is more effective at eradicating H pylori. When quadruple therapy is taken at the same time , cure rates appear similar to when the medicines are taken sequentially.
Combination products are available.
Follow-Up
Follow-up testing to check that the bacteria have been eliminated should be done no sooner than 4 weeks after therapy is completed. Test results before that time may not be accurate.
Failure
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How Venous Leg Ulcers Are Treated
Most venous leg ulcers heal within 3 to 4 months if they’re treated by a healthcare professional trained in compression therapy for leg ulcers. However, some ulcers may take longer to heal, and a very small number never heal.
Treatment usually involves:
- cleaning and dressing the wound
- using compression, such as bandages or stockings, to improve the flow of blood in the legs
Antibiotics may also be used if the ulcer becomes infected, but they don’t help ulcers to heal.
However, unless the underlying cause of the ulcer is addressed, there’s a high risk of a venous leg ulcer recurring after treatment. Underlying causes could include immobility, obesity, previous DVT, or varicose veins.
How Can A Foot Ulcer Be Prevented
The best way to treat a diabetic foot ulcer is to prevent its development in the first place. Recommended guidelines include seeing a podiatrist on a regular basis. He or she can determine if you are at high risk for developing a foot ulcer and implement strategies for prevention.
You are at high risk if you:
- Have neuropathy
- Have a foot deformity
- Wear inappropriate shoes
- Have uncontrolled blood sugar
Reducing additional risk factors, such as smoking, drinking alcohol, high cholesterol, and elevated blood glucose are important in the prevention and treatment of a diabetic foot ulcer. Wearing the appropriate shoes and socks will go a long way in reducing risks. Your podiatric physician can provide guidance in selecting the proper shoes.
Learning how to check your feet is crucial in noticing a potential problem as early as possible. Inspect your feet every dayespecially between the toes and the solefor cuts, bruises, cracks, blisters, redness, ulcers, and any sign of abnormality. Each time you visit a health care provider, remove your shoes and socks so your feet can be examined. Any problems that are discovered should be reported to your podiatrist or a medical professional as soon as possible, no matter how simple it may seem to you.
The key to successful wound healing is regular podiatric medical care to ensure the following gold standard of care:
- Lowering blood sugar
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Hypertension And Wound Healing: How Does Hypertension Affect Pressure Ulcers
Pressure ulcers, deep wounds, pressure sores, bedsores, pressure wounds they go by many names, but the discomfort remains the same. While quick to develop, these tissue injuries are relatively simple to treat and the sooner the better, since left untreated, they can lead to many complications like sepsis, cellulitis, bone and joint infection, and in some cases, even cancer.
Pressure ulcers, deep wounds, pressure sores, bedsores, pressure wounds they go by many names, but the discomfort remains the same. While quick to develop, these tissue injuries are relatively simple to treat and the sooner the better, since left untreated, they can lead to many complications like sepsis, cellulitis, bone and joint infection, and in some cases, even cancer.
Left untreated, pressure ulcers can lead to many complications like sepsis, cellulitis, bone and joint infection, and in some cases, even cancer.
Medical History And Examination
Your GP or practice nurse will ask whether you have any other symptoms associated with venous leg ulcers, such as:
- swelling in your ankles
- discoloured or hard skin
They’ll try to determine the cause of the ulcer by asking about underlying conditions or previous injuries, such as:
Read more about how venous leg ulcers are treated.
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High Blood Pressure And Wound Healing
PaulaonMay 23, 2013
The Dangers of High Blood Pressure
High Blood Pressure and wound healing do not go together. Hypertension or high blood pressure is a measurement of how hard your body has to work to pump and circulate blood through the arteries. There may be no symptoms of high blood pressure, but a severe condition can bring on severe headaches, fatigue and weakness, blurry vision and even nausea or vomiting. Unmonitored symptoms can sometimes lead to heart failure.
High blood pressure, or hypertension causes blood to move through the hearts pumping chambers less effectively, with increased pressure in the heart, which robs your body of oxygen and nutrients.
To compensate for reduced pumping power, the hearts chambers respond by stretching to hold more blood. This keeps the blood moving, but over time, the heart muscle walls weaken and are unable to pump as strongly.
High Blood Pressure and Wound Healing
What happens when high blood pressure and poor circulation continue? This reduces much needed oxygen flow to the cells through the veins and capillaries, which regenerates and heals the cells.
Many times the kidneys react to continue high blood pressure by causing the body to retain water and sodium. . The resulting fluid buildup in the arms, legs, ankles, feet, lungs, or other organs, can lead to congestive heart failure.
What Can You Do?
A stomach ulcer can be caused by a variety of factors, including:
Looking After Yourself During Treatment
To help your ulcer heal more quickly, follow the advice below:
- Try to keep active by walking regularly. Sitting and standing still without elevating your legs can make venous leg ulcers and swelling worse
- Whenever you’re sitting or lying down, keep your affected leg elevated with your toes level with your eyes
- Regularly exercise your legs by moving your feet up and down, and rotating them at the ankles. This can help encourage better circulation
- If you’re overweight, try to reduce your weight with a healthy diet and regular exercise
Read more about preventing venous leg ulcers.
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Can You Prevent High Blood Pressure
High blood pressure may be prevented by living a healthy lifestyle include:
- Eat a nutritious, low-fat diet. The National Heart, Lung and Blood Institute of the NIH outlines the DASH diet, that is describes as a “flexible and balanced eating plan that helps create a heart-healthy eating style for life.”
- Get regular exercise.
- Maintain a healthy weight, and if you are overweight or obese, try to lose weight.
- Drink alcohol in moderation.
Diabetes Linked To Ulcer
The same bacterium responsible for most stomach ulcers may play a role in the development of Type 2 diabetes among overweight and obese adults, researchers at NYU Langone Medical Center are reporting today.
And in the same way that antibiotics eradicate the bacterium and heal ulcers, antibiotics might eventually prove useful in diabetes prevention, they suggest in an article appearing in the Journal of Infectious Diseases.
Non-diabetic adults infected with Helicobacter pylori , tended to have higher blood sugar than adults without H. pylori, according to the study co-authored by Yu Chen, an associate professor of environmental medicine at NYU, and Dr. Martin J. Blaser, chairman of NYUs department of medicine.
Chen and Blaser assessed blood sugar levels using measurements of glycosylated hemoglobin , a marker of excess glucose in the bloodstream that in recent years has become a key tool for diagnosing and monitoring diabetes.
Helicobacteri pylori is a complicated bacterium. Persistent H. pylori infections beginning in childhood have been linked decades later to ulcers of the stomach and small intestine, and a heightened risk of stomach cancer. Although H. pylori can inflame the stomach, many infected people have no symptoms.
Blaser called H. pylori a complicated and interesting organism that affects children and adults in entirely different ways. In previous work he and Chen found that H. pylori protects children against asthma and allergy.
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What Tests Diagnose High Blood Pressure
Blood pressure is measured with a blood pressure cuff . This may be done using a stethoscope and a cuff and gauge or by an automatic machine. It is a routine part of the physical examination and one of the vital signs often recorded for a patient visit. Other vital signs include pulse rate, respiratory rate , temperature, and weight.
The American Heart Association and the American College of Cardiology recommend specific steps to measure blood pressure in a medical setting.
- The patient should relax in a chair for at least five minutes, with the back supported and feet on the floor
- The patient should not have had caffeine, tobacco products or participated in any exercise for at least 30 minutes before the blood pressure check
- The patient should not talk for the five minute rest period
- The blood pressure cuff should not be placed over clothing instead it should be placed directly on the skin
- The arm being tested should be supported or be rested on a table or arm rest
- The cuff being used should be the appropriate size for the patient
- Blood pressure should be checked at least two times, separated by 1-2 minutes, and an average taken to estimate that personâs blood pressure
- For the first visit for a blood pressure check, the blood pressure reading should be measured in both arms and the higher of the two readings should be used to decide upon treatment
Other studies may be considered depending upon the individual patients needs
What Natural Remedies Therapies And Supplements Lower Blood Pressure
Alternative therapies may be helpful to people trying to control their blood pressure.
- Acupuncture and biofeedback are well-accepted alternative techniques that may help some people with high blood pressure.
- Techniques that induce relaxation and reduce stress are recommended. These include meditation, yoga, and relaxation training.
- These techniques alone may not control high blood pressure for many people. They should not be used as a substitute for medical therapy without first consulting with your health care practitioner.
Dietary supplements and alternative medications and therapies are sometimes recommended for high blood pressure.
- Examples include vitamins, garlic, fish oil, L-arginine, soy, coenzyme Q10, herbs, phytosterols, and chelation therapy.
- While these substances may be beneficial, the exact nature of their benefits is not known.
- Scientific studies have produced no evidence that these therapies lower blood pressure or prevent the complications of high blood pressure.
- Most of these substances are harmless if taken in moderate doses. Most people can take them without problems.
- Talk to your health care practitioner if you are considering any of these treatments. Substituting these therapies for medical therapies that have been shown to lower blood pressure and the risk of complications may have a harmful effect on your health.
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What Medications Treat High Blood Pressure
- Of appropriate, chlorthalidone is the preferred diuretic.
Beta-Blockers
- Beta-blockers reduce heart rate and decrease the force of heart contraction by blocking the action of adrenaline receptors. Beta blockers are widely prescribed and effective but can cause increased fatigue and decreased exercise tolerance because they prevent an increased heart rate as a normal response to physical activity.
- They are also prescribed for people who have associated heart disease, angina, or history of a heart attack.
- Examples of beta blockers include, carvedilol , metoprolol , atenolol
Calcium Channel Blockers
- Calcium channel blocking agents work by relaxing the muscle in artery walls and by therefore reducing the force of contraction of heart muscle.
- Example of calcium channel blockers include, nifedipine , diltiazem , verapamil , nicardipine , amlodipine , and felodipine
Angiotensin-Converting Enzyme Inhibitors
- ACE inhibitors stop the production in the body of a chemical called angiotensin II, which causes blood vessels to contract. Narrower blood vessels are associated with increased blood pressure. Relaxing artery walls leads to lower blood pressure.
- Examples of ARBs include losartan , valsartan , candesartan , and irbesartan
Blockers of Central Sympathetic System
Direct Vasodilators
Take your high blood pressure medicine as prescribed and only discontinue them on the advice of your doctor or other healthcare professional.
Swelling In The Legs And Ankles
Venous leg ulcers are often accompanied by swelling of your feet and ankles , which is caused by fluid. This can be controlled by compression bandages.
Keeping your leg elevated whenever possible, ideally with your toes at the same level as your eyes, will also help ease swelling. You should put a suitcase, sofa cushion or foam wedge under the bottom of your mattress, to help keep your legs raised while you sleep.
You should also keep as active as possible and aim to continue with your normal activities. Regular exercise, such as a daily walk, will help reduce leg swelling. However, you should avoid standing or sitting still with your feet down. You should elevate your feet at least every hour.
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How Often Should You Check Your Blood Pressure
The most important element in the management of high blood pressure is follow-up care.
- Routine blood pressure check-ups are important to monitor readings and decide upon a treatment plan.
- With age and the natural progression of hardening of the arteries, systolic blood pressure may elevate over time. A treatment that once worked well may no longer work as well and your medication treatment may need to be changed.
- Routine physical exams and screening blood tests may be suggested to help monitor the success of blood pressure management.
- Follow-up visits are a good time to discuss with your doctor any medication side effects that you may be experiencing. Your doctor will have suggestions for managing side effects or may change your treatment.
- Follow-up visits are a great opportunity for monitoring for other associated risk factors, such as high cholesterol, smoking cessation, and obesity.
Signs You May Have An Ulcer
Did you know that stomach ulcers also called peptic ulcers affect at least 1 in 10 Americans over the course of their lives? And while stomach ulcers can be treated easily when caught early, lack of medical care can lead to serious complications.
Understanding the signs of stomach ulcers is important in helping you get the treatment you need. At Prima Medicine in Fairfax and South Riding, Virginia, our care team has the experience and knowledge to diagnose and treat stomach ulcers. Weve curated this guide to help you recognize the warning signs of an ulcer and understand what you can do about it.
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