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High blood pressure

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Family
GUEST COLUMN

What goes up must come down

4/12/2012
Dr Nithi Mahanonda

Automatic blood pressure meters make checking your blood pressure regularly much easiest than it used to be.

Hypertension, or high blood pressure, is a risk factor that can lead to a narrowed coronary artery and other arteries throughout the body, and it can plague people of any age. There are many reasons why a person's blood pressure is high, but about 80% of the time, the cause cannot be determined.

Blood pressure changes throughout the day depending on many factors such as activities, stress levels, pain levels and emotions. Immediately after exercising, blood pressure can drop. This can also happen while eating.

So, to determine a person's blood pressure, it has to be measured when the person has been resting for at least 30 minutes. If it is measured after a meal or after a stressful discussion, it might not be reliable.

Early morning is when our blood pressure is at its peak, which, coincidentally or not, is also the time when most heart attacks and strokes occur.

There are many blood pressure measuring tools available, and the automatic ones give pretty accurate results. However, it is best to have it checked by a doctor or a nurse to calibrate the automatic machine.

High blood pressure can affect the body in many ways. It can affect how your kidneys and arteries, brain, eyes and limbs function.

Usually, there is no obvious symptom, and by the time the symptom shows, the organ is already damaged. Therefore, people with high blood pressure must be monitored by doctors from various fields to be on the safe side.

Treating high blood pressure with no known cause might have to rely on medication, together with a change in lifestyle. A person who keeps their weight within the healthy range and exercises regularly won't need so many pills to keep the blood pressure down.

In the past, people believed that it was normal for blood pressure to increase as people got older.

A healthy blood pressure is 120/80 mmHg, and should remain so for the rest of our lives. It can go a little higher, but should not exceed 130/85 mmHg, especially for those who risk having narrowed arteries such as people with diabetes, high cholesterol, history of a myocardial infarction, paralysis and smoking. Ideally, it should be kept at 120/80 mmHg regardless of age.

Many people do not take high blood pressure seriously and wrongly assume that medicine will work magic. They also think that once their blood pressure has come down, there is no need to continue taking the medicine, and they end up returning to the hospital with far more serious problems such as paralysis, a stroke, myocardial infarction or kidney failure.

Years ago, a patient of mine in his 50s came to see me because he had a headache. His blood pressure was as high as 200/120 mmHg.

A physical check-up and blood test could not determine the cause of the high blood pressure, but he was under a lot of stress. Luckily his organs were not yet damaged.

I prescribed some medicine and told him to exercise and watch his weight. After a few months, his blood pressure came back down to normal - 130/70 mmHg. I assumed he would stick to his healthier lifestyle, and so we eventually parted ways.

Five years later, he came back to see me because his right arm felt weak. From the X-ray result, I saw that there was some bleeding in the right side of his brain. He confessed that he had stopped taking the blood pressure medicine because he had thought he was well enough, and throughout the five years, he had been fine. It was very fortunate (or unfortunate?) that this silent problem caused a blood vessel in his brain to rupture and brought him back to my attention without a more serious condition.

Another patient, also in his 50s, came to see me because he felt tired and tight in the chest during heavy activities. He had a history of untreated high blood pressure for years, and his heart was slightly enlarged. Protein was found in his urine sample.

His cardiologist and his kidney doctor agreed that he needed an X-ray angiogram (dye test), and it was found that while his heart was fine, the artery that supplied blood to his right kidney was very narrowed. He was treated by balloon angioplasty and stent placement, so his blood pressure came down from 210/110 mmHg to 130/80 mmHg within just three months. His tiredness disappeared as well.

You can never be too careful when it comes to your blood pressure. Have it checked regularly. If it is already high, try to determine the cause and treat it accordingly. Do not stop taking medicine without consulting your doctor.

Always exercise and keep your weight within the healthy range. It is a much preferable option than watching your body ruined.

Dr Nithi Mahanonda is a consultant cardiologist and interventionist at Perfect Heart Institute, Piyavate Hospital. Visit his website at www.drnithi.com (and Facebook).

(Source: Bangkok Post, Family, GUEST COLUMN, What goes up must come down, 4/12/2012, Dr Nithi Mahanonda, link


Hypertension Vocabulary

blood pressure - ความดันเลือด (See Wikipedia)
blood pressure changes throughout the day

hypertension - when blood pressure in the arteries is at very high levels for long periods of time ความดันโลหิตสูง,  ความดันเลือดสูง (See Wikipedia)
high blood pressure - Same as "hypertension"
pressure - a force causing change ความกดดัน

what goes up must come down - meaning: the force of gravity (แรงดึงดูดของโลก) and blood pressure

risk - danger,the possibility that something dangerous or unpleasant might happen ความเสี่ยง
factor - a fact or situation which influences the result of something ปัจจัย
risk factor - one dangerous thing (that can help cause bad things to happen)

artery - one of the thick tubes that carry blood from the heart to other parts of the body เส้นโลหิตแดง
coronary artery

narrowed - when a tube becomes smaller (making it difficult for fluid or water to pass through it)
a narrowed coronary artery

plague - be a big problem (that people must deal with and solve)
it can plague people of any age

determine - find out; discover; to learn what or why something happened ระบุชี้ชัด
about 80% of the time, the cause cannot be determined

factors - one of the things that effects a situation or event ปัจจัย
depending on many factors

stress (noun) - a feeling of worry and tension from difficulties in life ความเครียด
stress levels

stressful (adjective)
stressful discussion

under a lot of stress

blood pressure changes throughout the day depending on many factors such as activities, stress levels, pain levels and emotions

determine - to officially find out or decide something ตัดสินใจ ชี้ขาด กำหนด
determine a person's blood pressure

measure - find out what the size of something is, how big or small it is วัด,  วัดขนาด
measure blood pressure
to determine a person's blood pressure, it has to be measured when the person has been resting for at least 30 minutes

reliable - dependable, trustworthy; correct; not failing ที่น่าเชื่อถือ เชื่อถือได้, ไว้ใจได้
reliable measurement
reliable measurement of blood pressure
If it is measured after a meal or after a stressful discussion, it might not be reliable

heart attack - (See Wikipedia)
myocardial infarction -
Same as "heart attack"
strokes


coincidence (noun) - when two things exist at same time by accident  การเกิดขึ้นพร้อมกัน
coincidentally (adverb) - accidentally โดยบังเอิญ

peak - the time when something is at its highest or greatest level ช่วงเวลาที่พบมากที่สุด
peak blood pressure
early morning is when our blood pressure is at its peak, which, coincidentally or not, is also the time when most heart attacks and strokes occur.

accurate - correct, exact and without any mistakes ถูกต้อง, แม่นยำ
results - what is produced in the end by an activity or task
accurate results
pretty accurate results

calibrate - to adjust and make accurate the equipment you use to measure something
calibrate a machine
calibrate the automatic machine

There are many blood pressure measuring tools available, and the automatic ones give pretty accurate results. However, it is best to have it checked by a doctor or a nurse to calibrate the automatic machine.

functioning - working or operating in a normal way เป็นปกติ ใช้การได้ปกติ
functioning normally
not functioning normally

kidney
- ไต
how your kidneys function

arteries - the blood vessels that bring blood from the heart to the tissues of the body
limb - the arms or legs 
high blood pressure
can affect how your kidneys and arteries, brain, eyes and limbs function

obvious - clear; easy to see, recognise or understand ชัดเจน
symptom - a sign that someone has an illness อาการ
obvious symptom

organ
- in biology and anatomy an organ is a collection of tissues joined in a structural unit to serve a common function อวัยวะ
damaged organ

usually, there is no obvious symptom, and by the time the symptom shows, the organ is already damaged.

monitored - watch carefully what is happening, to make sure everything goes well เฝ้าระวัง
Therefore, people with high blood pressure must be monitored by doctors from various fields to be on the safe side.

medication - a medicine, or a set of medicines or drugs used to improve a particular condition or illness
lifestyle - the living conditions and things people do everyday (fashion, home decoration, pets, cooking, music, tv, movies, garden, etc) รูปแบบการดำเนินชีวิต
Treating high blood pressure with no known cause might have to rely on medication, together with a change in lifestyle.

the healthy range for weight  

keeps weight within the healthy range

A person who keeps their weight within the healthy range and exercises regularly won't need so many pills to keep the blood pressure down.

exceed - to be greater than a number or amount to go beyond a limit เกินกว่าที่กำหนด เกินปริมาณ
diabetes - a serious medical condition in which your body does not produce enough insulin to reduce the amount of sugar in the blood โรคเบาหวาน  (See Wikipedia)

cholesterol - a chemical found in food, consuming high quantities over time is associated with heart disease (See Wikipedia)
assume - to accept something to be true (as basic, without question or proof)

It can go a little higher, but should not exceed 130/85 mmHg, especially for those who risk having narrowed arteries such as people with diabetes, high cholesterol, history of myocardial infarction, paralysis and smoking. Ideally, it should be kept at 120/80 mmHg regardless of age.

Many people do not take high blood pressure seriously and wrongly assume that medicine will work magic.

stroke - a medical condition is which the blood flow is suddenly stopped and cannot reach the brain อาการเส้นโลหิตในสมองแตกอย่างเฉียบพลัน ภาวะหัวใจวาย หมายถึงการที่หัวใจไม่สามารถสูบฉีดเลือดไปเลี้ยงสมองได้ชั่วขณะ

kidney
- one of the two organs in your body that clean your blood and remove waste ไต
kidney failure

They also think that once their blood pressure has come down, there is no need to continue taking the medicine, and they end up returning to the hospital with far more serious problems such as paralysis, a stroke, myocardial infarction or kidney failure.

patient - someone who is receiving medical treatment คนป่วย, คนไข้

Years ago, a patient of mine in his 50s came to see me because he had a headache.

physical check-up

physical check-up and blood test could not determine the cause of the high blood pressure, but he was under a lot of stress.

watch his weight - be careful about weight and keep from adding weight

prescribed - when a doctor writes out medicine for you to take, on an official piece of paper, when presented a pharmacy supplies you with the medicine สั่งยา
prescribed medicine

I prescribed some medicine and told him to exercise and watch his weight.

eventually - at the end of a period of time or at the end of a process ในที่สุด
parted ways - when two people leave each other and go different directions (during a short walk or in life, for example)
eventually parted ways 

stick to -
continue doing something (not change)
stick to his healthier lifestyle


After a few months, his blood pressure came back down to normal - 130/70 mmHg. I assumed he would stick to his healthier lifestyle, and so we eventually parted ways.

X-ray - the most common form of medical imaging, looking inside the body for medical problems รังสีเอ็กซ์, ภาพเอ็กซ์เรย์ (See Wikipedia)
ray - a narrow beam of light, heat, etc. travelling in a straight line from its place of origin ลำแสง แสงอาทิตย์

the X-ray result

from the X-ray result, I saw that there was some bleeding in the right side of his brain.

He confessed that he had stopped taking the blood pressure medicine because he had thought he was well enough, and throughout the five years, he had been fine.

fortunate - lucky โชคดี
unfortunate - unlucky โชคร้าย, เคราะห์ไม่ดี

blood vessel -
the tubes carrying blood around the body หลอดเลือด (See Wikipedia)
blood vessel ruptures
blood vessel in his brain ruptures

It was very fortunate (or unfortunate?) that this silent problem caused a blood vessel in his brain to rupture and brought him back to my attention without a more serious condition.

chest - the upper front part of the body of humans and some animals, between the stomach and the neck, containing the heart and lungs หน้าอก
felt tight in the chest
another patient felt tight in the chest during heavy activities.

urine - น้ำปัสสาวะ
urine sample - some urine from a person so doctor can test it for disease

protein
was found in his urine sample

cardiologist - a heart specialist; a doctor who treats heart conditions แพทย์ผู้เชี่ยวชาญโรคหัวใจ
dye - to change the colour of something using a special liquid สารย้อมสี

angiography -
a technology used by doctors to look into blood vessels (See Wikipedia)
X-ray angiogram (
dye test) - the medical image produced by angiography

balloon angioplasty - the technique of mechanically widening narrowed or obstructed arteries: "the latter typically being a result of atherosclerosis. An empty and collapsed balloon on a guide wire, known as a balloon catheter, is passed into the narrowed locations and then inflated to a fixed size using water pressures some 75 to 500 times normal blood pressure (6 to 20 atmospheres). The balloon crushes the fatty deposits, opening up the blood vessel for improved flow, and the balloon is then deflated and withdrawn. A stent may or may not be inserted at the time of ballooning to ensure the vessel remains open" (See Wikipedia)

stent - a tube put into the body to hold open passageway such as a blood vessel   (See Wikipedia)
stent placement

regularly - done often at regular intervals such as every week or month; done habitually โดยปกติ,  เป็นประจำ, เสมอๆ
check regularly
have blood pressure checked regularly

treat - give medical treatment to cure a disease, to make a disease or medical condition better
if it is already high, try to determine the cause and treat it accordingly.

consulting - talking with an expert to get their expert advice on a subject  หารือ
consulting your doctor
do not stop taking medicine without consulting your doctor.

always exercise
keep your weight within the healthy range 

option - a choice; something that you can choose in a particular situation ตัวเลือก ทางเลือก
preferable - something you like more than other things
much preferable option

ruined - destroyed; fallen apart (nto working anymore)
your body ruined

It is a much preferable option than watching your body ruined

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