Diplomate, Board Certification of Emergency Medicine
Chairman, Department of Emergency Medicine Ma'ayenei
Hayeshua Hospital
Blood pressure treatment is a fast changing field. New
medications arrive daily and we have progressed a lot from
the time when we used powerful medications to reduce blood
pressure that caused all sorts of side effects such as
depression, weakness and excessive urination. Indeed, one
medication that used to be given had the troublesome side
effect of growing hair. This very effective blood pressure
reducer was a nightmare for women. Soon a scientist was able
to change the drug enough so that it grew hair without
reducing blood pressure, and this drug, minoxidil, became
the first drug approved for use in male baldness in the
U.S.A.
Now one takes a pill once a day or even a patch on the skin
once a week, and doesn't even notice the change. But even
so, every class of drugs has its side effects and some work
better for some groups of people than others. The current
range is a class called ACE inhibitors, which can really
help in patients with heart failure, but is also a good
first drug for all people with high blood pressure.
The tried and true beta blockers are cheap and effective in
younger patients, and help also to control heart rate and
extend life after heart attack. The calcium channel blockers
have come under a lot of fire recently; I tend to avoid them
for the treatment of high blood pressure. If you are taking
a pill for this problem, learn all you can about the
drug.
There should be one that is perfect for you.
Low blood pressure is a different problem. If the upper
number falls below 80, the kidneys are in danger of dying.
Usually falling blood pressure in a sick person is a
terminal event, and high power medications are necessary to
maintain blood pressure. We also can see low blood pressure
in dehydration and various poisonings. However, many people,
especially pregnant females, athletes, and young women have
low blood pressure all the time. This should not be a
concern unless there is extreme weakness or fainting,
especially when one is rising from a sitting position to a
standing one.
I would, however, state that blood pressures that are lower
than 85 are usually abnormal, but each case must be
evaluated individually. This discussion of low blood
pressure was in response to a correspondent from Bnei Brak.
I hope I answered your question. Write me in care of the
Yated.
A message from Glaxo, the sponsor of this column. Flu
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