High Blood Pressure: Natural Self-help for Hypertension, including 60 recipes. Michelle Berriedale-Johnson

Скачать книгу

– this gives a good indication of whether or not your heart is enlarged

       listening to your heart with a stethoscope to check for heart murmurs and to listen to your heart beat rhythm

       listening to your lungs to check for signs of fluid build-up on the chest

       listening to your neck and abdomen with a stethoscope to detect any noises due to turbulent blood flow through damaged carotid or renal arteries

       examining the backs of your eyes to look for any signs of arterial damage (see below).

      If your blood pressure remains consistently raised, you may have the following routine investigations:

       chest x-ray – to check the size and shape of the heart and to look for evidence of congestive heart failure with fluid build-up on the lungs

       ECG – heart tracing to look for signs of left-ventricular thickening, irregular heartbeat or evidence that the heart muscle is struggling

       analysis of a urine sample – to look for protein and sugar, which would suggest blood vessels in the kidney are damaged

       blood test for urea and electrolytes – to check kidney function and your salt balance

       blood test for fasting blood lipids – to see if your blood cholesterol or other fat levels are raised.

      If your doctor suspects your blood pressure is due to an underlying cause, you may have one or more of the following tests carried out:

       If your potassium level is low, and you are not on diuretic treatment, you may have a hormone problem leading to high blood pressure. You will therefore have blood tests taken to check levels of other hormones such as aldosterone, cortisol and renin.

       Blood tests to assess kidney function (creatinine clearance rate).

       An intravenous urogram – a substance that shows up on x-ray is injected into your blood stream and a series of x-rays taken. This shows any narrowing of your renal arteries, how well your kidneys concentrate the dye in the urine, and outlines your urinary system to show up anatomical abnormalities or shrinkage of the kidneys.

       Ultrasound of your kidneys.

       Blood tests to measure catecholamine levels or measurement of urinary vanillylmandelic acid if phaeochromocytoma (tumour of the adrenal gland) is suspected.

       If acromegaly is suspected from changes to your facial features and the fact that your tongue, jaw, hands and feet are getting bigger, you will have your blood levels of growth hormone measured.

      EYE EXAMINATIONS

      High blood pressure damages small arteries throughout your body. Those in the back of the eye have the advantage of being visible using an ophthalmoscope and they show the state of arterioles throughout your system, including your brain. Early changes due to hypertension include thickening of retinal blood vessel walls. If hypertension becomes long-standing or severe, the blood vessels leak and little haemorrhages form. Other changes are probably due to obstruction of vessels and reduced blood circulation.

      Your doctor will regularly check the back of your eyes for signs of damage if your blood pressure has been high. This is performed in a darkened room using an ophthalmoscope, which contains a number of lenses and a light source. Sometimes you may have one eye dilated first with drops to make the task easier. The doctor is looking for various abnormalities known as Keith-Wagener retinal changes. These are divided into four stages of severity:

       Grade 1 – retinal arteries are more tortuous i.e. less straight. Because they are thickened and bulging under pressure, they also reflect light from the ophthalmoscope more than usual. This gives them an appearance known as silver wiring.

       Grade 2 – as in grade 1, plus evidence that the thickened, bulging arteries are compressing the veins where they cross over them (arterio-venous nipping).

       Grade 3 – as in grade 2, plus signs that the arteries have started leaking. Leakage of protein-rich fluid produces white, soft, ‘cotton wool’ – like blobs while leakage of blood produces flame-shaped haemorrhages.

       Grade 4 – as in grade 3, plus swelling, bulging and blurring of the head of the optic nerve (papilloedema).

      If haemorrhages, exudates or papilloedema are visible in the back of the eye, it shows that malignant hypertension (see page 5) has developed. These are the same sort of processes that are occurring in the brain and which are thought to lead to a stroke. It is very important that your hypertension is brought under control quickly and safely. You may be admitted to hospital for complete bed rest while your drug treatment is adjusted.

       Peripheral Vascular Disease

      Hardening and furring up of the arteries throughout the body can lead to peripheral vascular disease in which blood supply to your legs is severely limited. Even a mild increase in exercise means that your muscles need extra blood and oxygen – if these cannot be supplied, your leg muscles will start to cramp. This causes a severe pain in the calf muscles which comes on during exercise and stops when you rest – a condition called intermittent claudication. If your blood supply is severely affected, even walking 100 metres or less on the flat can bring symptoms on. If blood supply is very poor, ischaemic pain may occur at rest, tissues may break down to form a leg ulcer and eventually gangrene may set in. Severe peripheral vascular disease is most likely in someone with hypertension who also smokes, or who also suffers from diabetes.

      Aspirin will help to thin the blood and improve blood supply. Some tablets also work by increasing the flexibility of red blood cells so they can squeeze through small blood vessels more easily. Interestingly, research shows that taking garlic powder tablets, ginkgo biloba or a mix of Tibetan herbs known as Padma

Скачать книгу