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Tuesday, May 23, 2006
This is Mrs. X. She came to our clinic just the other day complaining of dizziness. Her blood pressure reading is 160/100. Is she really hypertensive? Its difficult to say unless she comes back for follow up for another blood pressure reading and for a hypertensive work-up. The problem is that she only visits a doctor whenever she is dizzy and she hops from one doctor to another. The big question is: Is the dizziness due to hypertension or the hypertension due to the dizziness? Just like the question about the chicken and the egg.

Hypertension is a very common condition. Here in our locality we don't end the day without a hypertensive patient. Most of the time its not even their chief complaint. They would appreciate it much more if you just concern yourself with their chief complaint than dealing with their hypertension. I remember one old man in his late 50's telling me that if I want him to be strong I won't give him antihypertensive medication. Quite strange really. No matter what you tell them. They are like walking time bombs ready to explode anytime.

Hypertension is a silent killer just like diabetes. Most of the time it is asymptomatic. You don't have to watch out for nape pain, dizziness, and headache to tell you that your blood pressure is rising. These symptoms usually don't occur unless you are already in the advanced stage. So what are you waiting for? Go to your physician and have your blood pressure reading checked!
posted by Amelyn R. Rafael,MD @ 3:20 PM  
  • At 12:28 AM, Blogger Automaciej said…

    My blood pressure always jumps when it's being measured. :-)

    I've been once sent for the bottom-of-the-eye checking, because it jumped so high. Fifteen minutes later it was back to normal.

  • At 11:46 AM, Blogger Amelyn R. Rafael,MD said…

    automaciej, that is probably what we call white-coat hypertension or sympathetic type. The American Heart Association now recommends treatment with that type. Just visit your doctor and have a consult.

  • At 3:19 AM, Blogger Beth said…

    I'm glad I came across this blog via BlogMad. About a month ago I went to my doctor for a normal exam, the nurse took my blood pressure and it was 160/86. It has never been that high-even though I am overweight. I discussed this with my doctor and he asked which cuff she used. I said the small cuff. He then took my BP again and it was 120/80. Does the cuff size make that huge of a difference?

  • At 9:23 AM, Blogger Amelyn R. Rafael,MD said…

    Beth, yes cuff size can affect BP readings because a small cuff significantly inflate these readings. Ideally the arm circumference is taken first before BP reading is done. If not, the rule of thumb is that a large cuff is used for arm circumference beyond 33cm. There are guidelines on this provided by the American Heart Association.

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Name: Amelyn R. Rafael,MD
Home: San Fabian, Pangasinan, Philippines
About Me: Family Physician, and Associate Professor (Clinical Anatomy and Medical Physiology)
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