3 questions to ask your doctor if he says you have high blood pressure

hi guys my name is Sanjay Gupta a consultant in York today I wanted to do a little video on the subject of blood pressure if there's one thing that causes a ton of anxiety it is the mention of high blood pressure a common scenario for example is that a patient goes to see his doctor for a routine visit or an unrelated complaint and then the first thing the doctor or the practice nurse will do is measure their blood pressure then the doctor shakes his head and says oh your blood pressure's a little high today maybe you should come back again and have it checked again next week and if it is again high then we will consider putting you on tablets and the poor patient is immediately left feeling really anxious and worried about this he goes home he consults dr. Google and everywhere he looks there are these horror stories of how high blood pressure can cause strokes or heart attacks or kidney failure and then when the poor terrified patient goes back to the doctor to have his blood pressure checked he's already so anxious and unsurprisingly his blood pressures measures high which then triggers off more anxiety and the prospect of taking medications for the rest of his life so this video is for that patient and my aim is to help that patient understand and demystified the concept of blood pressure by asking the doctor three important questions before contemplating medications okay as I as far as I see it this number the blood pressure number is only important for two reasons one the number is a symptom of something else going on in the body and in which case the aim should be to try and identify the cause of this number being high and treating it okay it doesn't make sense to make the number look prettier I give tablets to lower the number if the number is a sign of something else because if you just treated the number then you are missing the underlying problem so the first thing I would say is that the number is important if it's a sign of something else in which case you want to identify it and to the number by itself if the number by itself is causing harm then that's important too and in that sense in that case it does make sense to make to reduce the number if the number itself is causing harm then it does make sense to reduce the number it's also true to say that we are all different again and therefore it doesn't seem logical to me to have this one value which defines everyone so the current guidance for example in the UK where I am is that if your blood pressure's over 140 or 90 you have high blood pressure well that doesn't make sense because we're all different people so why is why do we have to rely on one value to define us surely what we want to know is whether that blood pressure is high for that individual so instead of asking is my blood pressure high well we should be asking and what we should get the answer to is the question is my blood pressure high for me okay so here are three questions that you want your doctor to answer for you before you even start worrying about your blood pressure alright so the first question you have to ask is what is my number you know what is my true accurate blood pressure now the first thing to say is that the blood pressure in number fluctuates wildly in everyone throughout the day and night and it depends on so many things it depends on what they're doing whether they're stressed or relaxed it depends on whether they're exercising or they're at rest it depends on whether they're awake or asleep so it doesn't make sense to use isolated values to gauge whether a person's blood pressure is high or not in fact all the blood in fact the most inaccurate way of measuring blood pressures in the doctor surgery because the patients are stressed it is a artificial surrounding and it is not truly representative of that person's blood pressure so this kind of poor patient who's gone and has his blood pressure checked that's an inaccurate value okay a more accurate way of measuring blood pressure to do serial blood pressure measurements at home or an even more accurate way is to have a 24-hour blood pressure monitor the 24-hour blood pressure monitor what that does is it makes automated recordings of the blood pressure several times during the day and night and then it allows the doctor to calculate an overall average and that average is a far better and more accurate representation of the blood pressure rather than isolated values so the first thing I would recommend you know if you're faced with the prospect of having high blood pressure is to ask your doctor what is my number please do a 24-hour blood pressure monitor and tell me what my average number is and you'll be surprised because actually very often the average number is far lower than these isolated values that are measured in the doctors clinic upon which a lot of doctors will start patients on tablets so that's the first thing to do the second question to ask is to say is my blood pressure a symptom of something else very often the high numbers that are recorded are a symptom of a suboptimal lifestyle excessive weight smoking a sedentary lifestyle excessive alcohol intake excessive stress poor sleep patterns such as sleep apnea can all contribute to an elevated blood pressure and I would always recommend that whenever patients are diagnosed with high blood pressure they take a long hard look at their lifestyles and modified those factors that could be contributing this is really important because if you just take pills to make the numbers look prettier then in some ways you've not really tackled the underlying problem which is the bad lifestyle and therefore the overall risk of the patient is largely dictated by the bad lifestyle rather than just the blood pressure number so taking a tablet to make the number look prettier doesn't really dramatically alter that person's risk it's far better to tackle all those things about the lifestyle which may make the person healthier and then so during the blood pressure numbers will also improve finally the most important question is that you have to ask yourself is all my numbers causing me harm are they doing me harp is the number is my number doing me harm okay now everyone worries about being at increased risk of strokes and heart attacks and kidney damage but the truth is that these risks are only realized in the long-term meaning that if you've had several years of chronically elevated high blood pressure then there's a risk of having such events however to expose you to this risk there must be a degree of low-level damage going on in the body right it can't be that you have nothing going on in the body and ten years later you have a stroke that wouldn't make sense so something must be going on in the body which may not be visible to the outsider and the patient doesn't realize it and then ten years down the line they have something which is a big event like a heart attack or a stroke or something like that the now the soap to expose you to the higher to the risks the kind of those big risks you have to be having a degree of low level damage happening in the body chronically the problem with high blood pressure is that if the blood pressure is high then are tiny tiny blood vessels the tiniest blood vessels which happen to be the ones that infiltrate our organs and supply our organs with oxygen-rich blood they tend to be also be the thinnest and most fragile and if you have a blood pressure which is high for you then that number does increase the risk of these tiny blood vessels getting damaged they often can burst and then they heal by clotting off and therefore those areas supplied by those tiny blood vessels don't get the blood and so because you have millions of tiny blood vessels one or two doesn't make a huge difference but over a period of time as you continue to damage more and more and more blood vessels you continue to get increased levels of low level damage which person may not be able to see or sense from the outside but I'll going on in the body and eventually they culminate ten years down the line with a bigger event like a heart attack or a stroke or kidney damage we can look for such low-level damage okay in particular we can visualize these tiny blood vessels in our eyes in the retina so it's a simple look if your doctor looks at the back of your eyes he'll be able to see whether there is any effect of damage to these tiny blood vessels you can see look tiny little hemorrhages in the eyes similarly the tiny blood vessels also supply our kidneys and if the blood vessels and our kidneys are affected then even before our kidney tests go become abnormal you can detect that the kidneys start leaking more protein because and this protein extra protein can be measured in the urine so that's another way of detecting low-level damage before any high level damage occurs finally if the blood pressure is truly high for that patient then the heart would have to work harder to pump blood around the heart is a muscle and therefore if the heart is working hard if the muscle is working harder than the muscle will hypertrophy or become more muscular and you can see that easily by doing an ultrasound or an echocardiogram for the heart and that will easily share whether the heart is looking more muscular and if the heart is more muscular than that does suggest it's working against a higher pressure for that individual when we look at the majority of all virtually all the research points to the fact that it is those people who have high blood pressure who have high values who have or those people who have low-level damage evidence of low-level damage who tend to come to harm from high blood pressure rather than those people who don't have evidence of low-level damage okay and therefore when you can detect low level damage it becomes really important to be aggressive with lowering the blood pressure because the number itself is probably doing harm as well so of course I would always recommend the lifestyle modification but then also aggressively trying to lower the pressure with medication and I would say that is irrespective of what the number is if the number is say 130 over 80 and the person's got all this evidence of all this damage I would still be more aggressive by lowering the blood pressure whereas if I had a patient who had a blood pressure of 150 over 90 and didn't have any evidence of low-level damage then I wouldn't be so aggressive I would still recommend lifestyle modification wherever possible but I wouldn't necessarily jump in and give this patient medications so you know blood pressures far more complex and I hope that this video has been helpful in helping those people who worry about their blood pressure you know you want your answer these three questions what is your true number is your number a sign of a bad lifestyle and finally is your number doing you home and this will then allow you to decide what works for you you know it'll give you an idea of what your number is it'll give you it'll allow you to work out whether there are any lifestyle factors that may be contributing and of course modifying them and when you do modify the lifestyle factors it's good to again use a 24-hour average to monitor your progress right and then finally whether you really need the medications or not great so I'm sorry I haven't put her well personally I would say I would love to hear your thoughts about this video whether you found it useful or not I'm sorry I haven't done a video for a few weeks now I was kind of burnt out but I'm now a lot more rejuvenated and I'm looking forward to doing more videos very soon by the way I'm going to the USA next week first I'm going to Boston and then from there I'm going to go to San Francisco and do a road trip down to San Diego Val LA so if anyone is in any of those places and you want to meet for a coffee than to give me a shout leave me a comment and I'll be sure to respond thank you so much by the way I have a Facebook page which is at your cardiologist and I have a website which is WWE cardiologist calm thank you so much all the best take

Channel: York Cardiology

Views: 2,361,568

Keywords: Heart palpitations anxiety, Heart palpitations after eating, Heart palpitations causes, Heart palpitations symptoms, Heart palpitations treatment, Heart palpitations cure, Ventricular ectopics, Heart disease symptoms, Heart racing, Heart flutter causes, Heart palpitations at night, high blood pressure, hypertension, strokes, heart attacks, dr sanjay gupta, health anxiety

Id: XjF5QgFARVc

Length: 13min 21sec (801 seconds)

Published: Sun Jul 14 2019