How to treat hypertension effectively? 9

How to treat high blood pressure naturally? When and how often to measure blood pressure? What are important medicines for high blood pressure therapy? What is renal denervation for hypertension?

Good diet and regular exercise are key to control of blood pressure. Blood pressure should be kept as low as possible. Dr. Anton Titov, MD. How often to check blood pressure? Hypertension natural treatment. Story of patient with high blood pressure who had a stroke. Renal denervation in treatment of resistant hypertension. Video interview with top expert in cardiology. Second opinion ensures that hypertension diagnosis is correct and complete. Second opinion also helps to choose the best treatment strategy for high blood pressure. Seek second opinion on hypertension and be confident that your treatment is the best. Hypertension natural treatment diet exercise. Renal denervation. Medical Second Opinion. Hypertension is often silent. People are not aware of their high blood pressure until stroke or heart attack happens. Dr. Anton Titov, MD. What is the best way to treat hypertension? What principles of high blood pressure treatment do you apply in your medical practice? Medical Second Opinion. Cardiologist, Professor of Medicine, Harvard Medical School. Dr. Dale Adler, MD. Yes. You are correct. People often do not have good control of their blood pressure. We have so much data linking high blood pressure especially to stroke. Hypertension also causes kidney problems. Hypertension is linked to definite heart attacks a little bit less. But high blood pressure causes hypertensive heart disease. The heart muscle gets thicker. In patients with hypertension heart muscle becomes more rigid and less compliant. It is always remarkable that even today in the United States 25% of patients with hypertension do not have good control of their high blood pressure. Treatment of hypertension is so basic. Dr. Dale Adler, MD. But many patients do not succeed in its treatment. What is the best way to treat hypertension? First step is to know how high is your blood pressure. We live in era when everyone has equipment to measure blood pressure. It’s very easy for patients to check their blood pressure. I always tell my patients. Don’t go crazy checking blood pressure all the time. Check your blood pressure about three times per week. Check blood pressure in different circumstances. Sometimes you have been very busy and active. Sometimes you are under stress. Check it once. Medical Second Opinion. Dr. Anton Titov, MD.  Is it useful to check blood pressure on both arms? Difference of blood pressure results of more than 15 mm between two arms has been linked to higher risk of death. Second medical Opinion. A large difference in blood pressure results between two arms can indicate a problem in the aorta or blockage in different blood vessels. Dr. Dale Adler, MD. So it is absolutely true. Check blood pressure in both arms at the same time. Do it at least the first time you take blood pressure measurement. We also want patients to check their blood pressure in the morning when they wake up. People also should check blood pressure when they are under stress. Check your blood pressure also when you are relaxed. Blood pressure is similar to LDL cholesterol. The lower level of blood pressure, the better it is for your health. Same is true with LDL cholesterol levels. So lower blood pressure results mean lower risk of stroke. It is important not to make blood pressure so low that patients have symptoms. Sometimes the blood pressure is too low. Patients may feel dizzy. Or they may have blurred vision. Or they feel they are about to pass out. We don’t need to make blood pressure very low by using medications. People should be really mindful of how they eat. They should keep their weight in good order. People also should be really fit. By doing these three things they can help themselves a huge amount. Dr. Dale Adler, MD. I always tell my patients a sad story. It is a story about a man who always had very high blood pressure. His hypertension was very difficult to treat. And I always said to him this. “I am worried about your diet.” And he always replied. “My diet is great.” Then unfortunately one day this man had a stroke. After stroke he could not eat on his own. His hand was paralyzed. Since that time we never had a problem with his blood pressure. Never. Not once. It is possible that stroke changed something in his brain. But there is a better explanation of his normal blood pressure after stroke. What he ate after stroke was controlled by others. His food became more healthy. So often there is a strong dietary component to hypertension. We have strong medications at our disposal to treat hypertension. In some patients with resistant hypertension we need to use three and four medications. But almost always we can get patient’s blood pressure under control. Medical Second Opinion. Dr. Anton Titov, MD. What are examples of medicines we use today to treat hypertension? Carvedilol is a nonselective beta blocker. It is also an alpha blocker. Carvedilol can be very helpful to treat high blood pressure. Medicines that antagonize aldosterone are useful to treat hypertension. For example, Spironolactone or Eplerenone also can be very helpful to treat hypertension in difficult cases. Technology of renal denervation received a lot of attention recently. Dr. Dale Adler, MD. Can you put a catheter into the renal artery? Dr. Anton Titov, MD. Can you apply radiofrequency ablation? Ablation of sympathetic nerves around renal artery can decrease the sympathetic nervous system drive from the renal arteries. Many studies on renal denervation have been done. Very careful studies in animals showed renal sympathetic denervation would have a good effect. There were also small clinical trials in humans. It looks like renal denervation was very effective. These trials were not “blinded”. It is usual method to conduct clinical trials. But “blinded” clinical trial did not show a good effect of renal denervation procedure on lowering high blood pressure. Maybe one day we will know more about that technology. Medical Second Opinion. This clinical trial is SYMPLICITY HTN-3. Hypertension natural treatment by diet and exercise. Dr. Anton Titov, MD. Can you avoid medications? How to treat resistant hypertension? Medications and renal denervation.