Hypertension treatment. Success and failure. Two clinical cases. 11
Get your high blood pressure treated today and for the rest of your life. Leading hypertension treatment expert tells two stories of patients. They show how effective and timely hypertension treatment can influence quality and quantity of life. Dr. Grossman, is there a clinical case that could illustrate some of the topics that we discussed today on hypertension treatment? Dr. Anton Titov, MD. Especially in the setting of metabolic syndrome and obesity. Dr. Ehud Grossman, MD. The best example that I can give is this. It was 20 or 30 years ago. Then the patient was 60 years old then. He came to me. He was diabetic, he had severe hypertension, systolic blood pressure of 200, all side effects of hypertension. He had target organ damage, left ventricle hypertrophy, mild renal failure. I gave him four medications to lower the blood pressure. He died only recently when he was 90 years old. He never had even myocardial infarction or stroke. He died of cancer. Of course, you can say that anti-hypertensive medications exposed him to cancer. But without the medications he would not have lived even 5 years. He would have died at the age of 65 or 70. But he survived to the age of 90. He was alert and active, but, unfortunately, died of cancer. You have to die of something. So he died of cancer. That gives you an example of how important it is to control the blood pressure. You can not rely in hypertension treatment decisions on a single case. Dr. Ehud Grossman, MD. You have to rely on big data and see what is the advantage and the benefit of lowering arterial blood pressure. I believe that if the patient is compliant, in about 90% to 95% of the patients I can control the blood pressure. Maybe I cannot lower patient’s blood pressure to 130 over 80. But I can lower blood pressure to 140 over 90 in most patients. I think that’s a very important story. Because it underscores how and why it’s important to really weigh the real risks as opposed to perceived risks. Dr. Ehud Grossman, MD. Sometimes something does not cause pain. There is no symptom in the body that something is wrong. But it doesn’t mean that the disease does not carry significant risks. For example, hypertension. You cannot go back. When you have a stroke, that’s it. You are handicapped, you are paralyzed, you cannot go back and say this. “Oops, I want to live again and take the anti-hypertensive medication”. It’s too late! Dr. Anton Titov, MD. You see so many patients who didn’t treat high blood pressure. Dr. Ehud Grossman, MD. Just recently, between Rosh Hashanah and Yom Kippur, several months ago I had a good friend of mine. He was a cantor, a well known person. He had hypertension and diabetes. He didn’t take the medications. He told everyone that he had his blood pressure under control. I didn’t treat him at all. Then he went to an eye doctor, ophthalmologist, who said. “Oops, you have changes in the blood vessels in the eye. You have to be careful and control your blood pressure”. And he said, “OK, it will be OK”. Then he traveled to the United States and he died of subarachnoid brain hemorrhage. This was definitely a consequence of hypertension that was not treated. So don’t challenge your life! You have to take medications. You have to lower the blood pressure. Life has enough external risks – accidents, whatever it is. Dr. Anton Titov, MD. Sometimes you can control something and prevent diseases. So do it. Yes! Dr. Grossman, is there anything else you’d like to talk about? Are there any questions that I should have asked and didn’t ask? I think you’ve covered the topic of hypertension well enough for everyone. If someone has more questions they can contact me. I would be happy to help and give answers. Dr. Grossman, thank you very much for this conversation! Dr. Anton Titov, MD. I very much appreciate it. We are looking forward to continue reading your research and sharing your data with patients around the world. Dr. Anton Titov, MD. Thank you! Dr. Ehud Grossman, MD. My pleasure!
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