Secondary hypertension
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- Опубліковано 24 кві 2021
- High blood pressure is important for 2 reasons. The first is that high blood pressure could be a symptom of something else that is going on within the body and the second is that the number itself can do harm.
Much of modern day high blood pressure management focuses on the second point I.e a high number can do you damage and therefore if we lower the number aggressively we can minimise further damage. It is generally uncommon for doctors to try and look for what may lie underneath and the reason they don’t is because in the majority of the cases you don’t find anything specific underlying the high blood pressure that one can reverse and therefore putting patients on through rigorous investigation is not deemed cost-effective and it is more cost effective and perhaps even more profitable to simply tell the patient to lose weight, cut down on their salt, and take medications. These patients are often billed as having primary hypertension i.e there is no underlying cause. Unfortunately the problem with this approach is that 5-10% of patients actually have an underlying and potentially reversible cause of hypertension and if we don’t aggressively look for it we miss it and subject the patient to a lifetime of medications when actually they may not be needed.
These patients who have an underlying cause for high blood pressure are termed as having secondary hypertension and today’s video is on the subject of secondary hypertension. As mentioned earlier, 5-10% of all patients with hypertension have secondary hypertension. When you take patients between the ages of 18-40, the prevalence of secondary hypertension is close to 30% and certainly if anyone is below 30y, then it is vital that they be aggressively investigated for causes of secondary hypertension.
Lets talk about blood pressure first and as you know I love analogies so ill try and use an analogy to help you understand blood pressure and also how certain pathologies can cause high blood pressure.
When I want to understand blood pressure, I like to think of a hose pipe attached to a tap. The tap is a little bit like the heart, the hose pipe all our blood vessels and the kidneys a bit like the hole at the end of the hose pipe. When we think of blood pressure we are essentially thinking of the pressure within that hosepipe. What determines the pressure in the hosepipe?
How much water is within the hosepipe
The circumference of the hosepipe
The stretchability of the hosepipe
The size of the hole at the end of the hosepipe
In primary hypertension the assumption is that for whatever reason (be that genetic, age , bad luck or lifestyle), the hosepipe is less stretchy and this is why the pressure is high. However if we think about it there are so many other ways by which we could increase the pressure within that system could become elevated (secondary hypertension).
If for some reason the water within the hosepipe is increased, then the pressure within the system would also be increased - this could happen for example with hormonal changes which may increase the amount of fluid we retain or even medications that we may take which could cause more fluid retention within the system or even something that increases how fast or hard our heart beats for a prolonged duration of time.
If we reduced the circumference of the hosepipe - so any narrowing throughout the length of the hosepipe could increase the pressure upstream from the narrowing.
If we reduced the stretchability of the pipe either due to hormonal changes or medications then that would increase pressure
Finally if we made the hole at the end smaller then the pressure would increase. The hole at the end represents our kidneys and therefore if there is any damage to our kidneys that that would have an impact on our blood pressure
A cardiologist who’s taking the time to actually educate the public.... How uplifting! There’s still hope for humanity in the midst of the darkness slowly descending on us.
I have been treated for hypertension since I was pregnant with my first child....48 years ago.....
Today I have learnt more about this condition than I did in all those 48 years.
Thank you Dr Gupta
My deep prayers for you and your family on the loss of your father. Thank you for continuing sharing with all of us during this time.
Dr Sanjay, you are a blessing
Breaks my heart looking at you, Sanjay. I know you're hurting. Your Dad loved you just as much. Now carry on his name and know he's with you in spirit. You will meet again one day.
Thanks so much for educating us, I appreciate you kindness
@@lenaaugustine628 ой, ленка....
Listening to you alone can lower high blood pressure. Dr. You are so good, I will keep watching and share. Thank you very much
Even at this time of sadness you still think of us and make videos. Thank You Dr Sanjay.
Stay Safe...
You know there is a great saying in Arabic.
" The carpenter's door is always broken.".
( Carpenter every day goes to fix doors of others;, he has no time to fix his own door.)
Just remember that.
Thomas, I misread your comment and you actually make a good point. It's a great quote and Sanjay would do well to listen but I doubt he will. His desire to fix everyone is why he's a doctor and that's from the heart.
Sanjay, you are just not an good cardiologist but an amazing doctor and a good human being! Keep it up, you will be blessed too.
Your father - and mother - must have been exceptional to have fathered a man such as yourself. My heart goes out to you. Thanks for another hugely informative video.
My deepest CONDOLENCES..i miss my parents every day of my life😥
Thank you for the information, education and enlightenment.🙏🙏🙏🙏
So great to see a Doctor who thinks like an engineer. Causes rather than guidelines. Loved your POTS video as well!
Prayers 🙏🏾 Cry when tears come, laugh when the laugh comes - grief is the wildest roller coaster ride of emotions. Keep your seat belt on at all times.
Your father will be with you always. ❤️
What lovely, comforting words. ❣️. You surely must have a very caring heart.
@@elisafrye2115 I know grief all too well. I have lost both my parents and my son. I have been riing this ride for a while now. Thank you :-)
Sending heartfelt condolences on the loss of your Father. Its been clear he's meant so very much to you. 🖤
I FINALLY found a Doctor that is attacking the problem rather than just the symptoms!! I love your educating videos!!
After years of taking 4 BP medications and multiple potassium pills daily, I was recently diagnosed with hyperaldosteronism, which caused my hypertension. CT scans also confirmed nodule on my adrenal gland. Thanks so much for these videos you provide us!
I have been listening to all your videos, they have helped me enormously. Understanding alone helps reduce the anxiety which in itself is a contributing factor with my high blood pressure. Thanks
Hello Doc!
Always a pleasure to see and hear from you. And my deepest sympathies and most sincerest condolences on your loss.
You are such a beautiful and kind man. I only wish you were my cardiologist in the USA.
❤Lovely photo of your Dad & you I'm sure ❤ hes been very proud that you are his honorable son & benefiting people worldwide from all walks of life ❤ May you & your family be comforted by treasured memories & May he rest peaceful ❤🙏
I agree. I love the picture of Sanjay and his Dad - wish he would post it.
Prayers for you and your family, Dr. Gupta. Wishing you all peace in your time of grief. Your father must have been incredibly proud of you and your service to others. You are an extraordinary Doctor who is deeply appreciated.
So proud of you, Sanjay, for continuing your professional life and sharing with us in spite of the pain and grief you feel. Still praying for you. I know you miss your Dad and always will.
Thanks for making the subject so simple and importance of looking into Secondary Hypertension before prescribing the Drugs.
Enjoy listening to your videos. You are a good caring doctor and wonderful person.
Sorry about the passing away of your Dad. He is in a better place and will be with you in spirit.
Those who know,do. Those that understand, TEACH. -Aristotle
Dr, thank you for empowering us!!
Your Video on Magnesium was so educating and it helped me a lot .You are awesome teacher!!🙏
I'm going to a cardiologist for the first time tomorrow, as an echocardiogram found Pulmonary Hypertension and the right side of my heart is enlarged. Thanks to your videos I feel so much more prepared for my appointment. Thank you for the time and compassion that you bring your channel. It's a true blessing. I'm so sorry for your loss.
from my research enlarged heart is due to bad diet. you want to remove salt from your diet. you want to also reduce inflammation
My blood pressure goes up when I do not have sufficient food in my body. Sometimes iI like to go to bed minus my dinner but, I dare not...pressure will go up. Advice please. Continue to care and love your dad.
This happens because blood is diverted to stomach after food and thus overall pressure comes down. Its temporary though and not really a solution. Blood pressure still remains high thereafter. I solved this same problem by eating a bowl of salad and handful of nuts. Its not necessarily carbs/proteins that is needed here, but presence of digestible food in the stomach. Good luck !
Thank you for this thorough talk on secondary hypertension!
I am very sorry for your loose . You will see him again ..hearth is a temporary home . He got to be so proud of you !! You are a great person .
My BP runs high consistently 140/90, I’m 20 pbs overweight. Today I took 1000mg of Niacin (B3) with lunch. Normally I take 500mg with a meal. Not thinking about my bp, I checked 2 hours after eating and was SHOCKED...118/74. I waited 3 minutes as I always do and checked again...Niacin did it, lowered my bp. I am going to start monitoring niacin intake vs bp
Niacin is good 👍
How has Niacin been working for you this far?
Condolences for the loss of your father Sanjay.
I am sure a prouder Dad would not have been found.
His spirit lives on in your memories and your nature, and you will in turn pass these fine traits to your children.
Thank you for your inciteful videos.
What a charming and delightful video from someone who has not only medical expertise but humanity and actual communication skills. Your videos have a calmed the mind for one recently diagnosed high blood pressure gen x’er. Thank you.
I just watched your video from 2019 on 3 things to ask if your Dr. says you have high blood pressure. Your opening described my situation exactly. My Dr. went right to medication. I even asked if there is anything I can eat more or less of or walk more? He just said no. and gave me a prescription. I'm 52 and have never taken any medication for any ailments.
Prayers for your mom
Thank you so much for your huge efforts in education. If I had heard this info sooner in my life I could have saved myself a lot of bad health!!
I'm sorry for your loss Sanjay....... instead of commenting on your great content I wanted to acknowledge something I noticed at the start of your video, was that your Dad... I hope the loss in your heart is healing and know that his energy is always with you. Thank you for your great content
like father like son surely your father b kind soul like you. prayers for your father
The loss of a parent can impact on our lives a lot more than we can ever realise, it gives those that were close as you were a deep sense of loneliness that is their even when we have other close family members still with us.
I am truly sorry for your loss and send heartfelt prayers your way.
May your memories be at your side for always
Dr. Sanjay Gupta thank you for another enlightening video done inspite of this great loss. May God be with you and your family at this most difficult time of spiritual healing of the heart.
This man is a brilliant cardiologist, his explanations have helped me a great deal, and made my conversations with my care providers less one sided, and forced them to listen. Thanks Sanjay!
My heart goes out to your family in the loss of your beloved father, Dr Gupta. I can tell you from sad experience that you will always miss him, but with time you will find comfort in knowing he lives on in your heart and your loving memories of him. Our earthly lives end, but love lives on.
We all treasure your continuing compassion for those whose lives you touch with your wisdom.
You are such a great doctor and a greater human being. My mum is a heart patient on dialysis for 3.5 yrs and is very unwell. I can correlate to what u are going through..every phone call frightens me as I live in UK and she is in India
I hope you cope with your loss ..it must be slightly easier for you to do that, being a doctor. Don't know what I would do when I get the bad news! God help us all.
My severe hypertension has now caused me to have a left ventricle high blood pressure.
What a wonderful doctor who has so much concern to his people !!!
Thank you so much Doctor sir. 🙏🙏
Excellent video. Made many strong points in the subtlest way possible ! God bless you for all the good work you're doing, Doc. And condolences on your loss.
My condolences to you. 💕
Thank you for your videos.
Sorry for your loss. Prayers go out to you. Thank you for educating all of us!
So sorry for your loss. 🙏🙏
To be honest, I cannot even imagine the cardiologists speaking to me on this level. In fact, the last one couldn't wait to get out of the room and since he left this one seems to get pissed off when any question gets asked, as if asking means she's being challenged. The only way I could think to get their attention is to play this video for them. But I don't think they would listen. They don't care. Thank you for this education though. I've brought down my blood pressure, and gotten off the drugs, but I'm not sure what damage was done and don't know how to find out.
I agree one hundred percent. This man is a god-send. Dr. Gupta is what All doctors should aspire to become!!!
I have a suggestion for you. If you are able to do so, then seek out a new cardiologist. Not all of them are of the low caliber of the two you described. Thank Goodness!! Wishing you Good luck and Good health.🙏
@brussel sprout How did you lower your pressure?
How did you get the bp down?
@@margaretcordova3268 I know you didn't ask me but I've got a suggestion for you. About 2 years ago I started taking a couple tablespoons of Apple Cider Vinegar every morning. Within a short period of time I was able to ditch my blood pressure medication. I am back to taking the BP medication now because of the fact that another med that I now take has interactions with the Apple Cider Vinegar. But was curious as to HOW it worked so Well?... and research showed me that the reason is probably because it contains a whopping load of potassium!? Anyways, just thought I would pass this along.
(A BIG word of Caution here: IF you are taking an ACE inhibitor such as Lisinopril, do NOT add more potassium. It could have you reach a dangerous level in your blood stream pretty quickly!!)
@@gloriamaryhaywood2217 I got off Lasaraton today. It was giving me horrible acid reflux! I woke up in the middle of the night with the worst case of acid reflux!!!! I was shaking so bad too! Apple cider vinegar does not have potassium in it. Meds destroy your system. I have gone down to one meal a day to see if I can lose my extra weight! I also try to take my kale shake everyday!
Condolences to you for your loss. Your videos have helped everyone tremendously, just so you know.
I'm very sorry for your loss. Prayers are with you, Doctor. 🙏🙏
I wish more GP's (and in some cases hospital doctors) would screen for Primary Hyperaldosteronism, especially if you have resistant hypertension and on more than one BP medication. This disease is much more common than previously thought when Professor Conn did his finest work.
May time heal the pain. 7 years later I still miss my dad a lot. Thanks for your awesome posts!
My deepest condolences.
Thanks Doc.
My sincere condolences. Thank you for videos.
Thank you so much !!
Thank you Doctor and my deepest sympathy for your loss. Kind regards from Switzerland.
So sorry for your loss. Your grief is evident and it's very noble to take the time to continue with your mission to educate and inform.
Thank you doctor.
Thank you !
Excellent!
Doctor, after taking too many antihytamines, spraying myself with anti-repellant bug spray and drinking 2-3 cups of coffee a day, ( I was on holiday in Florida and had free coffee) my blood pressure went from 120/60 to 199/99 and my HB was 115. I could not stop drinking water or going to the bathroom all day. I told the Dr. ,in Emerg. about my intake of OC preparations. He basically ignored that., wanted to give me a huge injection of perinodopril . I declined. That was in Dec.2021. This past Dec, same thing with inordinate amt. Of waster intake. I LOOKED BACK& realized that I was inhaling an OC organic inhaler 5× more than recommended. The excessive water intake was due to my body trying to get rid of the toxins that I ingested.
Thanks doc,really appreciate your videos
Extremely sorry about your father.🙏
Thank you for all that you do for us
My sympathies to you Dr. Gupta and your family on your great loss.
So sorry Dr Sanja. 🙏🏼🙏🏼🙏🏼for you and your family.
Beautiful soul you are. Be blessed.
hello, dr gupta - i'm so sorry for your loss. i hope that your lovely memories and the compassion that you give to all of us will be a comfort to you in the time ahead. you have many people out here wishing you well. thank you so much for this video on 2e hypertension - it came at the perfect time. peace.
Thank you so very much for this video. I became a subscriber because of the depth of information on this video. Thank you again.
My deepest sympathy for the loss of your father. I can understand your pain, i lost my mother less than a year ago. Stay strong brother 🙏
Thank you for another excellent video
Greetings from Mauritius! Good to see you back online, Doctor and thank you so much for all your advice.
All the best to you doctor, and thank you!
Wonderful person, this man, thank you.
I've benefitted greatly having access to your output. Sincere condolences.
It's always a pleasure to listen to your videos so sorry for your loss.Four years ago I had a tubeloctomy all my life my pressure was low the highest my systolic would go was 110and diastolic 80but after that diastolic is between 90 and 95.is that secondary.you thought us not to be obsessed with numbers so I don't check a lot am 50years
Amazing stuff. Thank you doc
Thank you for all you do for us by sharing these thoughtful and insightful videos. You are a gift to us all.
The thoroughness and balance of the videos are empowering. I've learned much from them. Honestly, you have taught me much more than my own doc.
@York Cardiology : Sincere condolences to you Boss ... and thank you for your excellent and informative channel ... utmost respect to you for taking the time to educate and inform.
your work and knowledge is amazing!!! thank you
You are a very special person. God Bless You.
Hello doctor...thanks for sharing ~
Welcome back Dr. Pray your wonderful Dad is in heaven and looking down proudly at his son. Keep up the good job advising us all.
It is so nice to have all this explained! Love this channel!
Take care 🙏🙏💕
Hi Dr so sorry to hear about the death of your father my condolences to you and your family God bless you.
My heartfelt condolences, Doctor, yr videos are so valuable and great gifts to all humans, You give clear knowledge, almost all viewers who watch your videos are highly benifited, God Bless you!
Thanks for this video. It's so good of you to think of others but please take care of yourself. You look tired, and I'm sure it's coz you're not sleeping well. Just remember you are just as important as everyone else and take time to slowly adapt. I know you like analogies. I saw a video where you were talking about baby snakes and the mother snake. Tbh I can't remember anything else. I'm terrified of snakes and for days after I had dreams of being strangled by snakes loool. I hope that made you smile. Thanks again for everything you do. You really are a special person. Just go easy on the snakes analogy please xxxxxxx
Is this your office or your Dad's? I hope you're finding some solace and peace through this sad ordeal. Praying for you. Be safe traveling. Love the picture of you and him. Please post it! 😢💕
I really enjoy your video
You are awesome,
thx allot for this great informative video!
thx
I’m really very sorry for you loss Dr Gupta. I imagine your farther was immediately proud of you.
Thank you from Stowe VT.
Oh my goodness-You look just like your dad. I’m so sorry to learn he is no longer with us. My sincerest condolences 💐
Thank you Dr Sanjay for your videos they are so helpful to me you are a blessing.
Very helpful. Thank you for your teachings.
Thank you Dr Gupta for this valuable information. So sorry for your loss
I offer my deepest condolences on the death of your beloved father.
May he rest in peace.
My condolences Dr. Gupta. Thanks for sharing your knowledge