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Today, 09 February 2010

› Strike three, Mr President

› Cooked head discovered

› Zuma apology 'unwelcome'

› 'Illegal' traps blasted

› Madiba to grace Parliament

Yesterday, 08 February 2010

› No credit to FW - Zuma

› Zapiro revives showerhead

› 'Our president has failed'

› Praise for Amla

› 'Zuma should be forgiven'

Question

I am 44 years old and was recently diagnosed as having high blood pressure. I am now on a beta-blocker, for life, I am told. What causes high blood pressure and how do beta-blockers work?

Answer

We really don't know what causes high blood pressure, or hypertension. It is likely that there are a number of different causes. There does appear to be a genetic link in hypertension, but the reasons are not clear. Environmental factors such as being overweight, stressed and eating a high salt diet only seem to play a part in those people who have a family history of hypertension.

Hypertension is very common, affecting more than 50 million people in the USA alone. It is more common among black people than white, which is definitely seen in South Africa.

A diagnosis of hypertension is generally made after more than two readings, taken on separate days, of a blood pressure of more than 140/90 mm Hg (mercury). Hypertension is traditionally thought to be asymptomatic, but so many patients have told me that they feel better once they are on medication that I wonder about this. Certainly there are no specific symptoms until pressures are high enough to be dangerous. A diagnosis of hypertension is for life. The dangers of untreated, or inadequately treated, hypertension are stroke, heart disease and kidney failure.

Treatment is varied and changing all the time, with new drugs appearing on the market almost daily. Beta-blockers are one of the commonest types of treatment. They act by blocking the beta-adrenoreceptors in the heart and blood vessels. These are involved in the control of blood pressure. They also act on beta-adrenoreceptors elsewhere in the body, the lungs, pancreas and liver. They are generally well tolerated, but can cause tiredness, sexual dysfunction and bronchopsasm in asthmatics.

Non-drug treatments are usually used as well as drug treatment as, on their own, they are seldom enough to bring blood pressure back down to normal levels. Weight loss and exercise definitely help in the control of blood pressure, so keep active, even if you are on medication.

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