Caitlin Whyte (Host): Hypertension or high blood pressure is a pretty common condition, but you still want to do your best to keep it at a normal level. Today, we are talking all about hypertension with Dr. Nirav Shah, the Medical Director at the Kaplan Family Center for Cardiovascular Medicine and Interventional Radiology.

 This is Doc Talk presented by Montefiore St. Luke's Cornwall. I'm your host, Caitlin Whyte.

Now. Doctor, to ground us in this conversation today, can you tell us what causes hypertension?

Niravkumar Shah, MD, FACC, FSCAI: Yeah, so, there are multiple cause, etiology point of view and risk factor point of view, before I get jump into that, I mean, what is high blood pressure, right? I mean, it's a hardening of the arteries. It's, again, based on the previous discussion that what I consider as one of the major risk factors for cardiovascular disease.

Also, it's kind of a leading killer in general because hypertension kills more than the all infectious disease process, including respiratory infection, AIDS, tuberculosis, you know, malaria in the developing country, all those combined, the hypertension is very important and it kills more people worldwide, in every year combining all those things. So again, what is hypertension and what's it's cause? You know, it's basically it's a hardening of the blood vessels and you check blood pressure and it has systolic and diastolic values and both are very important in order to determine that one person has high blood pressure or not.

What are the etiologies of the high blood pressure? I mean, yeah, of course there is a, something called essential or idiopathic hypertension, meaning there is, we don't know what is the cause of it. And 90 to 95 percent of all hypertensions are like that, but there are certain etiologies such as excessive alcohol intake, excessive sodium intake, diabetes, obesity, lack of exercise, all those can contribute to the high blood pressure.

There are other risk factors or other contributory factors such as kidney disease or neurological disease or liver disease, such as cirrhosis or sleep apnea, and that considered as a secondary hypertension. So there are etiology point of view, one need to rule out and make sure that there is no underlying other condition that contribute to the high blood pressure.

Host: Well, are there any symptoms then that people can watch out for when it comes to hypertension?

Niravkumar Shah, MD, FACC, FSCAI: Sure. I mean, you know, there are definitely certain symptoms that patient can present without knowing that that person is having high blood pressure or not, such as fatigue or reduced exercise tolerance, sometimes dizziness, lightheadedness, palpitation, shortness of breath. Sometimes patients may just have a headache, an incessant headache that doesn't go away.

And when they go to primary care physician, urgent care, the blood pressure is very high. So, I mean, there are certain predisposing factors, certain precursors and certain symptoms that can be watched out for to make sure that person is not having high blood pressure.

Host: And what are the dangers then of hypertension? What should we watch out for?

Niravkumar Shah, MD, FACC, FSCAI: So the high blood pressure, it's a kind of a disease that affect a lot of organs in the body, right? I mean, what it affects is not only the heart, but it also affects the brain, can cause stroke or kidney to cause a renal failure. It can also affect the peripheral vasculature to thickening of the arteries and blockage, it also affects the eye and cause sometimes blindness. So there are all the end organs such as eyes, livers, the lungs, the heart, the brain, peripheral arterial, all be affected by the high blood pressure.

Host: Gotcha. And as we wrap up, what are some methods then of lowering hypertension?

Niravkumar Shah, MD, FACC, FSCAI:

So, again, the lowering the blood pressure, right? So again, the risk factors, right? If someone is smoking, need to stop smoking. If they are diabetic, they need to control their blood sugar. But more importantly, I think also to reduce the weight if they are obese, right? If someone having sleep apnea, using the machine at night, but more importantly, what we call is a DASH diet, which is Dietary Approach to Stop Hypertension, where you increase the grain, vegetables, and fruits, decrease the meat and salt intake, but increase the fish and poultry, nuts and seeds. So diet is very important to control the blood pressure. And you know, of course the exercise. And reducing the weight. Every pound you lose, there is a decrease in the, the number on the blood pressure reading.

So it's very important to do the non pharmacological measure in order to reduce the blood pressure. But of course, there are a lot of medications that are available, very safe to use to reduce the blood pressure if someone failed to reduce it by lifestyle modification.

Host: Great, and Doctor, anything that we didn't touch on that we should know about hypertension?

Niravkumar Shah, MD, FACC, FSCAI: No, I think hypertension, again, it's very important risk factor for cardiovascular disease. Very important to make sure that diagnosed early and treat early to prevent end organ damage.

Host: Absolutely will thank you for joining us again today, Doctor, we so appreciate your time. To learn more about MSLC's Kaplan Family Center for Cardiovascular Medicine and Interventional Radiology, visit Montefioreslc.org. Please remember you can subscribe, rate and review this podcast and all of the other Montefiore St. Luke's Cornwall podcasts. I'm your host Caitlin Whyte. Thanks for listening.