Q: My husband is a young senior citizen who lately has been lethargic, sleeping lots, lacking energy, and just not behaving as he normally does. He’s usually a get going guy but something has changed. We thought it might be his heart so his primary care physician thought a trip to a cardiologist might be appropriate. That specialist ruled out problems there following heart catheterization. He was finally diagnosed with labile hypertension that fluctuated dramatically even while sitting in his doctor’s office. We’re naturally relieved it isn’t his heart but now want to address this blood pressure issue. What can you tell us about it?
A: Simply put, hypertension is a common disorder marked by consistent abnormally high blood pressure readings in the arteries whose responsibility it is to carry blood from the heart throughout the body. We’ve all seen pictures in a doctor’s office of the respiratory system showing a bare tree having a large trunk, many thick branches, and substantially smaller branches that as a complete unit, has the job of constricting and dilating to shunt the flow of blood throughout the body. In order for blood to circulate properly, a specific level of pressure is necessary. Depending on what an individual is doing, readings will vary. For example, during sleep, we consume less oxygen, making the job easier for the arterial system to function properly. Readings will commonly be lower. When we’re running a marathon, physically exercising, or stressed, the system performs in a more aggressive manner, causing a temporary increase in readings.
An average reading is about 120/80 for many. The first number is referred to as a systolic reading, the second is a diastolic reading. Each beat of the heart causes a different pressure within the system but the two numbers commonly increase and decrease together. Typically, if the systolic is up, so is the diastolic. Readings are often measured and recorded by using a sphygmomanometer (blood pressure cuff) and stethoscope, however another method that provides additional information is the 24 hour ambulatory monitoring and home monitoring method. This device records readings at regular intervals (even during sleep) and reduces white coat hypertension (an increase in blood pressure some individuals experience when in a physician’s office)may .
We all suffer from hypertension for a variety of reasons at one time or another. This does not imply that one or two high readings are necessarily cause for concern. High readings generally come to the forefront when they persist for extended periods of time or the adverse affects present rapidly and without apparent cause to the patient. Almost 95% of those with a diagnosis of high blood pressure are found to have what is referred to as essential or primary hypertension, implying there is no identifiable medical cause as the source. Looking at the bigger picture, however, pregnant women may have a form that concludes at the end of their pregnancy; then there are secondary, isolated secondary, white coat, malignant, and labile hypertension categories for others.
Labile hypertension, a condition that almost 15% of the adult population has, is defined as variations of blood pressure. Signs and symptoms may include fatigue, lethargy, headache and ringing in the ears. Emotional stress from work-related situations, medical problems, financial concerns and simply getting stuck in traffic can trigger elevated readings, requiring some patients to be placed on anti-hypertensive medication to help stabilize their readings.
Hypertension can be treated with diet, exercise, weight loss if appropriate and, when necessary, medication. However, your husband’s lethargy and behavioral changes may be because of depression, anemia, hypothyroidism, or other treatable conditions, so follow the advice of your husband’s physician so he can gain the stability he needs. Good luck.
