Tag: hypertension

Does Anesthesia Cause High Blood Pressure?

 

Going under anesthesia is frightening to many people. It’s scary when you’re not in control! Prior to surgery, anesthesiologists carefully question people about any health problems that you have that might impact your response to anesthesia. If you have hypertension or a history of elevated blood pressure readings, you might wonder whether anesthesia is safe. You might also wonder whether anesthesia can cause your blood pressure readings to be higher than normal. These are all good questions!

Fortunately, the anesthesiologists will monitor your blood pressure and heart rate closely before, during, and after your surgical procedure. Plus, they have medications they can administer if blood pressure becomes too high or too low during surgery. Let’s look at how anesthetic agents affect blood pressure.

How Anesthetic Agents Work

Anesthetic agents act on the central nervous system to reduce the perception of pain. These medications also induce a state where you’re unaware of what’s going on around you. Most anesthetic agents are delivered through an intravenous line or are inhaled as a gas. While under anesthesia, the anesthesiologist monitors you and is aware of how fast your heart is beating, your blood pressure, and breathing rate. He or she can adjust the anesthesia as necessary if they notice unwanted changes.

Sometimes, after surgery, people wake up and find their blood pressure is higher than normal. In fact, research shows that one out of four people experiences elevated blood pressures after surgery.  Although a transient rise in blood pressure after surgery is not likely to be dangerous, you might wonder why this happens, particularly since anesthetic agents typically cause a drop in blood pressure rather than a rise. Why might this happen?

Blood Pressure Increases During Surgery

When you’re under general anesthesia, you have a breathing tube in to protect your airway. Some people have airways that are sensitive to the placement of the breathing tube. When the breathing tube is placed, after you’re asleep, your sympathetic nervous system is activated and this increases blood pressure and heart rate. Once the tube is tube is removed, the sympathetic nervous system slowly quiets down and heart rate and blood pressure gradually come down too. Not everyone experiences a rise in blood pressure during surgery. In fact, some people experience a drop. It varies with the individual, the type of anesthesia, how individuals metabolize the anesthesia, and other factors as well.

Once you awaken from surgery and you’re in pain from the surgery, the discomfort can activate your sympathetic nervous system and cause a rise in blood pressure. Once you receive appropriate pain medications, blood pressure may come down. However, some pain medications can cause an increase in blood pressure. If you’re taking a medication for pain relief that triggers a rise in pressure, blood pressure readings may remain higher until the medication wears off. One common class of medications called non-steroidal anti-inflammatory medications (NSAID) can cause a modest rise in blood pressure.

Sometimes, other factors brought on by the surgery can cause blood pressure readings to be too high. When you wake up, you might be cold or anxious, and this can cause blood vessels to constrict and blood pressure to rise. Also, if you’re not yet breathing normally, lack of adequate oxygen delivery can cause a rise in blood pressure readings. Blood pressure is also impacted by how much fluid is in your body. If you’re receiving intravenous fluids and you aren’t able to urinate after surgery, this can cause a rise in blood pressure. If you have hypertension and routinely take blood pressure medications, the anesthesiologist may have recommended discontinuing them until the surgery is over. Your blood pressure may go up because you’re not taking your medications.

Usually, blood pressure will come down a few hours after surgery, although in some cases, readings can remain high for a day or two, especially if you have a history of hypertension and have been off your medications. If blood pressure reading stays elevated for more than a day or so after surgery, let your physician know.

What if You’re on Blood Pressure Medications?

Depending upon the type of blood pressure medication you’re taking, your medical team may recommend continuing your current blood pressure medication until the day of surgery. But, if you’re taking a class of antihypertensive medications called angiotensin-converting enzymes inhibitors (ACE inhibitors) or angiotensin receptor blocking agents (ARBs), they will probably ask you to discontinue the medications at least 24 hours before surgery. That’s because taking these medications can cause a drop in blood pressure during surgery and studies show outcomes are better when these medications are held prior to surgery.

If you’re taking certain types of blood pressure medications, like beta-blockers, your medical team may recommend that you keep taking them as discontinuing them could cause a sudden spike in blood pressure. Some physicians recommend stopping diuretics, a type of fluid pill used to treat hypertension, prior to surgery to lower the risk of dehydration. However, this is variable, so talk to your physician.

Talk to Your Medical Team

During your pre-surgery evaluation, make sure your medical team knows what medications you’re taking. Bring your prescriptions along and let the team know what supplements you’re on as well. They’ll advise you of which ones you’ll need to stop prior to surgery. Also, let them know if you’re allergic to any medications. If your medical team recommends that you continue taking your medications before surgery. If so, let them know the day of your surgery what medications you took and when. Again, bring your medication bottles along. Ask lots of questions and read any informational material they give you carefully.

Conclusion

Despite the fact that anesthetic agents usually cause a drop in blood pressure, you can still experience a rise in pressures after surgery for a variety of reasons. During and immediately after surgery, your medical team will keep a close eye on your blood pressure and it’s a good idea to monitor your pressures at home after surgery, especially if you have a history of hypertension.

References:

Anesth Prog. 2010 Spring; 57(1): 13-17.

Integr Blood Press Control. 2014; 7: 49-59.

Vasc Health Risk Manag. 2008;4(3):615-627.

Anesthesiology 1 2017, Vol.126, 16-27. doi:10.1097/ALN.0000000000001404.

Risks for High Blood Pressure

Risks for High Blood Pressure

You might be at risk for hypertension without even knowing it. Even if your blood pressure is normal it is still important for you to know if you are at risk. High blood pressure can creep upon you like a thief in the night because there is no symptom. As you blood pressure increases gradually you won’t feel any different until its in the critical range forcing you to seek immediate attention.

High blood pressure  has caused deadly strokes, heart attacks and kidney failure. Its not quite clear what causes high blood pressure but the natural aging process causes our arteries to stiffen, therefore by the time we are in our 60s most of us will have high blood pressure. However, this does not have to be the case if you know your risk factors and start taking immediate measure to reduce the possibility of being a victim of high blood pressure.

In the medical community doctors use “risk factors” to determine the chances of you developing a condition. This is why they weigh you and ask you about your family history and habits such as drinking, smoking and exercise. They use this information to make an educated guess based on research about potential problem that might occur in the future. This way, they can determine the appropriate treatment protocol and you can make the necessary life style modification.

Hypertension can be classified as either primary of secondary. The majority of people with high blood pressure have primary high blood pressure. Primary high blood pressure is associated our genes and lifestyle. Secondary hypertension is associated with a medical condition. If you are can modify your lifestyle by abstaining from the culprit agents you blood pressure can be normal. Likewise if your medical condition is manage properly then your blood pressure can be normal and you might not need medications.

Your kidney plays a major role in managing your blood pressure because it regulates water and sodium. When it is not working properly your blood pressure will be affected. High blood pressure can be one of the first sign of kidney disease. Conversely it can also cause damage to the kidneys. Therefore your physician will probably check your blood, urine and structure of your kidney to assess damage or disease. Unfortunately, in the late stages of kidney failure, they will stop working and you will need dialysis until you get a kidney transplant.

If you do not have any of the primary risk factors for high blood pressure, you are younger than 30 or older than 55, you present with extremely elevated high blood pressure, blood pressure medication is no longer working or just does not work at all  then your doctor might suspect you have secondary high blood pressure.

Primary Hypertension

  • Excess sodium
  • Inadequate potassium
  • Physical inactivity
  • Stress
  • Low levels of Vitamin D
  • African American
  • Smoking
  • Alcohol

Secondary Hypertension

  • Polycystic kidney disease – cysts present on kidney preventing it to work
  • Sleep Apnea– absence of breathing while asleep causes decrease oxygen in the blood which in turns damages the blood vessel
  • Glomerular Disease– the kidneys are unable to filter water and waste properly
  • Renovascular High Blood Pressure– the artery leading to kidneys are damage and the function of the kidney is impaired
  • Cushing Disease– too much cortisol is produce by a tumor on the adrenal glands or side effect of long term use of  corticosteroids that are use to treat some conditions
  • Aldosteronism– too much aldosterone that interferes with  sodium, potassium and water excretion by the kidneys
  • Pheochromocytoma-a tumor that releases hormones that can cause high blood pressure
  • Thyroid Disease– high or low thyroid function causes abnormal thyroid hormone secretion. Both condition can cause high blood pressure
  • Diabetes-blood vessels in the kidneys are damage  and blood flow is impaired result kidney function
  • Hyperparathyroidism-an increase in calcium secretion by the parathyroid gland result in calcium interacting with the blood vessels making them stiff
  • Coarctation of the aorta-a congenital anomaly causes the aorta to become narrow which results in a higher force to push blood around the body
  • Obesity-excess weight equals excess blood circulating through the body which place added pressure on the arteries
  • Pregnancy-one or more primary risk factor present
  • Medications and Supplements

To close, if you ever wonder if you are at risk for high blood pressure then this list should give you a good idea where you stand. Primary high blood pressure can be prevented if you make some adjustment primarily in what you eat. Not only will you see an improvement in your blood pressure you will also loose some weight.

 

 

What Foods Can Lower Blood Pressure

 

High blood pressure, or hypertension, is a leading health problem across most modern societies. Approximately a third of adults in the U.S. have significantly high blood pressure which threatens their well-being, while a further third have blood pressure readings lying above the ideal range.

Uncontrolled hypertension can lead to several life-threatening health problems. It puts a heavy strain on the heart, increasing the risk of cardiovascular disease including heart attacks, and it also contributes to kidney disease and strokes. In the U.S. alone it’s estimated that high blood pressure is a primary or major cause of over 1,100 deaths each day.

Although in some cases genetics play a part in determining who will develop high blood pressure, this in not the case for most of the population with hypertension. Much of the danger is linked to lifestyle factors, with diet making a huge contribution. A poor diet can be a direct cause of hypertension, while a healthy diet will not only reduce the risk, but can help control the symptoms if the condition is already established. So what should you consider if you want to eat in a way that encourages lower blood pressure?

The American College of Cardiology states that diet modification that mimics the DASH diet plan  can lower your blood pressure my approximately 11 mm Hg.  At first this might not seems like a significant reduction  but if a 10mm Hg reduction in blood can prevent you from adding another blood pressure medication then it something worth exploring. It all starts with evaluating your current food choices and modifying where necessary.

Foods to Avoid

Salt is far and away the most dangerous dietary cause of high blood pressure. Too much salt in your body reduces you kidneys’ ability to flush out excess fluids, and the resulting high levels of water in your system directly raise blood pressure. While a certain amount of salt is necessary for life, the average western diet contains more than twice the recommended maximum amount.

While it’s a good idea to reduce the amount of salt you add to meals at the table, the majority of the salt you eat will probably be in the form of highly processed foods. Trying to eat fresh ingredients wherever possible is usually far more effective in reducing your salt intake than sprinkling a little less on your food at mealtimes.

Also, foodstuffs which are high in saturated fats should be avoided. These fats raise your blood’s cholesterol levels, which can lead to deposits building up in your veins and arteries, forcing your blood through a smaller space and so raising your blood pressure.

Foods to Eat More Of

However, controlling blood pressure isn’t all about restricting your diet. There are several foods which can have positive effects if you eat more of them.

– Foods high in potassium can help your kidneys filter out excess sodium in your blood, therefore reducing salt’s harmful effects. Good sources of potassium include leafy greens, sweet potatoes, wild salmon, beans, and bananas.

– Fiber plays a vital role in reducing cholesterol levels in your blood, yet most people don’t consume enough of it. Foods that are rich in fiber include most types of grains and cereals, beans of all kinds, berries, leafy vegetables, and nuts and seeds.

– Magnesium is thought to have a modest influence on lowering blood pressure, particularly in older men. This vital mineral is found in many of the same foods as potassium, as well as in fruits including apples and figs.

– Garlic has long been held to help purify the blood and improve circulation. However, much of the benefit is thought to be lost through cooking, so if the prospect of consuming raw garlic is worrying, consider taking it in capsule form.

In essence, the best way to control blood pressure through your diet is to eat plenty of fresh fruits and vegetables, and avoid highly processed foods as much as possible. If you choose to eat meat and dairy, then opt for lean and low-fat versions, and try to reduce the amount of salt you add to food both in cooking and at the table.

Eating well may not be a 100 percent guarantee that you’ll avoid high blood pressure, but of all the factors under your control, it’s by far the one with the most influence, and a good diet will benefit your health in many other areas along the way.