INVESTIGATIONS AND
TREATMENTS
Positive tests may be done to see if there is a cause of your high blood
pressure and to see if it has affected your body.
These include:
- Blood tests.
- Chest x-rays.
- Electrocardiogram (ECG). This is a tracing of the electrical activity of
the heart. It is completely painless.
- Ultrasound scan of the heart. This gives a moving picture of the heart and
is completely painless.
- Ultrasound of the kidneys.
- Dye X-ray of the kidneys. An injection is given then X-rays are taken to
see the dye in the kidneys.
- Angiogram of the arteries in the kidneys. Another dye is used to look at
the blood vessels in the kidneys.
- Collecting urine for 24 hours to see how well the kidneys work.
Levels of blood pressure needing treatment
The level of blood pressure that needs treatment varies from one person to
the next. It also depends on the situation during which the blood pressure was
measured. Elderly people tend to have a slightly higher blood pressure which
does not require treatment. When measuring blood pressure two readings are
obtained, e.g. 120/80. Usually the bottom reading (80) is more important. A
reading higher than 90 which is recorded on several occasions will require
treatment. The severity of high blood pressure that is mild, moderate or
severe, depends on the bottom reading.
Drugs and their side effects
Most drugs have side effects and those used for high blood pressure are no
exception. The drugs commonly used in treating high blood pressure are beta
blockers, diuretics, ACE inhibitors and calcium channel blockers.
Beta blockers
Beta blockers are widely used in treating various conditions. They are used
as a first choice of treatment for many people. They are taken once, twice or
three times a day. A diuretic or water tablet may be added. Their side effects
may include tiredness, pain in the legs when walking and impotence. They should
not be taken by people with asthma or chronic bronchitis.
ACE inhibitors
ACE inhibitors are drugs which act on certain chemicals in the body,
widening the blood vessels and reducing the blood pressure. Their side effects
may include a persistent cough, rash and damage to the kidneys. In this case
the drug would need to be stopped and the kidneys usually recover.
Calcium channel blockers
Calcium channel blockers are drugs which interfere with the transport of
calcium in the cells of the smooth muscle in the walls of blood vessels, and in
the muscle and specialised conducting cells of the heart. This causes widening
of the blood vessels and therefore reduces blood pressure. Their side effects
may include headaches and slight ankle swelling.
However, most people tolerate these drugs well but if not, there are several
other drugs that could be used instead. The patient is usually tried on
different drugs until the most suitable one is found.
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