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MYTHS IN MEDICINE
(often popular belief does more harm than the most profound ignorance)
5 º MYTH (Part 1): "HYPERTENSION any symptoms? WHAT? (Part One)
Hypertension is the second condition Chronic health of all medicine (the first is the disruption caused as a result of poor diet).
And in hypertension where popular belief has had more influence with their myths (obviously influenced against).
Do you have a headache?: Has high pressure. Does
dizziness?: Their hypertension is uncontrolled.
Are you bleeding from his nose? (On why the doctors call "epistaxis"): the pressure must be through the roof.
And so a number of symptoms are those that "warn" hypertensives "things are not right."
Then suddenly begins to feel headache or dizziness, or start, for no apparent reason, bleeding from his nose (or feel anything unusual, things that are so numerous that it would be boring list), runs to the pharmacy or the nurse in the corner, or call the medical emergency ward (if he did not commit the folly have a home blood pressure). We take (or take) the pressure, and is indeed high, as assumed.
Then come the tips of the "people who know", "Take another tablet Ya! - Or" Rest and eat without salt, "or" Go running to consult your doctor. O
emergency physicians who have not even seen a instead, they put under the tongue an anxiolytic (before was worse, because they had the habit of putting there the contents of a capsule of nifedipine -10 mg, which was much, much more damaging than having high blood pressure). Given an injection of a diuretic (usually one called furosemide), are left with the "patient" two or three quarters of an hour, checking that the pressure has fallen, and leave as campers.
All these actions to increase the pressure seems logical and normal. But not for nothing.
The fundamental question is why patients with hypertension are terrified that way when their blood pressure rise unexpectedly? And the answer is what everyone expects: because they fear the consequences of having a "ATTACK OF PRESSURE" . Who does not know anyone who has suffered? Have remained hemiplegic, that means that half his body has lost a greater or lesser extent, mobility, and in half the cases where this has happened on the side of his right hand, usually can no longer speaking, because the brain center where he coordinates the complex process of issuing the word is in the same hemisphere that coordinates skilled movements of the hand (and leg on same side). Come on: the right-handed right hand, which are the majority, when the hemiplegia is on the right side, and backward on the right-left members.
Imagine an "attack" of that type.
John is having lunch while talking animatedly with his wife. In a moment he began to feel strange: you have trouble holding the knife in his hand, because the force is lost in her second to second, at the same time note that the corner of his mouth is tipping, what difficult to deliver voice, difficulty also worsens rapidly, note that each time makes it more difficult to establish the right things but in his brain to think properly, or baste the phrases in his brain feels well basted. Begins to feel a terrible panic, and so instinctively tries to stand, but as the leg on the same side also lost the forces (which is not noticed when sitting), collapses.
Now who is in a panic is your wife. Kneels down, lying flat on the floor and starts to question what is happening desperate. But he does not respond, first because it is clouded, and second because he can not utter words.
She runs off to seek help, and when it arrives, the first thing you do is take your blood pressure. As expected, is very high, say by way of example that has 260 mm of mercury systolic ("maximum pressure" as the call usually) and 165 mm in diastolic blood pressure (or "minimal" as we call it almost always). Clarification: doctors and nurses have the habit of branding the blood pressure in millimeters of mercury, other people do it in inches of mercury (in centimeters and communicate them to our patients their pressure to speak the same language), by As for all the world John has, after the "attack", 26 / 16.5. "The consequence of all this?:
John has suffered" an attack of pressure. "
But it is false, what John has suffered a stroke. (The more often a transient ischemia-needed blood in an area of \u200b\u200ba cerebral hemisphere, which produces "neuronal suffering" - or a heart attack, permanent absence of blood in the same area, which triggers the death of the millions of neurons that make up that portion of the brain that handles the movement of the upper and lower half away, and the speech center, if the opposite half is half right hand, as we saw above-).
But perhaps John was not hypertensive, or if it was, their blood pressure levels were always bounded because it was a good patient, taking medications faithfully, and she attended each visit with your doctor without miss any.
What happened then?
The brain is the organ care of the whole economy, and is the most readily reveals any failure in that care.
Like the rest of the body is nourished and oxygenated blood. Blood runs through your arteries at a given pressure. But as is the body that commands everyone else, has been given a grace that others do not: You can adjust the pressure of his own arteries. For a very complex mechanism, regardless of pressure from the rest of the body is high, he always keeps the tension in your arteries to the level it should be (almost all lower general blood pressure).
Suppose two neighboring areas of brain, and call them and A B . Each has an artery that irrigate it. sector say that it supplies to 1 artery, and the industry B 2 artery. As a precaution, the artery 1 out very small arterioles that lead to the sector B, and artery 2 arterioles ranging A sector (in addition, each sector receives arteries arterioles, say, 3, 4, 5 ... but not so cumbersome to explain, let's stay only with the 1 and 2 ).
There is a universal disease which known as "atherosclerosis" .
That word comes from the Greek athéeree: means porridge and other Greek word, Skléeroosis, which means hardening .
artery consists of three layers, each called "coat" the inside (or close), the mean (which is muscle) and external. Atherosclerosis is the formation of deposits or yellowish plaques in the intima and the innermost portion of the tunica media, cholesterol and other substances that over the years calcifying go. In this plate is called atheroma . This occurs in the arteries of large and medium caliber.
Most of the time, these plates are slowly closing the lumen of the artery, until in a moment, the surface roughness of each atheroma results in the formation of a small blood clot that completely blocked. There occurs a type of "stroke", called "thrombosis" (word derived also from the Greek thrombo , meaning clot).
By going slowly closing, say, the artery No. 1 the 2 through their side is going to send blood to that neurons in the area A are not deprived of nutrients and, most importantly, oxygen. But the moment that the thrombus plugs total and instantly the main artery of the area (the No. 1 ), the area A is without sufficient oxygen, and the neurons that comprise begin to suffer the lack of vital element, so get to work getting worse, until in two or three minutes they do not. That's what happened to John while having lunch with his wife. The brain then sends messages to the blood pressure to rise with the double purpose of "pop" the blockage, and significantly, increase the flow of emergency through the collateral artery from 2.
In short, to end this nonsense, stroke is the one that pushes up the pressure, not high pressure that produces a stroke. (Although we must recognize that chronic high blood pressure and ill-treated or untreated, "is a precursor, in addition to the nutritional derangements of the highly dangerous" atheroma ").
Another type of stroke, thankfully less common, which we call "stroke" ( the Greek, "in" + bóllein "throw" ), and we define saying it is the sudden occlusion of an artery by a clot or some other foreign substance (eg, a piece of atheroma that emerges from a plate), and pushed through the blood moves through arteries , which become increasingly smaller as they move away from the heart to the periphery, until they find one with a diameter less than the piston and the jammed, preventing the movement thereafter. In these cases the problem is more serious because the affected brain area was not prepared, as in thrombosis, with "extra blood" coming from the neighboring artery through collaterals. Therefore, in the stroke is much more common in death of neurons that simply "suffering."
That is the reason why the victims of thrombosis can do better (sometimes 100%), than those of stroke, that is usually left with hemiplegia for the rest of his days.
The million dollar question is should we lower the pressure to the victim of a stroke?. My opinion is NO . He who has high blood pressure for several hours should not do any harm (the economy supports it without problems), and if he has suffered a thrombosis (much more common than stroke), neurons "suffer" but not "die."
I thought, imagining demystify the fact that hypertension has no symptoms, that things would be simpler. I'm used to explain this to my patients with words and pictures, but I've become much more difficult than imagined. So, we will continue the theme in the next issue, as there is still a lot of talking. Thirty
second installment: "Da HYPERTENSION SYMPTOMS? WHAT?" (Part II)
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