Mr. Dan

Blood pressure is the pressure exerted on blood vessels, and is determined by the amount of blood pumped by the heart and the stiffness of the blood vessels.

Mr. Dan

When blood pressure remains high, it causes severe damage to blood vessels. Damaged blood vessels become harder and more likely to cause arteriosclerosis, which in turn causes blood pressure to rise further, creating a vicious cycle. A major problem is that blood flow throughout the body changes rapidly, increasing the risk of serious illness.

Mr. Dan

According to the diagnostic criteria of the Japanese Society of Hypertension, hypertension is defined as home blood pressure of 135 mmHg or more in the critical period or 85 mmHg or more in the diastolic period, and blood pressure in the office of 140 mmHg or more in the critical period or 90 mmHg or more in the diastolic period.

Mr. Dan

In Japan, there are so many people with high blood pressure that it is sometimes called a national disease. It is estimated that 43 million people have high blood pressure, which is approximately 1 in 3 Japanese people. It is especially common among middle-aged and elderly people, and is strongly influenced by lifestyle habits such as a diet high in salt, lack of exercise, obesity, and stress.

Mr. Dan

There can be various reasons. One of the reasons is that high blood pressure itself does not have any symptoms, many people postpone the problem just because their blood pressure is high, and in the case of secondary hypertension, it is difficult to distinguish it from primary hypertension when there is another disease that is controlling blood pressure. Not only people who have symptoms, but also young people with high blood pressure, people whose blood pressure suddenly rises, and people whose blood pressure does not go down even with medication may have secondary hypertension.

Mr. Dan

Typical examples include renovascular hypertension, which causes a sudden increase in blood flow to the kidneys, sexual hyperaldosteronism, which causes tumors in the adrenal glands to secrete excessive hormones, and pheochromocytoma, and sleep apnea syndrome. It may also be affected by certain medications, such as steroids. Identifying the cause and treating it Accurate diagnosis is important because blood pressure may improve.

Mr. Dan

This can lead to serious complications such as stroke, myocardial infarction, and kidney failure. Young people in particular tend to be cautious and think that they are still fine, but early detection and treatment can significantly shorten their healthy life expectancy. This is not a secondary restriction, but the same applies to current hypertension.

Mr. Dan

We investigate the cause using blood and urine tests, abdominal echocardiography, and imaging tests such as CT and MRI. Considering the burden on the patient, we start with relatively simple tests and proceed with specialized tests as necessary.

Mr. Dan

The key is to treat the underlying disease. Treatment methods vary depending on the disease, such as kidney treatment for kidney disease, surgery for adrenal tumors, and CPAP therapy for sleep apnea syndrome. If drug-induced hypertension is suspected, consider and implement discontinuation or reduction of the suspected drug.

Mr. Dan

yes. Medications that lower blood pressure are used in parallel with treatment of the underlying disease to prevent complications.

Mr. Dan

This is a bit technical, but the aforementioned primary hyperaldosteronism has traditionally been said to be “diagnosed by hypokalemia,” but in reality, about half of patients have normal potassium levels.

Mr. Dan

If high blood pressure is left untreated, there is a risk of various diseases. If common treatments are not effective, it is important to consider the possibility of secondary hypertension. Many people think that the sun gets higher in the morning, but it is actually said that it is often highest in the morning.