What Is Secondary High Blood Pressure?
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Dear Dr. Donohue: I am a 42-year-old male who has had high blood pressure for the past two years. I have been on many medicines, but my pressure doesn’t go much lower. I don’t smoke or drink. No one else in my family has high blood pressure. I am about 25 pounds overweight. My doctor mentioned that I might have secondary high blood pressure. What is that? — R.B.
Answer: Ordinary high blood pressure, or hypertension, is essential hypertension — high blood pressure that comes on its own. Secondary high blood pressure is an elevation of pressure due to another process. A leading cause of secondary high blood pressure is a narrowed kidney artery. Because of the narrowing, the kidney thinks body’s blood pressure is too low. It begins to turn out large quantities of renin, a kidney-made chemical that raises blood pressure. This kind of high blood pressure is known as renovascular hypertension. It can be cured by relieving the blockage in the kidney artery. Adrenal gland tumors, Cushing’s disease and a very unusual tumor called a pheochromocytoma are other causes of secondary high blood pressure. The bright side of secondary high blood pressure is its curability when the “secondary” process is treated. Your young age and the fact that your pressure doesn’t respond to the drugs well are two factors that suggest a secondary process might be going on Even though you didn’t ask, you can help yourself by losing the extra 25 pounds of weight you carry. Diet and exercise do work. You also can do yourself good by reducing greatly the amount of salt in your diet. Proof of secondary high blood pressure involves some complicated tests, so don’t be surprised if your doctor arranges them for you. Readers interested in ordinary high blood pressure can order the pamphlet on this common condition by writing: Dr. Donohue — No. 104W, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6 Canada with the recipient’s printed name and address. Please allow four weeks for delivery.
Dear Dr. Donohue: I have jogged for many years. It’s kept my weight down, and I do feel really fit. Twice I have sprained an ankle by stepping in a pothole I couldn’t see. What’s the right way to treat a sprained ankle? — G.R.
Answer: I can’t improve on the time-honored RICE recipe. “R” is for rest. Don’t put weight on a joint whose pain increases by so doing. “I” is for ice. A good way to apply ice is to put it in a plastic bag and then put a thin towel between the bag and the injured joint. Keep the ice in place for 15 minutes. Repeat the icing three or four times in the first day or two. Then switch to hot packs. “C” stands for compression. An elastic wrap does just fine. “E” is for elevation. If it’s the ankle that’s injured, the leg should be propped up. All these steps are done to prevent bleeding and swelling during the first two days of an injury. Use pain medicine as needed. Tylenol is a good choice. |
