Pulmonary Arteriovenous Malformations and Hereditary Hemorrhagic Telangiectasia
Summer Heat Means Those Of Us With PH Must Remain Vigilant
As I opened my email inbox, a headline instantly caught my eye: "Massive heat wave heading for USA next week." This got me thinking about how heat affects those of us with pulmonary hypertension (PH). Here in sunny San Diego, many in our PH community are bracing for the extreme heat.
As summer officially kicks off this week, the forecast looks perilous for those of us with PH. Heat and sunlight can exacerbate PH symptoms, a common ordeal we all share. We must tune into our bodies and monitor how we react to prolonged heat and sunlight. Although I adore the sunshine and the beach is my sanctuary, I notice an increase in my symptoms on hotter days, including palpitations, headaches, and shortness of breath.
Relocating from the Gulf Coast of Texas to Southern California has been a blessing for me. It offers more opportunities to enjoy the outdoors without the oppressive heat and humidity that worsened my health in Texas. Fellow Bionews columnist Benjamin Hofmeister, who battles multiple sclerosis, says he also faces similar challenges with the heat and humidity in Alabama.
For many PH patients, diuretics like Lasix (furosemide) are lifesavers, preventing swelling and reducing the risk of congestive heart failure (CHF). However, these medications make us more susceptible to heat, and sweating can lead to dehydration. Our kidneys are vital to regulating electrolytes, minerals, and water, but those with chronic kidney disease (CKD) face compromised functioning of these organs. Eating a balanced diet and monitoring fluid intake becomes a delicate dance to maintain our health.
Did you know that summer heat can diminish our appetite, too? When it's scorching hot, I crave cooler foods and tend to eat less, which isn't great since I already have the eating habits of a grazing toddler on most days. In response, my nephrologist set up a few sessions for me with a dietitian who specializes in kidney disease.
After two of these appointments, the dietitian humorously suggested I ask my daughter, Kayla, for advice. Kayla is a registered dietitian, so I asked her for some insight about why we eat less during the summer months. Following are excerpts of our conversation.
JC: Why are we less hungry when it's hot out?KC: When it's hot outside, our bodies work hard to stay cool, and all this extra work can decrease our appetite. The body prioritizes regulating its temperature, often at the expense of hunger signals. Physiologically, digestion generates heat, so eating less helps keep internal temperatures down. Unsurprisingly, hot weather can also exhaust us, which diminishes our hunger.
What heart-healthy, lighter foods do you recommend during these times?For heart-healthy eating in the heat, stick to light and nutrient-rich foods. Fresh salads with avocado and nuts, whole grains like quinoa and barley, and lean proteins like grilled chicken or fish are excellent choices. Seasonal fruits and veggies like berries, cucumbers, and tomatoes are refreshing and packed with vitamins and antioxidants. If you haven't tried grilling fruits or vegetables lately, give it a go for a quick and easy summer side dish!
How can those who need to monitor fluid intake due to CHF or CKD increase foods with higher water content?For those needing to monitor fluid intake due to conditions like CHF or CKD, balancing hydration with dietary restrictions is key. Opt for foods that boost hydration but are lower in volume. Fruits like grapes or berries offer hydration in smaller, more controlled quantities than watermelon or cucumber. Always coordinate with your healthcare provider to adjust fluid intake recommendations to your daily needs and medical guidance.
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Kayla is excellent at keeping me in check, especially when it comes to my favorites like watermelon and cucumbers. These refreshing, high-water treats are delicious but best enjoyed in moderation. My nephrologist constantly reminds me of this, particularly on those scorching summer days when I feel extra thirsty.
It's a tricky balance between managing fluid retention and avoiding dehydration. Remember, our bodies work nonstop to regulate our temperature and stabilize us. Let's be mindful and give them the care they deserve during these hot summer months. Stay cool, stay hydrated, and relish all of summer's fantastic joys!
Note: Pulmonary Hypertension News is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Pulmonary Hypertension News or its parent company, Bionews, and are intended to spark discussion about issues pertaining to pulmonary hypertension.
What Does High Blood Pressure Feel Like?
Generally, high blood pressure does not cause any symptoms. If a person does experience symptoms, they may include headaches, dizziness, and sleep issues.
Blood pressure is the force of the blood against the walls of the arteries as it goes around a person's body. Sometimes, it can become too high, which can be dangerous.
According to the Centers for Disease Control and Prevention (CDC), nearly half of all adults in the United States have high blood pressure (hypertension).
In this article, we explore the myths surrounding high blood pressure symptoms. We also discuss when to see a doctor and how to manage hypertension.
Most of the time, high blood pressure has no symptoms. It is known as the silent killer.
Symptoms people may think are due to high blood pressure include:
However, these symptoms may not be due to high blood pressure, and anyone experiencing them should speak to a doctor as they may also be signs of other health conditions or side effects of medications.
Measuring blood pressurePeople cannot rely on only physical symptoms to alert them of high blood pressure. To diagnose or monitor hypertension, a person should measure their blood pressure regularly.
A person can measure their blood pressure at home.
Blood pressure readings are in millimeters of mercury (mm Hg). The top number (systolic) indicates the pressure in the arteries as the heart beats. The lower number (diastolic) indicates the pressure as the heart rests between beats.
As long as a person measures their blood pressure correctly, the results are just as reliable as a doctor's measurement.
The following table from the American Heart Association (AHA) shows the classification of high blood pressure in adults:
Learn more about how to understand blood pressure readings here.
Researchers have shown a clear relationship between higher systolic and diastolic blood pressure and increased risk of cardiovascular disease.
In an analysis of 61 studies, researchers found that a 20 mm Hg higher systolic and a 10 mm Hg higher diastolic blood pressure were each associated with a doubling of the risk of:
Another older study, including 1.25 million participants, showed that higher blood pressure had associations with:
Although high blood pressure does not usually cause symptoms, anyone experiencing a sudden, severe headache or nosebleed should check their blood pressure.
If their blood pressure is above 180/120 mm Hg, they should stay rested for five minutes and recheck their blood pressure. If the blood pressure is still higher than 180/120 mm Hg, they need to seek medical help at their doctor's office.
If a person is experiencing severe symptoms, such as chest pain, shortness of breath, or visual difficulty, they need to call 911 for emergency medical treatment as they may be experiencing a hypertensive crisis.
Medications to reduce blood pressure can cause side effects such as dizziness. If this side effect does not go away or affects a person's daily activities, they should speak with their family doctor.
GeneticsAccording to the CDC, high blood pressure can be affected by genetics.
A 2020 study suggests a person's chance of inheriting high blood pressure is roughly 24–30%.
Lifestyle factorsThe following environmental factors may influence a person's blood pressure:
Since there is a strong connection between environmental factors and blood pressure, healthcare professionals have been promoting hypertension prevention.
The AHA recommends:
A healthy diet for the heart consists of eating:
People who follow a healthy diet to prevent hypertension and cardiovascular disease should also avoid or limit:
People who eat well, stop smoking, lower their stress, and exercise regularly may see benefits in their general health.
The DASH diet (Dietary Approaches to Stop Hypertension) may be beneficial in helping to prevent or treat high blood pressure.
Learn more about the DASH diet here.
Below are some commonly asked questions about what high blood pressure feels like.
How does a person feel when their blood pressure is high?Generally speaking, a person with high blood pressure will not feel any different or experience symptoms.
However, in rare cases, when a person's blood pressure is dangerously high, it can cause symptoms like difficulty breathing, a severe headache, and chest pain.
This is known as a hypertensive crisis and can lead to a medical emergency, so a person must seek immediate care.
What are the symptoms of very high blood pressure?When a person experiences sudden, very high blood pressure, with readings of 180/120 mm Hg or greater, this is known as a hypertensive crisis.
The symptoms of this include:
If a person is experiencing these symptoms, they should call 911.
What hurts when you have high blood pressure?High blood pressure itself typically doesn't cause pain. In fact, it's often called the "silent killer" because it can damage a person's body without causing noticeable symptoms.
However, high blood pressure can lead to complications that can hurt, such as a severe headache and pain in the abdomen, chest, or back.
Doctors and health professionals often refer to high blood pressure as a silent killer, and it is a risk factor associated with cardiovascular disease.
People who have high blood pressure may not experience any physical symptoms and may not be aware that their blood pressure is high.
During a hypertensive crisis, people with a blood pressure above 180/120 mm Hg may experience symptoms such as chest pain, shortness of breath, blurry vision, headache, or nosebleed.
People experiencing a hypertensive crisis require emergency medical attention.
The most reliable way to detect high blood pressure is by regularly checking blood pressure measurements.
Treatment Options For High Blood Pressure (Hypertension)
Hypertension increases your risk of heart attack and stroke. A variety of treatments can help you manage your blood pressure, including lifestyle changes and medications.
Treatment for high blood pressure typically involves a combination of medication and lifestyle changes. The goal is to get your blood pressure into its optimal range.
Elevated blood pressure doesn't necessarily raise your risk of heart attack or stroke. But without attention, it can progress to high blood pressure — which definitely does raise your risk.
Read on to learn more about lifestyle changes and medication options for high blood pressure.
A healthy lifestyle is the first line of defense against high blood pressure. Habits that help manage blood pressure include:
Learn more lifestyle strategies and habits for lowering blood pressure.
Some people find that lifestyle changes alone are not enough to manage high blood pressure. In these cases, many types of blood pressure medications with different modes of action can help.
For some people, a combination of two or more drugs may be needed to manage their blood pressure. Your doctor can recommend the right medication protocol for you.
High blood pressure medications can be divided into the categories listed below, based on how they work. The drugs in each section are just a sampling of what's available.
DiureticsDiuretics, sometimes called water pills, help the kidneys get rid of excess water and salt. This reduces the volume of blood that needs to pass through the blood vessels, resulting in lower blood pressure.
There are four major types of diuretics defined by how they work. They include:
Diuretics in the thiazide group generally have fewer side effects than the others, particularly when taken at low doses. If you have early stage high blood pressure, lower doses are recommended.
Beta-blockersBeta-blockers help the heart beat with less speed and force. The heart pumps less blood through the blood vessels with each beat, so blood pressure decreases. Some examples of beta-blockers include:
Alpha-beta-blockersAlpha-beta-blockers have a combined effect. They're a subclass of beta-blockers that block the binding of catecholamine hormones to both alpha and beta receptors.
They can decrease the constriction of blood vessels like alpha-1 blockers, slowing the rate and force of the heartbeat like beta-blockers. Examples include:
ACE inhibitors help the body produce less of a hormone called angiotensin II, which causes blood vessels to narrow. These medications decrease blood pressure by helping blood vessels expand and let more blood through.
Some ACE inhibitors include:
ARBs block the action of angiotensin II directly on the blood vessels. It attaches at the receptor site on the blood vessels and keeps them from narrowing. This causes blood pressure to fall.
Some examples include:
Calcium channel blockers limit calcium from entering the smooth muscle cells of the heart and blood vessels. This makes the heart beat less forcefully with each beat and helps blood vessels relax, lowering blood pressure.
Examples of these medications include:
Your body produces types of hormones called catecholamines when it experiences stress. Catecholamines, such as norepinephrine and epinephrine, cause the heart to beat faster and with more force. They also constrict blood vessels, raising blood pressure.
The muscles around some blood vessels have alpha-1 or alpha-adrenergic receptors. When a catecholamine binds to an alpha-1 receptor, the muscle contracts, the blood vessel narrows, and blood pressure rises.
Alpha-1 blockers bind to alpha-1 receptors, blocking catecholamines from attaching. This keeps them from narrowing blood vessels so blood is able to flow through the blood vessels more freely, and blood pressure falls.
Examples of these drugs include:
When an alpha-2 receptor is activated, the production of norepinephrine is blocked. This decreases the amount of norepinephrine produced. Less norepinephrine means less constriction of blood vessels and lower blood pressure.
Since alpha-2 receptor agonists can work in the brain and central nervous system, they're also known as central agonists. This makes these medications useful for treating a large range of health conditions beyond high blood pressure.
Examples include:
VasodilatorsVasodilators relax the muscles in the walls of blood vessels, especially small arteries, called arterioles. This widens the blood vessels and allows blood to flow through them more easily. Blood pressure falls as a result.
Examples include:
Treatment for high blood pressure includes ongoing care as well as individual treatments tailored for specific situations and younger age groups.
Ongoing medical careTo make the most of your treatment, it's vital to get regular medical checkups and blood pressure tests. Regular checkups allow your doctor to monitor how well your treatment is going and make any necessary adjustments to your treatment plan.
If your blood pressure starts inching back up, your doctor can respond promptly. Doctors' visits also give you an opportunity to ask questions and bring up any concerns.
Treatment for specific situationsAdditional treatment options may be needed in certain situations, like resistant hypertension or secondary hypertension.
Resistant hypertension refers to blood pressure that remains high after trying at least three different types of blood pressure medications. Someone whose high blood pressure is controlled by taking four different kinds of medication is considered to have resistant hypertension.
Even such hard-to-treat cases can often be managed successfully. Your doctor might prescribe a different medication, dose, drug combination, or more aggressive lifestyle changes.
Secondary hypertension is high blood pressure that's directly caused by another health condition or drug side effect. Blood pressure often drops substantially or even goes back to normal once doctors diagnose and treat the root cause.
Treatment options for children and teensThe first line of treatment for children and teens with high blood pressure is a healthy lifestyle. This includes:
Children may take the same blood pressure medications as adults when necessary. For children with secondary hypertension, blood pressure often returns to normal once the underlying condition is treated.
High blood pressure treatment usually involves a combination of lifestyle changes and medication. Sometimes, lifestyle changes are enough to return your blood pressure to normal levels. These changes may include diet, exercise, and weight loss.
If your high blood pressure continues, be sure to consult a doctor who can prescribe the appropriate medication.
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