PETER M. BRIER



Title:

Medical doctor

Company:

Internists of Central Pa.

Years In Field:

30 plus

Q: What causes high blood pressure? Does stress play a role in it?

A: Hypertension can be caused by certain kidney conditions, hardening of the arteries and, rarely, tumors. However, the most common cause of hypertension is unknown. This is a condition that is called essential hypertension, and it is often familial in nature. Stress may elevate blood pressure by increasing certain hormones in the bloodstream. Hypertension may often have no associated symptoms until the late stages of the disease.

Q: Should patients monitor blood pressure at home?

A: It is helpful for patients and their physicians if patients monitor their blood pressure at home. Readings may vary throughout the day, and home readings give an idea of the adequacy of control without the artificial environment of a physician`s office.

Q: What is the best way to get high blood pressure under control? Can it be done with lifestyle changes alone?

A: Some cases of hypertension can be controlled by certain lifestyle changes, such as losing weight, salt restriction and self-relaxation. Often, medications are needed as well. Early treatment often consists of lifestyle changes before drug treatment is considered.

Q: What is the DASH diet, and how can that help?

A: The DASH diet is a diet recommended by the National Institute of Health, which is high in fruits, vegetables, grains and low-fat dairy products. It may lower blood pressure and help in lowering cholesterol and weight. It may be accessed at the NIH website. It is similar to the Mediterranean Diet.

Q: Why are diuretics used to treat high blood pressure? Are they the most effective medication, or are there others that should be considered?

A: Many medications are useful for the treatment of hypertension. Among them are diuretics, which decrease the volume of fluid and salt in the body. Other drugs lower blood pressure through direct actions on the arteries, modifying certain hormones, or direct effects on the central nervous system. All these have certain limitations and side effects as well as advantages. It is helpful for patient-physician interaction to determine the best treatment for an individual patient, and follow-up is essential.

Interview contucted via e-mail by The Patriot-News staff.