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Doctor insights on: Nice Guidelines Hypertension

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Is ideal BMI range dependent on person's race for diabetes/heart disease risk reduction? Why?

Is ideal BMI range dependent on person's race for diabetes/heart disease risk reduction?  Why?

No: The BMI is simply your weight with respect to your height - an overly simplistic and thereby essentially flawed assessment of your health. It's a bit better when used in combination with body fat measurement. That being said, a high BMI might be associated with diabetes and heart disease amongst other health conditions. ...Read more

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Dr. Howard Schneider
324 doctors shared insights

Hypertension (Definition)

A blood pressure reading has two numbers: a systolic blood pressure and a diastolic blood pressure. The systolic blood pressure is the maximum pressure the blood exerts on the vessels when the heart is beating. The diastolic blood pressure is the pressure the blood exerts on the vessels in between heartbeats. Hypertension, or high blood pressure, begins when the systolic blood pressure remains above 140 or when the diastolic blood pressure remains above 90. Hypertension can be a result of increased blood flow through vessels or increased resistance to ...Read more


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Is the dash diet good for hypertention?

Is the dash diet good for hypertention?

DASH diet HTN: Yes it is the best way we know how to prevent and treat HTN. Recommend the book by Thomas Moore et al. I specialize in high blood pressure and and salt and happy to do 2nd opinion. Live. ...Read more

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Does the cardioemolic stroke patient (otherwise healthy) benefit from statins ?!

Does the cardioemolic stroke patient (otherwise healthy) benefit from statins ?!

Cardioembolic stroke: Good question. Strictly s[peaking, statin should not help cardioembolic stroke. Howevere, statin may help the cause of cardic source of emboli such as ischemic cardiomyopathy. ...Read more

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Sweden has reviewed 16000 peer reviewed articles and concluded a low carb diet is safe and good for health. Do american doctors agree?

Sweden has reviewed 16000 peer reviewed articles and concluded a low carb diet is safe and good for health. Do american doctors agree?

Low Carbs: Yes. Even the U.S. Government has changed and advocates this approach to nutrition and dieting. The U.S. Recommendations, backed up by science, is that 65% of calories should come from protein sources, 25% from carbohydrate sources and 15% from fats. ...Read more

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Bp constantly 160/80 despite micardis (telmisartan) 80, norvasc 5, labetolol 50. Pulmonary htn with ckd, lupus.. imdur, diuretics not advised by md. Other choices?

Bp constantly 160/80 despite micardis (telmisartan) 80, norvasc 5, labetolol 50. Pulmonary htn with ckd, lupus.. imdur, diuretics not advised by md. Other choices?

160/80: There seems to be much going on and not fully helping you. For now please check your blood pressure every other morning and every other alternate night. I suspect that the blood pressure data will be different from day to day, in which case you must contact your doctor for treatment advice. Please let me know how things develop. ...Read more

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Solution for isolated systolic hypertension 158/70 and triglycerides 220? Total cholesterol normal, not overweight, daily exercise, healthy diet.

Solution for isolated systolic hypertension 158/70 and triglycerides 220? Total cholesterol normal, not overweight, daily exercise, healthy diet.

It is unlikely: that you will be able to modify these abnormal findings without additional pharmacological intervention. An extreme diet of withholding sodium (<1gm) and very low carbohydrate might help but would be unpleasant. Your health care provider should be able to advise you and prescribe additional medication that will allow you to improve the numbers while still living an acceptable life style. ...Read more

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100% healthy, no hypertension, hypercholesterolemia, or diabetes, ideal weight, very active, 59 y.o. woman, 2 days later, heart attack, related?

100% healthy, no hypertension, hypercholesterolemia, or diabetes, ideal weight, very active, 59 y.o. woman, 2 days later, heart attack, related?

There are known: risk factors for coronary artery disease and you have named them but there is also genetics. In addition you haven't mentioned smoking or emotional distress. Takasubu can cause heart attack in a distressed woman and perhaps that is the root of the event. Smoking can undo all the good for the things you mentioned. ...Read more

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Can LDL be too low for a patient with a history of atherosclerosis, TIA, hypertension and currently on NOAC? Current LDL at 50 under 20mg simvastatin

Can LDL be too low for a patient with a history of atherosclerosis, TIA, hypertension and currently on NOAC? Current LDL at 50 under 20mg simvastatin

LDL-P or LDL-C? Big: difference. Outcomes always match LDL-P (http://goo.gl/zwrkCs); Not LDL-C [a guess of how much cholesterol (in mg) is carried by all LDL particles in a dL of blood plasma] data, See: http://goo.gl/NmdIfm. Since every cell in body manufactures cholesterol (part of every cell membrane), very low LDL-C (down into teens) is rarely a health issue. LDL-P not being very low IS a major health issue. ...Read more

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Is there any new recommendations regarding hypertension and pre hypertension in people with definite coronary artery disease?

Is there any new recommendations  regarding hypertension and pre hypertension in people with definite coronary artery disease?

For younger: men <60, the recommendation is stricter blood pressure control <= 120/80 with beta blocker, thiazide diuretic and/or ACE inhibitor or ARB. For older folks the current recommended pressure threshold is <= 130/85 but that recommendation could change within the next 2 years. Salt restriction to less than 2000 mg daily is also recommended along with cardiovascular exercises daily. ...Read more

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Please explain how warfarin contributes to arterial calcification, despite great lipid profile, in patient who has taken drug for 27 years.

Please explain how warfarin contributes to arterial calcification, despite great lipid profile, in patient who has taken drug for 27 years.

Some articles: I hope these studies help: http://goo.Gl/vnjyg http://goo.Gl/xwwh3 http://goo.Gl/yymu8 there are others, but i hope these help. Would be difficult to explain in this limited space. ...Read more

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Palliative care question: good reference guideline for end-stage COPD clinical/functional markers for poor response to CPR, and should recommend DNR?

Palliative care question: good reference guideline for end-stage COPD clinical/functional markers for poor response to CPR, and should recommend DNR?

COPD and DNR: I recommend going to uptodate and review what their recommendations are. This is the best source of good medical information I have found. When you read the sections on these issues you can also click on the reference to see the cited reference. ...Read more

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Are ARB's for Isolated Systolic Hypertension 50yr old best treatment with good BMI With healthy LifestyleI?Can they be used alone without diuretics?

Are ARB's for Isolated  Systolic Hypertension 50yr old best treatment with good BMI With healthy LifestyleI?Can they be used alone without diuretics?

For some patients: ARBs are a good choice for high blood pressure in some patients, and can be used without a diuretic. However, the best choice of medication is based on the other conditions a patient has, the other medications they are taking, race, and how high the blood pressure it. Your doctor will be able to make a recommendation for which medication is right for you. ...Read more

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How is pulmonary hypertension vs. Regular hypertension?

How is pulmonary hypertension vs. Regular hypertension?

Very different: Pulmonary hypertension is high pressure in the lungs and associated with chest pain, shortness of breath and fainting spells. Essential or systemic hypertension is different and is high pressure in blood vessels outside of the lungs. It can cause headaches, cheat pain but usually no fainting spells. ...Read more

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Is the 48 hour hollywood diet (drink) unhealthy?

Is the 48 hour hollywood diet (drink) unhealthy?

Better idea: Anything offering to "detoxify" you is a scam. You'll become thin and physically fit long-term when, and only when, you change your ideas about food (it's fuel, not comfort or entertainment) and make physical aerobic exercise a habit that defines you and your lifestyle. Get with a bunch of real fitness people for friendship and enjoyable times -- rather than drinking something disgusting. ...Read more

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Is it safe to treat young patient <60 with resistant hypertension & afib with ARB+Metoprolol+Amlodipine+HCT+Dabigatran+Rosuvastatin? GFR>80, LDL-C<50

Is it safe to treat young patient <60 with resistant hypertension & afib with ARB+Metoprolol+Amlodipine+HCT+Dabigatran+Rosuvastatin? GFR>80, LDL-C<50

Yes, this is a: reasonable combination of medications but one would like to be certain that any reversible causes of the HTN have been evaluated and treated. Renal artery stenosis, morbid obesity, dietary noncompliance, etc. ...Read more