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I have Hypertensive Disorders I have a sustained high blood pressure for over 5 years. Please can you shed more light on the disease and its effects?

Ibrahim Y

Blood pressure is the pressure of blood in your arteries (blood vessels). Blood pressure is measured in millimetres of mercury (mmHg). Your blood pressure is recorded as two figures. For example, 120/80 mmHg.

1. The top (first) number is the systolic pressure. This is the pressure in the arteries when the heart contracts.

2. The bottom (second) number is the diastolic pressure. This is the pressure in the arteries when the heart rests between each heartbeat.

High blood pressure is a blood pressure that is 140/90 mmHg or above each time it is taken. That is, the blood pressure is ‘sustained’ at 140/90 mmHg or above. High blood pressure can be:

1. Just a high systolic pressure, for example, 160/70 mmHg.

2. Just a high diastolic pressure, for example, 120/104 mmHg.

3. Or both, for example, 160/110 mmHg.

However, it is not quite as simple as this. Depending on various factors, the level at which blood pressure is considered high enough to be treated with medication can vary from person to person.

What causes high blood pressure?

The cause is not known in most cases, this is called ‘essential or primary hypertension’. In some cases, high blood pressure is caused by other conditions. It is then called ‘secondary hypertension’.

Some secondary causes are as follows

1. Kidney disease

2. Endocrine diseases such as high level of Cortisol

3. Narrowing of the aorta

4. Ingestion of Steroid medicines

5. The contraceptive pills (not seen in all women that take pills)

6. Pregnancy, which can cause Pre-eclampsia

High blood pressure is more common in people:

1. With Diabetes Mellitus.

2. With a family history of high blood pressure.

3. Lifestyle factors such as overweight, eating a lot of salt, excessive intake of cholesterol diet, lack of exercise, taking a lot of alcohol.

Problems associated with Hypertension

High blood pressure is a ‘risk factor’ for developing:

1. Cardiovascular disease (such as a heart attack or stroke).

2. Kidney disease

3. Losing eye sight

4. Hypertension that is complicated with Diabetes Mellitus can cause erectile dysfunction. Also drug treatments can affect sexual performance.

Prevention of High Blood Pressure

1. Losing weights for those overweight.

2. Regular physical activity

3. Low salt intake

4. Eating healthy diet such as fruits, cereals, vegetables, and not much fatty food, drinking Alcohol in moderation.

Treatment is normally by drugs plus the preventive measures mentioned above. It can be cured if a secondary cause is treated. If it is a Primary Hypertension, it can be managed properly for one to have a good life.

My breasts are enlarged

More grease to your elbows as you address people’s health/social problems. I am a young man of 23 years. I am experiencing breast enlargement. What are the likely causes and remedy?

John

I have received three similar questions on the above subject matter.

Gynecomastia is an abnormal enlargement of one or both breasts in men. Milk production may or may not be present.

Gynecomastia is fairly common. It is a physiologic phenomenon that occurs during puberty, when at least half of males experience enlargement of one or both breasts. Pubertal hypertrophy is characterized by a tender discoid enlargement of the breast tissue beneath the areola and usually subsides spontaneously within a year.

Less commonly, gynecomastia may be caused by a hormone-secreting tumour of the breast, lung, or other organ. Biopsy may be performed to rule out the presence of cancer.

Pseudogynecomastia is breast enlargement due to fat accumulation.

Pseudogynecomastia can be distinguished by physical examination.

The causes of gynecomastia are multiple. A search for a common mechanism has not been successful. A number of researchers believe that in many cases (but not all); an altered androgen/estrogens ratio causes changes in cellular elements in breast tissue. This could be due to:

1. Decrease in production of androgen

2. Increase in estrogens formation

3. Decrease in sensitivity of breast tissue to androgens

Certain medications can promote breast growth. They interact with the natural levels of testosterone and estrogen, and upset the balance in some manner. Drugs that may cause gynecomastia include:

1. Hormones (androgens, anabolic steroids, estrogens agonists)

2. Antiandrogens or androgen-synthesis inhibitors

3. Antibiotics (isoniazid, ketoconazole, metronidazole)

4. Anti-ulcer medications such as cimetidine

5. Cancer chemotherapeutics, especially alkylating agents

6. Cardiovascular drugs, such as captopril and digitoxin

7. Psychoactive agents, such as diazepam and tricyclic antidepressants

8. Recreational drugs, such as alcohol and marijuana

9. Penicillamine

Alcohol and drugs can cause gynecomastia by mimicking estrogen and stimulating androgen production. Steroids and other excess androgens are sometimes converted by the body into estrogens and consequently cause male breast problems.

Choices of treatment for gynecomastia depend on several factors. The first is the cause of the disorder. If the gynecomastia is drug-induced, discontinuance of the agent may be all that is needed.

If it is pubertal, like in your own case, watchful waiting is in order, since in most patients the condition will resolve spontaneously.

In general, indications for treatment of such include: marked pain and tenderness, severe embarrassment or emotional disturbance. The most uniformly effective therapy at any stage is surgical removal of the glandular tissue through a periareolar incision.

There is a good chance your situation may improve with time especially if it is the pubertal one as I explain above. You may still visit a surgeon to have a look at it.

What are Ovarian Cysts?

I was confirmed to have Ovarian Cysts via many laboratory tests. Please what is your advice on that? I am really disturbed.

Eunice Audu

A cyst is a fluid-filled sac, and can be located anywhere in the body. On the ovary, different types of cysts can form. The most common type of ovarian cyst is called a functional cyst, which often forms during the normal menstrual cycle. Each month, a woman’s ovaries grow tiny cysts that hold the eggs. When an egg is mature, the sac breaks open to release the egg, so it can travel through the fallopian tube for fertilization. Then the sac dissolves. In one type of functional cyst, called a follicular cyst, the sac doesn’t break open to release the egg and may continue to grow. This type of cyst usually disappears within one to three months. A corpus luteum cyst, another type of functional cyst, forms if the sac doesn’t dissolve. Instead, the sac seals off after the egg is released. Fluid then builds up inside of it. This type of cyst usually goes away on its own after a few weeks. However, it can grow to almost four inches and may bleed or twist the ovary and cause pain. Drugs which are used to induce ovulation can raise the risk of getting this type of cyst. These cysts are almost never associated with cancer.

Many women have ovarian cysts without having any symptoms. Sometimes a cyst may cause problems such as

1. Pressure, fullness, or pain in the abdomen

2. Dull ache in the lower back and thighs

3. Problems passing urine completely

4. Pain during sexual intercourse

5. Weight gain

6. Painful menstrual periods and abnormal bleeding

7. Nausea or vomiting

8. Breast tenderness

Cyst can be treated by:

A. Watchful waiting. The patient waits and gets re-examined in one to three months to see if the cyst has changed in size.

B. Surgery. If the cyst doesn’t go away after several menstrual periods, has got larger it can be removed

1. Laparoscopy—if the cyst is small and looks benign on the ultrasound, your doctor may perform a laparoscopy. A very small incision on the abdomen

2. Laparotomy—if the cyst is large and looks suspicious, the doctor may perform a procedure called a laparotomy. This procedure involves making bigger incisions in the stomach to remove the cyst.

C. Birth control pills. Can be prescribed to prevent ovulating. That will lower the chances of forming new cysts.

It is very difficult or almost impossible to prevent ovarian cysts. Fortunately, the vast majority of cysts does not cause any symptoms, are not related to cancer, and go away on their own.

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