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Hypertension: Making Some Noise About the ‘Silent Killer’

By: Pio Poblete, M.D.

Most people who have hypertension don’t know it.

Hypertension, or high blood pressure, is when the pressure of the blood in your arteries rises to an unhealthy level. Left untreated, hypertension can lead to heart attacks or heart failure, strokes, aneurysms, and damage to your eyes and kidneys.

Even though hypertension is dangerous, most people experience no symptoms. They can be on the edge of a serious health episode and not still have a clue. That’s why hypertension is called “the silent killer.”

Are you at risk?

There are many factors that can put you at risk for hypertension:

  • Age. The older you are, the more your risk of high blood pressure grows.
  • Race. High blood pressure is widespread among blacks, and health complications from it tend to be more serious.
  • Family history. If you have close relatives with hypertension, you are more likely to get it.
  • Unhealthy weight. The more you weigh, the more the pressure you put on your artery walls and the higher your blood pressure.
  • Being a couch potato. People who are inactive tend to have a higher heart rate,  making your heart work harder and putting more pressure on your arteries.
  • Using tobacco. Whether you smoke, chew or are just around people who smoke (secondhand smoke), tobacco can cause your arteries to narrow, increasing your blood pressure and straining your heart
  • Too much salt (sodium). Before you reach for the salt shaker, too much sodium in your diet causes fluid retention, leading to higher blood pressure.
  • Too much booze. Having more than three drinks in one sitting can raise your blood pressure to unhealthy levels, and long-term heavy drinking can cause heart damage.
  • Stress. High levels of stress raise your blood pressure. And if you cope with stress by eating more, using tobacco or drinking alcohol, you only make the problem worse..

Your Next Step

Even though hypertension usually has no symptoms, it can be easily detected. Have your blood pressure checked at your next doctor’s appointment.

If you are diagnosed with hypertension, you can work with your doctor to control it. Your doctor may prescribe medicine, but you will also need to make lifestyle changes to keep your blood pressure down to healthy levels:

  • Eating a healthier diet with less salt
  • Exercising regularly
  • Quitting smoking
  • Limiting alcohol
  • Losing weight and maintaining a healthy weight

People who make lifestyle changes and get their blood pressure under control can often reduce their need for medicine, and sometimes even stop taking it.

If you haven’t had your blood pressure checked in the last year, now’s the time to contact your doctor. Don’t let the silent killer sneak up on you.

Dr. Pio Poblete is an MPCP partner and sees patients in the Columbia office. He received his medical degree from University of Virginia School of Medicine and is certified by the American Board of Internal Medicine.

Welcome Dr. Bacchus

We’re pleased to welcome Dr. Rafeena Bacchus to the Columbia office. Dr. Bacchus is board certified in internal medicine and completed her residency at the University of Maryland. In this short video, see Dr. Bacchus explain how to get the most out of your doctor’s visit.

Making the Most of Your Doctor Visit

A Q&A with Rafeena Bacchus, M.D.

Most of the time, your primary care physician is your first contact for health care. When you make an appointment, knowing how to prepare and what to expect will help you get the most out of your visit.

Q: What kind of appointments can I get at MPCP?
A: We offer two types of appointments:

  • A problem visit addresses a new problem or revisits an old one.
  • A physical examination is a preventative visit to review your history, examine your body from head to toe, check appropriate blood work (like blood sugar and cholesterol), administer age-appropriate immunizations, and offer age-appropriate screening referrals (like mammograms and colonoscopies).

Making the right kind of appointment will ensure that your doctor can effectively address your health needs.

Q: Can I do anything to get ready for my appointment?
A: There are several steps you can take ahead of time to make sure your appointment runs smoothly:

  • Be very clear about what you need when you make your appointment. This allows your doctor to properly prepare for your visit. For example, if you have abdominal pain, your provider can offer you a drape so you can undress from the waist down for an exam.
  • Know what referrals you need.
  • Take a few minutes to write down notes and questions to make sure all of your concerns get addressed.
  • If your provider asked you to monitor your blood sugar or blood pressure, remember to bring those logs in with you.
  • If you want to discuss tests ordered by a provider outside of MPCP, don’t assume that we have received these records, even if you asked for them to be sent. Track them down and bring them with you. If you need help tracking down records, call your provider’s assistant a day or two prior to your appointment to alert MPCP to this request.

Asking for copies of test results when you are seen elsewhere is always a good idea. It facilitates your bringing them to your provider for discussion and helps eliminate duplicate testing. Feel free to ask for the records and test results – they belong to you.

Q: When should I arrive for my MPCP appointment?
A: Come 10-15 minutes early to complete paperwork, use the bathroom and gather your thoughts. Turn off your cellphone. This will ensure your entire appointment is used for face-to-face time with your doctor.

Q: How long will my appointment last?

A: Appointment lengths vary from 10 minutes for simple problems to 30 minutes for physical examinations or complex problems.

While your provider would like to be able to address every concern you have, this may not be possible due to time limits. You may need more than one visit or visit type to address all of your concerns.

Q: Sometimes my visit is delayed. Why is that?

A. The most common reasons your doctor might be running late for your appointment are patient tardiness, complicated problems and emergencies. Feel free to ask the check-in staff if your provider is running on time.

Q. What does my doctor need to know about my medications?

A: Your doctor will need to know 1) what medications you take, 2) why you take them, 3) the dose for each one, and 4) how often you take them. We encourage all patients to create a list of all medications, supplements, and vitamins you take. Include any drugs a specialist or urgent care center added to your regimen. Some patients bring the actual pill bottles to avoid confusion.

Your doctor can print a list at checkout of all the active medications we are aware of you taking. Once your provider has a full picture of what you take, they can help you avoid drug-drug interactions or be alert to medication-induced illness.

Q. Is it okay to ask questions?
A. It’s your doctor’s job to make sure you understand and follow through on care, so don’t be afraid to ask questions.

If you don’t understand what your doctor tells you, say so. Repeat back what you hear to confirm you have it right. Take notes. If you still aren’t clear after you leave the appointment, call back and ask for clarification.

Q: What health records should I keep?
A. It’s a good idea to keep a folder with copies of these health records:

  • Recent test results
  • Your current medication list
  • Your insurer’s list of covered medications
  • A list of your providers with contact information
  • Pending referrals
  • Lists of your questions
  • Blood sugar or blood pressure diaries
  • Vaccine dates

Take notes at your office visits to help you remember important points about your care, and keep them in your folder so you can review them when necessary. Bring your folder on any visit to a healthcare provider, an urgent care center or hospital to help reduce gaps in your care.

Q: What happens after my appointment?

A: MPCP uses its online Patient Portal to communicate test results, or you doctor may call you. But if you don’t get test results in a timely fashion, be sure to ask for them.

Take prescribed medication as directed, and talk to your provider if you have side effects and need to make adjustments. If your doctor schedules a follow-up appointment, be sure to keep it so your doctor can check on your progress and make any needed changes to your care.

 

Dr. Rafeena Bacchus sees patients at MPCP’s Columbia office. She received her medical degree from SUNY at the Buffalo School of Medicine and completed her residency program in Internal Medicine at the University of Maryland. She is certified by the American Board of Internal Medicine.

Is Zika coming to Maryland?

A Q & A by: Jerry Levine, M.D., FACP, MPCP Medical Director

Q: What is Zika?

A: Zika is a virus spread mainly by Aedes aegypti mosquitoes, a species found in Maryland and many other states. These mosquitoes, when they bite people infected with Zika virus, become disease carriers and spread the virus by biting other people. In some cases, Zika can also be transmitted between sexual partners.

Q: Where does Zika come from?

A: Before 2015, Zika virus outbreaks occurred in areas of Africa, Southeast Asia, and the Pacific Islands. Since then, Zika has spread to parts of South and Central America, Mexico and the Caribbean.

See which countries have reported Zika: http://1.usa.gov/1Qq5Iow

Q: Is Zika in Maryland?

A: At the time this article was written, there were dozens of confirmed cases of Zika virus in Maryland, but all of those people were infected while traveling overseas. So far, no one has gotten Zika in Maryland, but the imported cases may result in local spread of the virus.

See Zika cases in the U.S.:  http://1.usa.gov/1PiUIcc

Q: Are people with Zika contagious?

A: At this time, the Zika virus is not believed to be airborne and is not primarily spread from person to person, which means there’s little to no risk of becoming infected with the virus from simply being near an infected person. However, Zika can be transmitted sexually.

Q: How dangerous is Zika?

A: Most people infected with Zika virus won’t experience any symptoms or will only have mild symptoms. Common symptoms include fever, rash, joint pain, muscle pain, headache or conjunctivitis (red eyes). The illness is usually mild with symptoms lasting for several days to a week. Hospitalization is rarely needed, and so far there have been only two deaths from Zika reported in the U.S. – an elderly man with other health issues and a baby born infected with the virus.

The main danger from Zika is that pregnant women can pass it to their unborn children. The CDC has confirmed that the virus can cause severe defects in unborn children, including microcephaly, which leaves babies with abnormally small heads and often with brains that do not develop properly. The CDC strongly advises that women who are pregnant or plan to become pregnant soon don’t travel to Zika-infected areas.

Q: If Zika comes to Maryland, what can I do?

A: There is no medicine or vaccine to prevent or treat Zika virus disease, so prevention is key. If Zika is reported in Maryland, take these steps to protect yourself and your family:

  • Use insect repellents containing DEET, picaridin, IR3535, para-menthane-diol, and lemon eucalyptus oil.
  • When weather permits, wear long-sleeved shirts and long pants.
  • Use air conditioning or window/door screens to keep mosquitoes outside.
  • Aedes mosquitoes typically lay eggs in standing water, so empty water from containers outside your home such as buckets, bowls, bird baths, flower pots, old tires and vases.
Q: What should I do if I think I have Zika?

A: The risk of getting Zika is presently very low in Maryland. However, if you travel to an area with Zika and develop a fever, rash, joint pain, or red eyes within two weeks of returning, see your doctor. Be sure to tell your doctor where you traveled. Zika can’t be cured, but your symptoms can be treated to make you more comfortable.

 

 

Jerry Levine, M.D., FACPDr. Levine is an MPCP partner and sees patients in the Columbia office.  He received his medical degree from New York Medical College, completed his residency program in Internal Medicine at University of Maryland Medical Center, and is certified by the American Board of Internal Medicine. Dr. Levine currently serves as MPCP’s Medical Director and Vice President.