Tag Archives: medical-issues

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.

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.

What To Do? Emergency Department vs. Urgent Care vs. Your Doctor’s Office

By: Jamie Harms, M.D.

Having an illness or injury often results in a good deal of anxiety and worry. You want medical attention and relief from your symptoms as quickly as possible. But where should you go to get the best, most appropriate and cost-effective care? The following are the most widely used treatment options and suggestions about when each might be best suited to meet your particular medical needs.

The emergency department:  Most emergency departments are part of hospitals, although there are free-standing emergency departments in Bowie and Queenstown. The ED is designed and equipped to handle serious or life-threatening emergencies.  It is always open, including nights, weekends and holidays. Patients are seen according to how sick or injured they are.   The most serious cases jump to the front of the line, even if they arrive later than everyone else.  Physicians in the ED are trained to look for life-threatening conditions, and the tests you will receive in the ED will help them decide if you have any of these.

The Emergency Department is the right place to go if you have a serious or potentially life-threatening illness or injury:  chest pain, sudden weakness on one side of your body, a new seizure, severe headache, persistent heavy bleeding, poisoning, or a large broken bone.

The Emergency Department is probably not the right place to go if you have a milder illness or a longstanding issue.  You are likely to wait longer for treatment. The Emergency Department doctors do not have access to your medical records.  Your visit will be much more expensive-as much as 4-6 times as expensive! Remember, they have to keep all that life-saving equipment available all the time. That’s great if you need it, but it’s just an extra charge if you don’t.

Urgent care centers:  There are lots of these in our area.  They often have extended hours, including evenings and some weekend hours.  They are designed and equipped to handle medical problems that need attention the same day, but are not life-threatening.  Patients are usually seen in the order they arrive, so your wait will depend on how many other people go to the Urgent Care Center at the same time you do.  Many Urgent Care Centers have X-ray and blood testing equipment.

An Urgent Care Center is the right place to go if you have a new illness or injury that occurs when your doctor’s office is closed: sprains and strains, painful urination, ear pain, severe cough or wheezing.

An Urgent Care Center is probably not the right place to go if your doctor’s office is open or if you have a serious or life-threatening condition. A visit to an Urgent Care Center is more expensive than a visit for the same condition at your doctor’s office. The provider in the Urgent Care Center does not know you and will not have access to your medical records. Urgent Care Centers are not equipped with life-saving equipment or providers trained to treat life-threatening illnesses or injuries.

Your doctor’s office:  No one knows you like your own doctor. Your doctor is equipped to treat many illnesses and injuries, and can arrange any testing you may need. Your primary care doctor has your medical records and knows your medical history. Patients are seen by appointment. Maryland Primary Care Physician offices reserve appointments for patients who need same-day treatment. Many MPCP offices have evening and/or Saturday hours for your convenience.  Call or check our website, mpcp.com, for a list of hours at your doctor’s office.

Your doctor’s is the right place to go if you have a new problem, such as sinus pain, ear pain or flu, cuts or other wounds, sprains or strains, cough, or a flare up of an old problem, such as back pain or migraine headache, or an ongoing problem that may require more testing or treatment, such as persistent stomach problems or joint issues.  You will pay the lowest copay at your primary care doctor’s office, and most times, you will be able to get an appointment the same day you call.

Your doctor’s office is the wrong place to go if you have a serious or life-threatening condition. If you need care in the next hour, go to the Emergency Department.

Don’t forget: Good communication is important to make sure you get good care. If you’re not sure what to do, call your primary care provider. Even when the office is closed, there is always someone on call who can direct you to the care you need. If you ever need to go to the Emergency Department or an Urgent Care center, take a list of all your medications and allergies with you. Let the staff know who your primary care provider is, and schedule a follow up appointment if needed.

Primary care quicker, less costly than the ER

A study by a New York health insurer claims 90% of conditions commonly seen in emergency rooms ─ like sinus infections, sprains and sore throats  – could be treated faster and at a lower cost elsewhere. Excellus BlueCross BlueShield reports that in 2013 emergency room visits in the state for these conditions were nearly 8 times more expensive than a primary care office, 3.5 times higher than an urgent care center, and 15 times costlier than telemedicine. Patients in ERs also had the longest wait times for treatment. The report concludes: “the best method of care for nearly all of these cases is for patients to see their primary care doctors.”

Important Facts About That Cough You Have

Cough is a frequent symptom seen in medical offices at this time of year. It can be a source of aggravation, frustration and anxiety for many patients. A cough falls into one of the following categories based on its duration: it can be acute, lasting less than 3 weeks; subacute, lasting from 3 to 8 weeks; or chronic, which lasts over 8 weeks.

The acute cough is mostly a result of upper respiratory tract infections and acute bronchitis. Most of the time, these are due to viruses and do not require the use of antibiotics. Fever may or may not be present and phlegm can be discolored. Pertussis, or whooping cough, is on the rise in the United States and may manifest by violent coughing and should be treated with an antibiotic. Approximately 15% of users of commonly prescribed blood pressure medications, lisinopril or zestril, may develop a cough, which usually begins within a week of beginning the medication. Treatment is stopping the offending medication and waiting 1-4 weeks for resolution, which you’ll want to coordinate with your primary care provider so you can get on an appropriate replacement medication. Lastly, pneumonia may also cause you to develop a cough. Depending on what incites coughing, therapy is supportive with cough medication, antihistamines, decongestants, antibiotics (if needed), and possible inhalers if asthma-like signs are present.

A subacute cough is most commonly a result of a prior upper respiratory infection. It can also be caused by asthma, postnasal drip, gastric acid reflux (even if heartburn is not present) or a primary lung disease. At this time, a chest X-ray should be obtained, especially for smokers or former smokers. Specific therapy is suggested depending on the cause.

Finally, chronic cough should be evaluated by requesting appropriate tests which may include sinus imaging, CAT scans, cardiac or gastroenterologic evaluations. A referral to a specialist may be needed.

If you or a loved one is suffering with a cough, particularly one that has lasted for more than 3 weeks, see your primary care provider, who can then determine an appropriate course of treatment.


Janice Rutkowski, M.D.Janice Rutkowski, M.D. is an MPCP partner and is certified by the American Board of Internal Medicine. She sees patients at the Arundel Mills office.