A Newly Recognized Cause of Suddenly Worsening Hypertension
Hypertension tends to progress with age, but usually does so gradually. Suddenly worsening hypertension, according to Modern Medicine (50#2:276), can, among other things, be caused by mood-elevating drugs that are used in the treatment of mental depression.
Even though these medications do not usually raise the blood pressure in otherwise healthy persons, existing hypertension tends to be worsened by them and may rise rapidly out of control. To avoid this problem, hypertensive persons taking anti-depressant medication should monitor the blood pressure more closely than usual, and, if necessary, take extra antihypertensive medication.
Nosebleeds
In adults, nosebleeds are much more likely to be symptomatic of serious conditions than they are in children. Apart from lesions in the nose, conditions such as overdosage with certain drugs (e.g: blood thinners such as Dicumarol), diabetes, blood disorders, and kidney failure must be looked for in a careful medical examination. One of the most common causes of nosebleeds in adults is hypertension, or high blood pressure (BP).
Since anyone who has just lost a lot of blood could be in shock, and thereby have a lower BP than usual, the Journal of Laryngology and Otology (98:277) recommends that the BP be taken several times after the patient has fully recovered. In this way, cases of hypertension that have been responsible for nosebleeding will not be missed.
Special Risk in Hypertension Newly Defined
Fever not only makes sick persons flushed and sweaty, but it can markedly lower their blood pressure too. This, no doubt, helps to account for the weakness and lightheadedness which usually accompany fever. Not recognized until now, this fall in the blood pressure adds to the effect of medicines that lower blood pressure and thereby poses a special risk for people with hypertension. According to a report in the New England Journal of Medicine (302:865), a patient who had regularly been taking two antihypertensive drugs developed a cold with fever and became so weak that he was unable to get up and walk without extreme faintness and staggering. At that time, his blood pressure was found to be excessively low. Not bothered by this any more after the fever went away, he again experienced this problem the next night when the fever returned.
Sudden reductions in blood pressure of this kind could result in bone-breaking falls or bring on strokes or heart attacks. Accordingly, people taking medicines for hypertension should not get out of bed when they are suffering from fever unless there is someone in attendance.
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