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Doctor On Call (DOC): Dr Michael MacDonald – High Blood Pressure (Additional Q&A)

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Doctor On Call, or DOC for short, is a brand new series brought to you by Medical Channel Asia. This series aims to bring doctors and specialists from various fields to give you an introduction to common health and medical topics that you and the Asian population are interested in. In our 4th DOC, held on 5 Oct (Tuesday), from 8pm to 9pm (GMT+8), we have Dr Michael Ross MacDonald, consultant cardiologist from Harley Street Heart and Vascular Centre, to talk to us about The Silent Killer: High blood pressure and heart disease.

This 3-part cardiology webinar series aims to educate the Asian population on the different aspects of cardiac conditions, ranging from the risk factors of heart diseases, to the most current updates on CPR, and the types of treatment options available after a heart attack.

For Part 1 of the forum, we have Dr MacDonald give us a short presentation on why high blood pressure is often called the silent killer. In Part 2, Dr MacDonald answers some of the questions posted by our audience, both collated from the registration process, and also posted LIVE.

As there were many good questions that were left unanswered due to time constraints, Dr Michael MacDonald has taken his time to answer them. Read on more to find out about the answers to these questions!

Additional Questions Unanswered during webinar

Q1: There are patients who claim that they are already hypertensive with BP of 130/80, having headache, and that taking their hypertensive drug relieves them with the headache. The usual BP for these patients without symptoms is around 110/70. How do we individualise their hypertension treatment?

Dr MacDonald: BP treatment should always be individualised. BP targets for some patients may not be suitable for others. For example, for some young people, we can target an optimal BP of < 120/80, but this may not be suitable for others like the elderly.

Q2: A patient of mine has been taking coffee 10x a day. His BP has been elevated for the past week. Is this diagnosed as hypertension?

Dr MacDonald: That is a lot of coffee! If there is any dubiety in the diagnosis I would arrange for him to have a 24 hour BP monitor, to confirm the diagnosis.

Q3: What does a 2D echo procedure do to our heart? What is being detected in our heart through that procedure ? What is suspected that such a procedure is being advised by the doctor?

Dr MacDonald: A 2D echo looks at the heart structure and function. It allows the doctor to check for valve function and muscle pump function. In addition, we are looking at chamber sizes and wall thickness. It is a standard test to look for heart diseases.

Q4: I experience high blood pressure, yet when I took clonidine (Catapres) sublingually, my BP did not decrease. Nevertheless, after I took a pain medication, my BP returned to normal.

Dr MacDonald: Everyones BP goes up and down all the time, and can change depending on exercise, stress, sleep, pain etc.

Q5: My father in law had hypertension but refused to take medication as prescribed by the doctor. He prefers to self monitor by checking blood pressure regularly. Every time when I check, his BP tends to increase and he feels pressure and keeps on checking repeatedly. What’s the best advice for him?

Dr MacDonald: He should have a 24 hour BP monitor performed by his doctor. This will give you an accurate diagnosis.

Q6: If your blood pressure is normal at rest, but you spend most of your day stressed with a naturally elevated BP, wouldn’t that mean you have high BP on the average?

Dr MacDonald: Potentially, this is probably best assessed with a 24 hour BP monitor.

What’s next in store?

    • Part 2:

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