Thursday, July 05, 2018
Doctor's Perspective
Causes of Hypertension

By Dr. Anthony Policastro
Hypertension - high blood pressure - is common and present in about one-third of individuals. Of that group, 95 percent have what is called essential or primary hypertension meaning there is no actual cause for their blood pressure elevation. We tend to assume that most patients have essential hypertension when they present with high blood pressure. The other five percent have what is known as secondary hypertension which means they have an identifiable cause for their elevated blood pressure. A variety of causes exist and include kidney failure. Individuals in this situation are relatively easy to diagnose. The primary issue is kidney failure and hypertension is one of many symptoms. A second cause is renovascular hypertension. In this situation, there is a blockage to the artery going to the kidney which gets less blood to filter which then causes the body to raise the blood pressure to get more blood to pass through. The blockage can be due to a number of factors including arteriosclerosis which is usually found in the heart, the legs or the brain. However, it can also occur in the arteries going to the kidneys. In some individuals the arteries going to the kidneys go into spasm. The result is the same in terms of the hypertension. This type of hypertension can be difficult to diagnose. A number of endocrine issues can cause hypertension. This includes an overproduction of various types of hormones. Hyperthyroidism (Graves Disease) with too much thyroid hormone is a good example. Another example is too much aldosterone (Conn's Disease) from the adrenal gland. There can be too much cortisol (Cushing Syndrome) in the bloodstream. This can be due to a hormone producing tumor, however, it can also be due to taking too many oral steroids. Long term prednisone use can cause it. All of these hormonal problems affect more than just the blood pressure and there are many other symptoms for each. Therefore, they are somewhat easy to diagnose in the patient with hypertension. Another cause of hypertension is coarctation of the aorta. In this condition, there is a narrowing of the aorta and the lower extremities do not get enough blood. The body adjusts the blood pressure higher to push more blood through. This condition is present at birth and is usually diagnosed in childhood. Another cause of secondary hypertension is a tumor known as pheochromocytoma. The tumor is benign however, it produces hormones that elevate blood pressure. The result is hypertension that does not always have a clear cause. The most difficult part of dealing with secondary hypertension is the fact that it is rare. Ninety five percent of patients have primary hypertension and there is no reason to evaluate every one of them for secondary causes. As a result we sometimes fail to recognize the patient that does need such an evaluation. Deciding what needs further evaluation and what does not is a challenge for the treating physician.

Diabetes education program Nanticoke Memorial Hospital will host a four-session diabetes educational program, The Diabetes Connection, on July 18, 25 and Aug. 1, 8 from 5 to 7 p.m. Pre-registration is required. As a person with diabetes, Nanticoke can help teach you the self-care skills needed to keep you on track.

The four-session diabetic program includes weekly education sessions in a group setting. One family member or significant other is welcome to attend. The cost of the program may be reimbursable by insurance. To register or for more information about this course, contact Nanticoke's Diabetes Education Department at 302-629-6611, ext. 2288.

Lymphedema Support Group Nanticoke Rehabilitation Services hosts lymphedema support groups on the third Thursday of each month from 1:30 to 3 p.m. at the Seaford Library and Cultural Center. This month's meeting is Thursday, July 19. This free support group is open to anyone affected by lymphedema including patients, caregivers, and relatives. Meetings will consist of a lecture by health care professionals and medical equipment providers followed by refreshments and an open question and answer session or discussion among participants. Registration is not required. For more information about this support group or to learn more about services provided by Nanticoke Rehabilitation Services, call 302-629-6224 or visit

Parkinson's support group Nanticoke Health Services, in conjunction with CHEER and Care DE and the Manor House, will hold a Parkinson's education and support group on Thursday, July 19 from 9:30 to 11 a.m. at the Manor House in Seaford. This support group is free and open to the public. Participating in support groups is essential for coping with an illness such as PD or other disorders that impair bodily movement. This support group is not only helpful for the individual diagnosed with PD, but also for caregivers, friends and family. Group members welcome guest speakers on a variety of subjects related to PD and provide support to each other through other small group discussions. Studies show that the information, training, and counseling that participants receive at support groups enhances the quality of life, help to alleviate stress, and may even boost the immune system. Tara Trout, LPN at Nanticoke Memorial Hospital, co-facilitates the group with Kathy Landis, caregiver resource coordinator at CHEER in Sussex County. For more information, contact Tara at 302-629-6611, ext. 3838.

Safe Sitter Class Nanticoke Memorial Hospital will host a Safe Sitter¨ class on Saturday, July 21 from 9 a.m. to 3 p.m. in the Nursing Conference Room. These classes are open to pre-teens and teenagers between 11 and 13 years of age who are interested in learning child care essentials and safety. The Safe Sitter¨ course is designed to train pre-teens and teenagers how to be safe baby/child sitters. Components include infant/child development and care, safety, injury prevention, first aid, accident management, emergency protocol, rescue breathing and choking management. The lessons are filled with fun activities and role-playing exercises. Cost is $35 per student, which includes the class and all materials needed. Pre-registration is required. To register or for more information, contact Nanticoke's Maternal Child Health Clinical Educator at 302-629-6611, ext. 2540.