High Blood Pressure Poses serious Risks, Doctor Warns
Uncontrolled high blood pressure is a risky condition, potentially leading to life-threatening events like aortic dissection – a separation of the layers of the aorta, the body’s largest blood vessel. This is particularly concerning when blood flow to the kidneys is compromised. When the renal arteries, which supply blood to the kidneys, are affected by a dissection, the kidneys release renin, a substance that further elevates blood pressure, creating a dangerous cycle.
A recent patient was warned about the severe risks associated with their current blood pressure levels.the doctor emphasized the danger to the remaining kidney, blood vessels throughout the body, and critically, the heart and brain. The risk of heart attack and stroke is significantly increased for individuals with elevated blood pressure. While predicting a specific event is impossible, the doctor stressed the patient was in “real danger.”
However,the doctor offered reassurance,stating that with consistent medical care and patience,a blood pressure treatment plan could likely be found to protect vital organs while minimizing unwanted side effects. The doctor specifically noted that depression and weight gain are not typical side effects of blood pressure medication.
Dear Dr. Roach: I am a 73-year-old woman who was diagnosed with bullous pemphigoid, a rare autoimmune disease, in January 2022. I have been treated by three different dermatologists with doxycycline, prednisone and Dupixent.Prednisone has been the only effective treatment.
I have been taking a dosage of 5-10 mg depending on the severity of flare-ups for the past three years. I dislike the side effects of weight gain and easy bruising with prednisone, but the skin blisters and intense itching necessitate its use. My doctor has suggested considering a treatment like Imuran, but the potential side effects seem concerning.
I would appreciate any thoughts you might have.
– D.B.
Dear D.B.: You are correct that bullous pemphigoid is a rare autoimmune blistering skin disease, commonly occurring in older adults. Your dermatologists have followed standard treatment protocols with doxycycline and prednisone. Thay also appropriately tried dupilumab (Dupixent), a powerful medication that proves effective for 92% of patients, making your lack of response somewhat unusual.
Other options to reduce or replace prednisone include dapsone, methotrexate, and mycophenolate – all established medications used cautiously by specialists.
It’s crucial to consider the long-term effects of prednisone on the immune system, blood sugar, blood pressure, and osteoporosis risk when evaluating option treatments. A steroid-sparing medication is worth serious consideration.
Readers may email questions to ToYourGoodHealth@med.cornell.edu.