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THE BEAN:
Kidney Empowerment

The Case of Jane Doe

9/19/2024

 
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Meet Jane Doe. Jane is a 55 year old teacher living in Jacksonville, Florida. When she isn’t busy planning lessons and activities for her students, Jane is catching up with friends, chasing her dogs around, or relaxing with a good book. Her health is one of her top priorities, so she is mindful of keeping up with her annual doctor appointments. This year, her primary care physician diagnosed her with hypertension after seeing the log of blood pressure readings Jane has kept. Let's review Jane Doe’s case.

Jane Doe has been taking her blood pressure regularly for 3 years at the instruction of her primary care provider when she noticed it rising. 
  • In year one, her blood pressure was in the 130s. 
  • In year two, her blood pressure was in the 150s.
  • In year three, her blood pressure was in the 180s. 
Ms. Doe has never had symptoms of hypertension. Her doctor put her on blood pressure medication and Jane felt terrible, but her readings were now back in the 130s. If her blood pressure is better now, why does Ms. Doe feel so bad?

Her doctor decided to refer her to nephrology since the original medications did not seem to be working. Ms. Doe met with Dr. Munjal who made a small, simple change in her medications. Dr. Munjal decreased her blood pressure medication and now her readings are in the 150s and the uncomfortable symptoms of “low” blood pressure have been minimized. Once these symptoms went away, her regiment was changed again to further lower the readings. The uncomfortable symptoms came back briefly, but soon went away as her body acclimated to having lower blood pressure again. Her new goal is 130-140 for her systolic readings. 

Dr. Munjal explained: “When someone has hypertension, the body can acclimate over time and not experience symptoms of hypertension. This means that when we try to bring the blood pressure back down to a lower range, you may not feel as great as the readings may look. It is important to keep this in mind when working to reach blood pressure goals. When we set a goal, we know that this may take a while to reach since changing blood pressure has to be done in steps. You may feel worse before you feel better.”

Working with blood pressure readings is not a sprint, it is a marathon. We must pace ourselves as we work through the steps needed to safely get the blood pressure down to a manageable range. If you have questions or concerns about your blood pressure, call to schedule an appointment with Dr. Munjal! 

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You (Don't) Snooze, You Lose

9/12/2024

 
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Did you know that sleep can be directly related with a risk of developing hypertension? Sleeping problems like trouble falling asleep, staying asleep, and too little sleep are all associated with increased risk of high blood pressure. It’s no mystery that a good night’s sleep and good sleeping habits can make a world of difference in overall health. 

Effects of Sleep Deprivation
Sleep deprivation does not always mean chronic sleep issues. Sleep deprivation symptoms can start after just one night. Some of the symptoms may include:
  • Low energy
  • Mood changes
  • Lack of focus
  • Poor memory
  • Inhibited or risky decision-making
Chronic sleep deprivation can also lead to increased risk of a variety of illnesses and conditions. These include, but are not limited to: cardiovascular disease, diabetes, obesity, mental disorders, and hormone imbalances. According to the Mayo Clinic, these hormone and metabolic disruptions lead to an increased risk in developing hypertension.

So, how do you fix it?
Here are some recommendations for getting a good night’s sleep:
  • Create a sleep-friendly environment in your room: 
    • Reduce light: light exposure can throw off the circadian rhythm which helps the body produce melatonin, the sleep hormone. 
    • Turn the thermostat down: The body’s temperature naturally drops while we sleep, so a cooler environment is more conducive to good sleep. Rooms that are too warm can negatively affect the sleep cycle and create more fatigue. 
    • Eliminate excess noise: Use a white noise machine, ear plugs, headphones, or soft music to drown out external sounds. 
  • Limit naps: naps can alter the circadian rhythm. It is generally recommended that naps be taken in the early afternoon and kept to 20 minutes. 
  • Reduce caffeine and alcohol intake: Caffeine can remain in the body for hours after consumption. While it may make some drowsy, alcohol can reduce sleep quality. Both should be avoided in the hours before bed.
  • No blue light or over-stimulations before bed: TV, computers, and cell phones stimulate the brain and can make winding down incredibly difficult. Additionally, the blue light emitted from electronic devices can affect the circadian rhythm as well, making it harder to fall asleep. 

Some results may be immediate, like feeling more well rested, while others may take getting into a routine to see effects. Keep in mind that this is only one of the many factors that can affect blood pressure. For blood pressure concerns, please call our office to schedule an appointment with Dr. Munjal. As always, stay safe and healthy! 

Resources:
Mayo Clinic: High Blood Pressure and Sleep.
The Sleep Foundation: Sleep Hygiene

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Factors that Affect Blood Pressure

9/9/2024

 
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Did you know that, according to the World Health Organization, it is estimated that 1.28 billion people (aged 30-79) in the world have hypertension? Surely, not all 1+ billion people with hypertension have the same cause, right? Listed below are 11 factors that can contribute to changes in blood pressure. 

  1. Exercise: Lack of exercise over time can lead to weight gain and cause higher blood pressure. Exercise can also temporarily raise the blood pressure, which should resolve on its own. Getting into a regular exercise routine can improve cardiovascular health and help lower blood pressure naturally. 
  2. Age: As we age, our blood vessels stiffen and harden, increasing the risk of high blood pressure.
  3. Nutrition: Diets high in sodium and/or low in potassium can lead to high blood pressure as these electrolytes balance one another out in the body. 
  4. Hormones: Hormones like aldosterone, cortisol, and catecholamines can affect the blood pressure due to their influence on fluid and electrolyte balance. 
  5. Stress: Changes in blood pressure due to stress are generally temporary due to changes in lifestyle and eating habits to assist with coping to high stress levels.
  6. Certain Chronic Conditions: Kidney disease and diabetes are two of the most common contributing factors to hypertension.
  7. Smoking/Vaping: The nicotine and chemicals in cigarettes and vapes can cause the blood vessels to narrow, causing the heart to beat faster, subsequently raising blood pressure. 
  8. Alcohol Consumption: Alcohol can increase blood pressure temporarily, but over time, it can lead to long term increases. Additionally, alcohol can lead to weight gain that will potentially lead to an increase in blood pressure as well. 
  9. Prescription and Non-Prescription Drugs: heart medication, steroids, diuretics, and drugs for pain management can all influence blood pressure.
  10. Pain: Pain can cause an increase in the heart rate and thus increase the blood pressure.
  11. Sleep Apnea: Obstructive Sleep Apnea (OSA) can cause high blood pressure due to a drop in blood oxygen levels. This can also have an effect on the cardiovascular system and kidney function, both of which may also contribute to hypertension.

Each person is different and can have multiple other factors working both with or against them when it comes to managing their blood pressure. If you have hypertension, consider the factors that are within your control and what you can do to improve your health. Make an appointment with Dr. Munjal for a consultation and additional guidance on your blood pressure management. As always, stay safe and healthy!


Resources:
https://www.who.int/news-room/fact-sheets/detail/hypertension

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    About The Bean 

    The Bean is a blog on a mission to share valuable information in the world of Nephrology.  We believe in empowering through education and The Bean is a great place to find resources and information on topics related to high blood pressure, kidney disease, dialysis, and topics that enhance the kidney minded lifestyle.    Enjoy and be sure to subscribe!

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Empowering Through Education.

  • Home
  • Your Team
  • How We Help
    • Kidney Diseases
    • Hypertension
    • Nutrition
    • Remote Patient Monitoring
    • Transplant Managment
    • Community Connections
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    • Patient Info
    • Education Topics
  • Online Access
    • Connect Health Tracker
    • Healow App
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  • Contact Us
  • The Bean