This article first appeared in the medical column “Ask-the-Doc” in the World Journal
Q: How can I find out how much cardiovascular damage I have?
A: You should learn how much cardiovascular damage you have. There are many indicators: Is there evidence of heart disease caused by high blood pressure? This can be coronary artery disease, or many types of heart failure. An enlarged heart can be one of the first indicators.
Are your blood vessels hardened? If the difference between the systolic and diastolic BP is more than 50, that could be an indication that they are. Usually, the bigger the difference between the numbers, the stiffer the arteries.
Are the blood vessels filled with cholesterol and narrowed? For people with no other signs, a carotid (neck artery) scan is easy to do and helps answer that.
Do your retinal blood vessels show effects of HBP? Your eye doctor can tell you, but you may need to ask, and get a report for your primary doctor).
Do you have serious peripheral artery disease (very narrowed or closed off blood vessels (calf pain when you walk or decreased foot pulses)? Do your kidneys show evidence of HBP damage (don’t work normally, and HBP appears to be the only cause)?
If the answer to any of these questions is yes, you need to be very aggressive and focused on getting your blood pressure to an acceptable level. You should know what your blood pressure is like most of the time (stressed at work or home, at doctor’s office or quiet in morning or night at home). You should keep checking until you can pretty much predict the range it will be in.
The easiest way is to check the kidney and eye. This is because the arteries that supply both these organs are extremely sensitive to hypertension. If blood pressure is poorly controlled, both the kidney and retina can be damaged and can be easily noted on examination. Kidney function can be evaluated through blood work. Primary care physicians frequently assess the kidney function of patients with hypertension.
Doctor’s profile: Dr. George Ting is specialized in Nephrology and Internal Medicine. He holds a bachelor’s degree from Columbia University, and medical degree from University of Southern California Keck School of Medicine. He completed his internship and residency at Rush University Medical Center and fellowship from Stanford Medicine.
By Richard Lee