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On the other hand, a high systolic pressure without a high diastolic pressure should not be rapidly lowered, else depression will be caused. In hypertension, as long as the heart, which is probably hypertrophied, remains perfectly competent, there are few symptoms, and the person does not seek advice until he notices one or more of several possible conditions.
Diabetes causes low blood pressure, provided there are no nephritis and no marked suprarenal stimulation. Excessive use of alcohol, while tending to promote hypertension by the disturbances that it causes, may give, by causing a weak heart muscle, a permanent low blood pressure. A single large dose of alcohol always lowers the blood pressure.
Hard physical labor and severe athletic work may cause arteriosclerosis to develop, and it is liable to develop in the arteries of the parts most used. Hypertension is generally a prelude to arteriosclerosis, and everything which tends to increase tension promotes the disease; everything which tends to diminish tension more or less inhibits the disease.
Endocarditis Acute, simple malignant Chronic Valvular Lesions Broken compensation Cardiac drugs Diet Resort treatment Cardiac disease in children Cardiac disease in pregnancy Coronary sclerosis Angina pectoris Pseudo-angina Stokes-Adams disease Arterial hypertension Cardiovascular-renal disease Arrhythmia Auricular fibrillation Bradycardia Paroxysmal tachycardia Hyperthyroidism Toxic disturbances Physiologic hypertrophies Simple dilatation Shock Stomach dilatation Anesthesia in heart disease
This is not to state that every high tension must be lowered, but every hypertension must be studied and a safer systolic pressure caused if it is possible without interfering with the person's efficiency. A high diastolic pressure, one above 105, certainly must receive immediate attention, and a diastolic pressure of 110 must be lowered, if possible.
For a patient who is in serious trouble from hypertension, bed rest is the most important element in the management. Int. In other words, a patient who lies awake long loses the best part of his night's rest as far as his circulation is concerned. This is one more reason for abstinence from tea and coffee in the evening by those patients who are at all disturbed by the caffein.
If a patient does not show such cardiac weakness but has high tension, the danger of hypertension is increased by his use of tobacco, and certainly in hypertension tobacco should be prohibited.
A systolic pressure much over 200 probably never goes down to normal, and if such a high systolic pressure goes down to below 170, we should consider the treatment successful. Every active treatment of hypertension should begin with a thorough cleaning out of the intestinal canal by purgation, best with mercury in some form.
This diagnosis probably accounts for the frequency with which neurasthenics have been said to have high blood pressure. Patients with high blood pressure may show all kinds of symptoms simulating neurasthenia, but hypertension is a much better diagnosis than neurasthenia for such patients, and will lead to more rational treatment.
Any great drain on the system, whether from diabetes without nephritis, or from profuse diarrhea of any type, will cause hypotension. Occasionally a girl with chlorosis who is not menstruating may have an increased blood pressure. Many of the hemorrhagic or purpuric conditions will show a hypotension. Meningitis in various forms may show a hypertension from cerebral and nervous irritation.
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