Will I have to take blood pressure medicine for life?

Dr Flo, I was recently diagnosed with high blood pressure and sometimes I feel dizzy. The doctor told me that my pressure will have to be monitored, but I still have a lot of concerns about the diagnosis. Was the pressure caused by anxiety, heavy workload or stress? What are the adverse effects of high blood pressure and will I be enslaved to medication for the rest of my life? Please advise me. Alnashir

Dear Alnashir,

The blood pressure reading is a measure of the force at which your heart is pumping blood, and the resistance to the blood flow within the blood vessels. It is expressed as two figures.

Normal blood pressure is between 90/60mmhg and 140/90mmhg. Anything above 140/90mmhg is considered high blood pressure.

In about five to 10 per cent of people with high blood pressure, there is an exact cause for it e.g. kidney disease, hormonal disorders, pregnancy, anaemia, tumours, drugs or some medications. Once the cause has been identified and dealt with, then the blood pressure is normalised.

For the majority, there are some risk factors associated with high blood pressure, such as age – blood pressure rises with age, and by the time it is detected as high, it has been rising slowly over many years and continues to do so.

Other factors associated with elevated blood pressure are being over 40 years, male, African, having a close relative with high blood pressure, a high-salt, high-calorie, high-fat diet, lack of exercise, obesity, taking too much alcohol, smoking and stress.

Most of the time you can’t tell that your blood pressure is high until it is measured. Therefore, you might have elevated blood pressure and still feel fine, as it continues to damage your blood vessels, causing stroke, heart disease, kidney failure and even loss of vision.

To prevent the long-term effects of high blood pressure, you are put on medicine to lower it to normal levels.

If after that the blood pressure readings are normal, then the medicine is working. If you stop taking the medicine, the blood pressure goes back up, which is why it is very important for you to keep taking the medicine. It’s not enslavement, it is lifesaving.

In addition to that, reduce the amount of salt in your diet, reduce the amount of fat and starch in your diet to healthy levels, reduce alcohol intake, stop smoking, maintain a healthy weight, exercise, eat a lot of vegetables and fruits, get enough sleep and manage stress.

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Dr Flo, I got married four months ago, and since then my wife and I have had intimacy problems. When we have sex, she feels pain around her vagina. We sought a doctor’s advice and she was told that she had an infection, was treated and got well. However, after we resumed intercourse, she got wounds around her vagina and developed abdominal pain. She’s also had two miscarriages in that time. I have tried to seek medical attention to no avail. Kindly assist. Kyalo

Dear Kyalo,

Pain during intercourse can be due to several reasons.

The wounds and abdominal pain indicate an infection, so it is advisable for your wife to see a gynaecologist who will check her urine, do a high vaginal swab analysis and culture tests and a pelvic ultrasound scan. Other tests may also be done depending on what the doctor finds.

As for the miscarriages, about 10 to 15 per cent of confirmed pregnancies end in a miscarriage. This may be due to infections, clotting disorders, genetic disorders in the mother or foetus, or abnormalities of the uterus, cervix or placenta. The risk is higher if the mother has had miscarriages before or is over 35 years old, or is a smoker or an alcoholic, or she has a poorly controlled chronic illness like hypertension, diabetes, kidney or thyroid disease. However, in many cases, the cause of the miscarriage is not found.

It would be good to be followed up by a gynaecologist so that the possible cause of the miscarriages can be assessed. If a cause is found and is treatable, then future miscarriages can be avoided.

When she gets pregnant again, she should start seeing an obstetrician/ gynaecologist as soon as she finds out she is pregnant.

Send your medical questions to [email protected] for absolutely free expert advice.

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Causes of pain during intimacy

Poor lubrication due to hormonal changes during pregnancy/breastfeeding, hormonal contraceptives, inadequate foreplay

Physical injury from an accident, surgery or female circumcision

Genital or urinary tract infection including vaginitis, cervicitis, bladder infection, pelvic inflammatory disease

Other illnesses in the pelvic organs e.g. uterine fibroids, endometriosis, ovarian cysts, painful haemorrhoids, irritable bowel syndrome, vulvar vestibulitis, inflammatory skin conditions

Vaginismus, where the muscles of the vagina involuntarily contract before or during intercourse

Psychological reasons – anxiety, stress, fear of pain, relationship issues, history of sexual abuse, etc. can lead to poor lubrication and contraction of vaginal muscles