Podcast: WHAT DOES YOUR DOCTOR SAY?

Episode: How to control and treat hypertension?

Leading: Dariusz Litera

Guest: Dr. Konrad Kaaz, MD, PhD, cardiology specialist

Duration: 19 minutes

Hypertension is one of the most common lifestyle diseases, affecting a significant portion of the adult population. The problem lies not only in its prevalence but also in the fact that it can be asymptomatic for a long time, leading to serious organ damage.

In this interview with cardiologist Dr. Konrad Kaaz, we discuss key issues related to the diagnosis, treatment, and daily management of hypertension. We place particular emphasis on the patient's role in therapy and the importance of lifestyle as a treatment component.

Full podcast transcript

[00:00:00] Introduction

Dariusz Litera:

One in three Poles suffers from hypertension. Unfortunately, most sufferers are unaware of the seriousness of the problem they face. Even those aware of their condition neglect treatment, which has a devastating impact not only on the circulatory system but also on the kidneys, among other things. This leads to complications that are life-threatening and even life-threatening. Can we prevent this? Today, your doctor is cardiologist Konrad Kaaz, MD. Good morning, doctor.

Dr. Konrad Kaaz:

Good morning.

[00:00:30] What is hypertension?

Dariusz Litera:

What exactly is hypertension?

Dr. Konrad Kaaz:

Hypertension is defined as an increase in systolic blood pressure above 140 mmHg, whether or not accompanied by an increase in diastolic blood pressure above 90 mmHg. This may or may not be accompanied, as the condition may be isolated systolic hypertension or isolated diastolic hypertension.

We characterize hypertension by degree – there are three grades of hypertension, depending on the values. We also distinguish optimal values, high normal values, and various clinical forms, such as resistant or malignant hypertension.

There's also what's known as white-coat hypertension, a very common condition in doctors' offices. Patients experience elevated blood pressure upon seeing a doctor.

[00:01:16] White Coat Hypertension and Hidden Hypertension

Dariusz Litera:

As soon as I enter the office, my blood pressure increases.

Dr. Konrad Kaaz:

Hidden hypertension also occurs – i.e. the opposite situation: the blood pressure is normal in the office, but not at home.

Dariusz Litera:

It depends on external factors. We may laugh, but the problem is very serious.

[00:01:35] Why is hypertension so dangerous?

Dr. Konrad Kaaz:

It's a lifestyle disease influenced by many risk factors. It's very widespread, and the biggest problem is that we don't recognize most of the patients and don't effectively treat those we do.

Dariusz Litera:

So even with diagnosis, treatment often does not bring results?

Dr. Konrad Kaaz:

We don't diagnose approximately 60% patients. Of those diagnosed, we successfully treat approximately 30%. Patients often don't engage in treatment and expect that a pill alone will solve the problem.

They do not care about non-pharmacological factors: weight loss, salt restriction, physical activity.

[00:02:35] Lifestyle and hypertension

Dariusz Litera:

So we're going back to the basics – diet, physical activity, limiting stimulants.

Dr. Konrad Kaaz:

Unfortunately, yes.

[00:02:50] How to measure blood pressure correctly?

Dariusz Litera:

How should we control our blood pressure?

Dr. Konrad Kaaz:

Men over 40 should undergo preventive screenings. Sometimes hypertension is detected accidentally.

The ideal measurement requires resting for approximately 30 minutes, with no activity or smoking. The measurement should be taken three times, averaging the readings, and on both arms.

Wrist blood pressure monitors are not recommended – the results may be unreliable.

[00:04:31] How often should you measure your blood pressure?

Dariusz Litera:

Is it worth measuring your blood pressure at the same time every day?

Dr. Konrad Kaaz:

It's best to take at least two measurements a day. One time doesn't always provide the full picture, as blood pressure can fluctuate throughout the day, for example, due to stress.

[00:06:21] Can hypertension be cured?

Dariusz Litera:

Can we completely cure hypertension?

Dr. Konrad Kaaz:

It's a chronic disease that we can control, but we can't cure. It's not an infection.

Mechanisms in the body cause a constant rise in blood pressure. Medications act like a "handbrake." When we stop taking them, the problem returns.

[00:07:24] Symptoms of hypertension

Dariusz Litera:

What symptoms may suggest hypertension?

Dr. Konrad Kaaz:

Most patients have no symptoms.

If they do appear, they are most often:

– headaches (especially occipital),

– easy fatigability,

– sleep problems,

– eye pain,

– general fatigue.

Complications may include atherosclerosis, stroke, heart attack, heart failure, retinal and kidney damage.

[00:09:03] The most dangerous complications

Dr. Konrad Kaaz:

Hypertension accelerates the development of atherosclerosis and increases the risk of heart attack and stroke.

It can also lead to pulmonary edema – a life-threatening condition.

[00:10:16] Stroke Symptoms

Dariusz Litera:

How to recognize a stroke?

Dr. Konrad Kaaz:

Symptoms may vary:

– drooping corner of the mouth,

– paresis of the limbs on one side,

– speech disorders.

Often, it is those around us who notice the symptoms first.

[00:11:43] Microstrokes and Cognitive Function

Dr. Konrad Kaaz:

Repeated minor incidents can lead to dementia and cognitive loss.

[00:12:10] The patient's role in treatment

Dr. Konrad Kaaz:

It's a disease that requires discipline. It can be easily controlled, but without patient involvement, it can significantly impair quality of life.

[00:13:01] Diet and salt

Dariusz Litera:

Is it enough to stop adding salt to food?

Dr. Konrad Kaaz:

No. Processed foods already contain too much salt. Salty snacks like chips and pretzels are particularly problematic.

[00:14:28] Physical activity

Dariusz Litera:

What is the impact of physical activity?

Dr. Konrad Kaaz:

Regular activity lowers blood pressure by about 5–10 mmHg in the long term.

Aerobic exercise is recommended, such as walking, cycling, and swimming. Intense isometric exercise is not recommended.

[00:15:49] Medical checkups

Dariusz Litera:

How often should a patient see a doctor?

Dr. Konrad Kaaz:

At the beginning of treatment, visits are more frequent – it is necessary to select the therapy.

After obtaining an inspection – every six months or once a year.

Initially, it is worth performing an echocardiogram to assess complications.

[00:17:03] Target pressure values

Dr. Konrad Kaaz:

Until the age of 65, we aim for values below 130 mmHg.

In older people, the values may be higher – due to the stiffness of the arteries and the body's tolerance.

[00:18:32] Can high blood pressure be completely controlled?

Dr. Konrad Kaaz:

We cannot completely eliminate pressure fluctuations.

Emotions, stress, and diet all contribute. We can control them with medication, but not completely eliminate them.

[00:19:02] Ending

Dariusz Litera:

Cardiologist Konrad Kaaz, MD, said in the podcast "What Does Your Doctor Say?" Thank you, doctor.

Dr. Konrad Kaaz:

Thank you very much.

Key takeaways for patients

– Hypertension is often asymptomatic and therefore requires regular measurements

– The disease is chronic in nature – it can be controlled but not cured

– The effectiveness of treatment depends on the patient's cooperation

– Diet, salt restriction and physical activity are key

– Regular measurements should be performed at least twice a day

– Untreated hypertension leads to serious complications, including heart attack and stroke

– In the initial period of treatment, more frequent follow-up visits are necessary

Information about the authors

Dariusz Litera – host of the podcast CO NA TO TWÓJ ELEKARZ (WHAT YOUR DOCTOR DOES) specializing in medical communication and patient health education.

Dr. Konrad Kaaz, MD, PhD – cardiologist, specialist in circulatory system diseases, dealing with the diagnosis and treatment of patients with heart diseases.

ATTENTION!

This material is for educational purposes only. It does not replace an individual medical consultation. If you experience any disturbing symptoms, consult your doctor.