Dr K K Aggarwal

How often should one get blood pressure checks done?

1. First BP should be checked at age four.
2. Subsequent BP should be checked at age 10, than twice between the age 10 and 20; thrice between the age 20 and 30 and then yearly from age 30 onwards.
3. Once drugs are started, a monthly follow up should be done until the BP is controlled.
4. Once the blood pressure is controlled one should have a follow up visit at 3- to 6-months interval.
5. More frequent visits are required if the initial blood pressure was more than 160/100 mm hg or the patient has complicating co-morbid conditions.
6. One should monitor serum potassium and creatinine (blood test for kidneys) yearly.
7. If accelerated hypertension (very high blood pressure) with acute target-organ damage (encephalopathy, heart attack, unstable chest pain, lung congestion, eclampsia, paralysis, head trauma, life-threatening arterial bleeding, or aortic dissection) is detected, one should get hospitalized immediately.
8. Accelerated hypertension with no acute target organ damage usually does not require hospitalization, but it requires immediate attention and combination oral anti hypertensive therapy.

Heart attack lowest in September but not amongst diabetics

There is a seasonal pattern of deaths from heart attacks with more fatal events (20 to 30 percent variation) occurring in the winter than the summer. But this seasonal pattern is absent in diabetics or those taking beta blockers or aspirin.

The heart attack trends are independent of gender, geographic location, age, and the type of heart attack (ST elevation or non-ST elevation). In-hospital mortality fatality rates for heart attack also follow a seasonal pattern, with a peak of 9 % in winter and 8.4% in the summer. Deaths from heart attack are highest in January and lowest in September, with a relative risk difference of 18.6 %.

Most people today survive a heart attack

Forty years ago, nearly 40% of heart attack victims who made it to the hospital never left, dying there from the attack or its complications. Today, that number is well below 10%. Younger victims fare even. Some people now go home as early as the next day.

Heart attack advances

• Better awareness of heart attack warning signs
• Most people today get to the hospital faster.
• Use of clot removing angioplasty and stenting or a clot dissolving drugs, which can stop a heart attack before it can damage the heart muscle. This must be used within three hours.
• Advances in drug therapy, especially anti platelet drugs and use of beta blockers and ACE inhibitor in heart failure.
• Early ambulation helps prevent the formation of potentially deadly blood clots.