When most people think of high blood pressure, they associate it with stress, discomfort and other minor symptoms. But the reality is high blood pressure, also known as hypertension, can have far more serious repercussions if left unchecked.
“The most well known risk associated with high blood pressure are strokes, but it can also cause heart attacks and your heart muscle to thicken, which decreases its efficiency over time,” says Jackie Jayasinghe. “It weakens your blood vessels, and can also affect your kidneys — it doesn't just affect the brain.”
Jackie is the nurse practitioner for the QEII Health Sciences Centre’s Hypertension Clinic. The clinic receives about 1,200 visitors each year; mostly referrals from family doctors, emergency departments and other specialists from across the province.
There are two types of hypertension. The most common is essential hypertension, which is genetically inherited and accounts for 95 per cent of patients. The other five per cent have high blood pressure resulting from a secondary health condition, such as sleep apnea, issues with kidney circulation or tumours that cause excess production of hormones. For Jackie and the rest of the clinic’s staff, their job is investigative; to first confirm that a patient has hypertension, and then determine the root cause.
“We treat hypertension through lifestyle changes and medication,” says Jackie. “Reduced sodium intake is a huge part of treating high blood pressure, as well as regular exercise and weight loss — it can be the equivalent of taking two blood pressure medications.”
The patients Jackie cares for tend to have elevated blood pressure levels that are often difficult to treat. They may take multiple medications and have altered their lifestyle with no improvement.
“We’re a resource for patients to control blood pressure levels,” says Jackie. “And we’re here to investigate secondary causes when necessary, as sometimes there is a level of expertise that not every clinic would have.”
That level of knowledge and expertise is crucial to treat patients like Gordon Danielson, who has been dealing with high blood pressure for decades. Gordon was on multiple medications but was seeing very little positive effects. He was referred to the clinic by his family doctor, when Jackie and the staff began to work their magic.
“I’ve had blood pressure problems for a long time, but I thought it was under control. I was on a ton of medications, but my family doctor noticed it was still elevated, and he recommended the clinic to me,” says Gordon. “They put me in the hands of Jackie, and she knows her stuff. I never thought, in my case, there could be a cause but with her extensive knowledge, they found something that could help improve my situation.”
Gordon was first investigated for Conn’s Syndrome, a situation where the adrenal glands produce excess amounts of the hormone aldosterone. This causes people to retain salt and water, raising blood pressure and causing the body to lose potassium. Gordon had low levels of potassium and high blood pressure, so a series of thorough tests were done.
The results came back inconclusive, in part because Gordon’s cortisol levels (another hormone released from the adrenal glands) were much lower on one gland than they should be. This led Jackie to reach out to an expert in Conn’s Syndrome from the Mayo Clinic in the U.S. for another opinion on Gordon’s situation.
“He instructed me to do some specific further testing, and it was discovered that Gordon had Subclinical Cushing’s syndrome,” says Jackie. “Essentially one of his adrenal glands was not only producing excess aldosterone, but also excess cortisol. This overproduction by the one adrenal gland was suppressing the other adrenal gland, so that it wasn’t producing as much cortisol as it should.”
“Gordon had the over-producing gland removed. His potassium levels became normal, and he was able to be taken off multiple medications.”
For Gordon, his improved health is immeasurable, as he is managing far fewer medications while at work, which sees him on the road quite frequently. While most people expect medical professionals to find a solution to their problems, Gordon was particularly moved by the efficient and thorough nature of the staff at the QEII’s Hypertension Clinic.
“To resolve my issues required some tricky blood tests and surgeries that aren’t that common,” says Gordon. “But she was able to seek out advice from other professionals she’s met, and for them as a network to find a solution – that dedication means a lot to me.”
“The effects of high blood pressure, if unchecked for a long time, can be grave. The fact that there’s a facility here that specializes in it is such a resource.”