Hypertension or High Blood Pressure

High blood pressure(HBP), also called hypertension, is a common condition in which the force of the blood against your artery walls is high than normal. It can develop at any age, but becomes more common as you get older.

Uncontrolled high blood pressure increases your risk of serious health problems, including heart attack, stroke, and kidney failure.

You can have high blood pressure for years without any symptoms. Some people with high blood pressure may have headaches, shortness of breath etc, but these signs and symptoms don't usually occur until blood pressure is at a severe level.

Fortunately, high blood pressure can be easily detected.

Machines that measure BP in public places (e.g. malls, pharmacies etc) can provide an estimate of BP, but should be verified by your Doctor.

You should have your blood pressure taken as part of a routine doctor's appointment. Ask your doctor for a blood pressure reading at least every two years starting at age 18. If you are age 40 or older, or you are younger with a family history of high blood pressure or other risk factors, ask your doctor for a blood pressure reading every year.

Your doctor will recommend more frequent readings if you've already been diagnosed with high blood pressure or have other risk factors for cardiovascular disease.

Primary hypertension

For most adults, there's no identifiable cause of high blood pressure. This type of HBP develops gradually over many years.

Secondary hypertension

Some people have high blood pressure caused by an underlying condition. This type of high blood pressure tends to cause higher blood pressure than does primary hypertension and often occurs suddenly.

Conditions that can lead to secondary hypertension include:

  • Kidney problems
  • Sleep apnea
  • Adrenal gland tumors
  • Congenital Blood Vessel defects
  • Thyroid problems
  • Medications, including birth control pills, decongestants, pain relievers and some prescription drugs
  • Drugs, such as cocaine and amphetamines
  • Chronic, excessive alcohol use

Risk factors

  • Age. The risk of high blood pressure increases as you age. High blood pressure is more common in men over 45. Women are more likely to develop high blood pressure after age 65.
  • Being overweight. The more you weigh, the more blood your heart must pump. The pressure on the artery walls and the work of your heart must increase.
  • Race. High blood pressure is more common among blacks at a younger age. Complications (stroke, heart attack and kidney failure) are more common in blacks.
  • Family history. High blood pressure tends to run in families.
  • Physical inactivity. People who are inactive tend to have higher heart rates. The higher your heart rate, the harder your heart must work with each contraction and the stronger the force on your arteries. Lack of physical activity also increases the risk of being overweight.
  • Tobacco. Chemicals in tobacco can increase your BP and damage the lining of your artery walls.
  • Too much salt in your diet/High Sodium Intake. Too much sodium in your diet can cause your body to retain fluid and increase the blood pressure.
  • Too little potassium in your diet. Potassium balances the amount of sodium in your cells. If you don't get enough potassium in your diet or retain enough potassium, you may accumulate too much sodium in your blood.
  • Too little vitamin D in your diet. Vitamin D may affect an enzyme produced by your kidneys that affects your blood pressure.
  • Drinking too much alcohol. Over time, heavy drinking can damage your heart. Having more than two drinks a day for men and more than one drink a day for women may affect your blood pressure.
  • Stress. High levels of stress can increase your blood pressure.
  • Certain chronic conditions. Kidney disease, diabetes and sleep apnea.

High blood pressure is uncommon in children, but poor lifestyle habits (unhealthy diet, obesity and lack of exercise) are increasing this statistic.


Uncontrolled high blood pressure can lead to:

  • Heart attack or stroke. High blood pressure can cause hardening of the arteries (atherosclerosis) and then heart attack, stroke or other complications.
  • Heart failure. To pump blood against the higher pressure in your vessels, your heart muscle thickens. The thickened muscle may have a hard time pumping enough blood to meet your body's needs, leading to heart failure.
  • Metabolic syndrome. This syndrome is a cluster of disorders of your body's metabolism, including increased waist circumference; high triglycerides; low high-density lipoprotein (HDL) cholesterol, high blood pressure; and high insulin levels.
  • Weakened and narrowed blood vessels in your kidneys. This can prevent the kidneys from functioning normally and lead to kidney failure.
  • Aneurysm. Increased blood pressure can cause your blood vessels to weaken, bulge and possibly burst
  • Hypertensive retinopathy damage to the retinal (eye) blood vessels resulting in vascular damage, leakage and blockages.
  • Memory Problems : Uncontrolled high blood pressure may affect brain function reducing your ability to think, remember and learn.


  • Regular Monitoring of BP, when a history of HBP is present or other risk factors exist
  • Reduce sodium intake and increase dietary potassium
  • Quit Smoking
  • Lose Weight
  • Increase activity levels
  • Stress Management
  • Medications
  • Dietary Fish Supplements

Be proactive – lifestyle changes have a major impact on your blood pressure and can reduce long-term consequences of high pressure. Don’t ignore HBP even if you feel normal!

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By: Michael D. Mills, MD, FRCSC

Please note: Opinions and information provided here are not medical advice and do not substitute in any way for routine medical care. Information contained here is intended to stimulate the reader to seek additional knowledge and professional health care services.

What Is Addiction?

Addiction is a condition that results when a person repeatedly engages in a compulsive act, such as ingesting a substance or doing an activity.

It is a complex brain disease involving altered function of reward and motivation systems. It includes substance abuse as well as behavioural addictions:


  • Tobacco
  • Alcohol
  • Street drugs
  • Prescription drugs


  • Gambling
  • Food
  • Sex
  • Work
  • Internet
    Research presented at the 2014 annual meeting of the American Psychiatric Association supported the idea of internet addiction by showing changes in the brain on neuroimaging. The web may occupy the majority of the "Internet addict's" waking hours. Studies suggest that compulsive Internet use affects 6 to 14 percent of Internet users.
  • Video Games
    Research shows that video game addiction is most common in boys and men. One study even found that 1 in 10 video players between the ages of 8 and 18 are "out-ofcontrol gamers" .
  • Shopping
    Excessive shopping is considered to be an impulse control disorder. Do you purchase items to avoid feeling sad — but then feel guilty afterwards? Do you have a closet full of unused clothes with price tags? Studies show that compulsive shopping more commonly affects women and often results in financial and personal problems.

People struggling with addiction are unable to control their actions or make rational decisions about their behaviour, even in the face of negative consequences. Addiction is not a function of one's moral strength.

Compounds and experiences with addictive potential activate the brain’s reward circuitry. These triggers are called reinforcers because the pleasurable feeling we get from them brings us back for more. Both alcohol and illicit drugs are powerful reinforcers, and cause the release of the neurotransmitter dopamine in the brain’s reward system.

Repeated activation by these compounds changes the brain’s reward system, and producing behaviours like excessive consumption, increasing levels of usage, and symptoms of withdrawal when the drugs/behaviours are taken away.

Users are often unaware that their behaviour is out of control and causing problems for themselves and others.

Four cardinal findings in addiction are:

  • craving
  • loss of control of amount or frequency of use
  • compulsion to use
  • ignoring the consequences of overuse.

The harms of substance use/overuse can affect every aspect of a person’s life.

They include:

  • physical injuries
  • depression, anxiety, irritability
  • degradation of interpersonal relationships
  • spending money on substances/activities rather than essentials
  • legal issues
  • Numbness/feelings of emptiness.

The person may feel good and forget about his or her problems with the addictive act. The person may come to believe that he or she cannot function or make it through the day without the substance/act. When the person uses substances/ acts to escape or change how he or she feels, using can become a habit.


There are many types of help for addiction available, but no one type is right for everyone. People may require multiple courses of addiction treatment in order to fully attain control over their addiction.

Addiction treatments include:

  • Psychopharmacology (drug therapy)
  • Self-help programs; lifestyle changes
  • Therapy
  • Inpatient rehabilitation
  • Outpatient treatment programs
  • Support groups
  • Therapeutic community living

Addiction treatment plans often include multiple forms of treatment for the best results. Quality addiction treatment centers will also take into account the possibility that more than one addiction, or mental illness, may be present in an individual.

Knowledge of addiction will allow us to recognize the early signs of addiction in ourselves and those around us and to seek guidance and treatment, where appropriate.


Addiction: An Information Guide © 2010 Centre for Addiction and Mental Health.

h t t p : / / w w w . psychiat r y. o rg/ n e w s r o o m / news - r e l e a s e s / internet-addictionreview- of-neuroimaging- studies

http://www.everydayhealth. com/ emotional-health/ i n t e r n e t - u s e - gaming-disorderincluded- in-newdsm5- 3775.aspx

http://www.everydayhealth. com/addiction/ shoppingaddiction. aspx

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By: Michael D. Mills, MD, FRCSC

Please note: Opinions and information provided here are not medical advice and do not substitute in any way for routine medical care. Information contained here is intended to stimulate the reader to seek additional knowledge and professional health care services.

Sleep Apnea

Untreated sleep apnea results in reduced oxygen delivery to the tissues. Frequent drops in your blood oxygen level and reduced sleep quality trigger the release of stress hormones. These hormones raise your heart rate and increase your risk of heart attack, stroke, diabetes, high blood pressure, heart failure, irregular heart rhythm and other conditions.

When your breathing pauses, you will have a light, poor quality sleep that will make you tired during the day. Sleep apnea is a leading cause of excessive daytime sleepiness.

Breathing pauses can last from a few seconds to minutes. They may occur many times (up to 30+) per hour. Typically, normal breathing then starts again, sometimes with a loud snort or choking sound. Sleep apnea is an ongoing condition that disrupts your sleep.


  • Loud snoring
  • Choking while you sleep
  • Pauses in breathing
  • Excessive daytime sleepiness
  • Morning headaches
  • Insomnia
  • Dry mouth in the morning
  • Frequent need to urinate during the night
  • Trouble concentrating
  • Memory or learning problems
  • Moodiness, irritability or depression

Risk Factors For Sleep Apnea:

  • Overweight - BMI over 25 have increased risk.
  • Smoker
  • Older age (40+ for men, 50+ for women)
  • Males – twice the risk
  • High Blood Pressure
  • Large neck size (>17 inches for men, > 16 inches for women)
  • Family history - inherited or lifestyle/habits


  • Sleep apnea is often undiagnosed. Doctors can't detect the condition during routine office visits and there is no blood test to help with diagnosis
  • Most people with sleep apnea aren’t aware of their diagnosis. A family member or partner is often the first to notice the signs of sleep apnea.
  • Doctors diagnose sleep apnea based on medical and family history, a physical exam, and a sleep study. Your Family doctor will evaluate your symptoms first and may refer you to a sleep specialist.

Types of Sleep Apnea – Obstructive and Central

  • The most common type of sleep apnea is obstructive sleep apnea. The airway collapses or may become blocked during sleep. This causes shallow breathing or breathing pauses.
  • Central sleep apnea is less common and results from a defect in the nervous system stimulus that regulates breathing.

Sleep Apnea - Treatment

  • CPAP (Continuous Positive Airway Pressure) uses a jet of air to keep your airway open so that you are able to breathe. CPAP is the frontline treatment for obstructive sleep apnea
  • Oral Appliance Therapy
    An oral appliance is a device that fits in your mouth like a mouth guard while you sleep - improving airflow
  • Surgery
  • Weight Management
    In some cases weight loss can help improve or eliminate your sleep apnea symptoms
  • Positional Therapy
    Better sleeping position can improve airflow
  • Lifestyle Changes
    a. quitting smoking
    b. cutting alcohol consumption

Sleep apnea is a chronic condition that requires longterm management. If left untreated, it can reduce the quality and duration of your life. If you think that you or a family member may have sleep apnea, see your doctor

h t t p : / / w w w . sleepeducation. org/essentials-insleep/ sleep-apnea

http://www.nhlbi. health-topics/topics/ sleepapnea

Send in your feedback / views at

By: Michael D. Mills, MD, FRCSC

Please note: Opinions and information provided here are not medical advice and do not substitute in any way for routine medical care. Information contained here is intended to stimulate the reader to seek additional knowledge and professional health care services.