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Recognizing a Genetic Disease as the Cause for High Blood Pressure in .NET framework
Recognizing a Genetic Disease as the Cause for High Blood Pressure
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Congenital adrenal hyperplasia, an inherited disease, is the genetic lack of one or more enzymes that eventually change steroids to cortisol in the adrenal glands This condition leads to an overproduction of other hormones that have properties similar to aldosterone When the pituitary gland does not detect sufficient cortisol, it sends out more ACTH to stimulate the adrenals, which then enlarge The two most common forms of congenital adrenal hyperplasia break down into the following categories: 1 The excessive steroids are Aldosterone-like, producing high blood pressure and low potassium Masculinizing, causing masculine changes in baby girls so that their genital organs are something between male and female
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Part I: Understanding High Blood Pressure
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In milder forms, responsible for the early onset of puberty in boys This symptomatic increase of male hormone activity (like increased hair and menstrual irregularity) can also occur in young girls 2 The excessive steroids are aldosterone-like, causing high blood pressure and low potassium, but no sex hormones are made As a result: Menstruation doesn t take place, so the disease is first detected at puberty in a girl The lack of male hormones in boys leads to abnormal development of the male sexual organs, so the disease is found earlier than in girls Although these conditions are rare, they re easily treated if diagnosed early Both types of patients take cortisol, which shuts off the excessive ACTH and the production of the abnormal steroids In the second form of congenital adrenal hyperplasia, the patient also takes sex hormones to replace the absent hormones Because these diseases are hereditary, they occur in certain families more often than others (The more common form is more often in Ashkenazi Jews; the less common form is more often in Sephardic Jews but in other families as well) This predictability alerts doctors to look for the condition whenever a new birth occurs in one of these families
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Checking Out Other Causes of Secondary High Blood Pressure
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Several other treatable diseases are associated with high blood pressure Most of them are reversible, and the high blood pressure responds to the correction of the disease unless it s been present for some time
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Coarctation of the aorta
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Coarctation of the aorta is a narrowing of the large artery that leaves the heart Depending on the severity, the narrowing is usually present at birth though not diagnosed until the teenage years The narrowing is usually close to the beginning of the aorta but below where the artery branches to the arms The result is high blood pressure in the arms and lower blood pressure in the legs (which the doctor can observe by simply measuring the blood pressure in the arms and the legs)
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4: Dealing with Secondary High Blood Pressure
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The narrowing results in the production of a murmur, a humming sound, which can be heard with the doctor s stethoscope in the area of the heart In addition, the doctor is unable to detect a pulse in the groin The kidneys respond to the lower blood pressure by putting out more renin (see the earlier section Handling blocked kidney arteries ); the increase leads to even higher blood pressure above the narrowing but not below it Children with this condition can have nosebleeds, dizziness, pounding headaches, and, when they exercise, leg cramps During a careful first examination of any baby, the doctor feels for the pulses in the feet and notes whether pulses are present or not If not, the doctor can order further evaluation with a CT or MRI of the chest The treatment consists of surgery to open the narrow area or sometimes balloon angioplasty, the same technique used to open the narrow blood vessels of the heart (See the Treating blocked kidney arteries section, earlier in this chapter for more on angioplasty) If the coarctation isn t treated, the patient may die before the age of 40 from complications of high blood pressure
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