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Joe Pelonio
01-29-2007, 5:50 PM
I'm not asking for e-mail diagnosis, but just any information about this
recent problem with my son.

Josh (19 years-old) passed his EMT test, and was hired by a local ambulance company. In the pre-hire testing process he has to do some physical performance tests, and his blood pressure was borderline high, not
dangerous but higher than their limits to let him do the test. He went to his regular doctor and they did EKG and blood tests, and told him that one side of his heart was working harder than the other, but gave him a work release saying that he could take the test, while awaiting the test results.

He went back to the job test today and the test involves treadmill and measuring heart rate at various stages. His rate was already above the passing limit, so again he couldn't take it. As bad as that is for his job, he (and my wife and I) are getting very concerned about his health.

My wife is on hypertension medication and the doctor already said it's probably a hereditary thing. Josh wants to be a paramedic, it looks like he may have to go onto some kind of medication/diet program before he can pass this test. His plan was to work two years as an EMT to while going to college so that he will have the experience he needs to apply for the paramedic program.

Phyllis Meyer
01-29-2007, 5:56 PM
Hi Joe,

My youngest Daughter usually has a high blood pressure reading. Very thin young lady so sometimes weight doesn't have anything to do with it. My family has a long history of high blood pressure. Keep following all the Dr.'s advice and have everything tested! Your Son will pass with flying colors! Have a great evening!

Sincerely,

Phyllis

Belinda Barfield
02-15-2007, 6:45 PM
Hi Joe,

I am new to the forum, just joined today in fact. You may already have answers to your questions, but there is no follow up post so I thought I would reply. Firstly, I hope all medical issues with your son are resolved and this is totally useless information to you. Secondly, I am not a doctor but do have some information to share.

Blood pressure is actually controlled by the kidneys. In certain instances the kidneys can "tell" the heart to ramp up blood flow, causing the heart to work harder than normal. If this is a long term situation a person can develop cardiomyopathy, basically thickening of the muscles of the walls of the heart. Your son is young, so for this to have taken place it would probably indicate a congenital condition of the kidneys or renal arteries (which supply blood to the kidneys). If your son is not seeing an internal medicine specialist, you may want to schedule an appointment with one for a full physical. Blood work would reveal any kidney dysfunction. In the short term, if no one has recommended it, ask him to limit his salt intake until you all can figure out what is going on.

It sounds like your son has life plan - good for him! It is possible that the EMT approval process has led him to treatment for a medical condition he would not have known about otherwise.

Belinda Williamson

Joe Pelonio
02-15-2007, 7:44 PM
I won't get into the debate, but would like to provide an update on Josh.

All of the tests came back normal, and while the doctor will be following up on a semi-annual basis there's no need for concern. The doctor himself called the testing people to tell them that the process of the blood pressure test itself raises his pressure, which is apparently common. If he sits and relaxes for a while it goes back to normal, but the level it was at when they failed him is according to the doctor "normal", just at the high end of normal. This has given him a bit of a wake up, so he's eating better and watching the salt. He loves to put soy sauce on eveything but will cut down on it.

Anyway, he did pass and has been in training all week, today will be on the road driving the ambulance with an instructor.

Dennis Peacock
02-15-2007, 8:38 PM
Hi Joe,

I am new to the forum, just joined today in fact. You may already have answers to your questions, but there is no follow up post so I thought I would reply. Firstly, I hope all medical issues with your son are resolved and this is totally useless information to you. Secondly, I am not a doctor but do have some information to share.

Blood pressure is actually controlled by the kidneys. In certain instances the kidneys can "tell" the heart to ramp up blood flow, causing the heart to work harder than normal. If this is a long term situation a person can develop cardiomyopathy, basically thickening of the muscles of the walls of the heart. Your son is young, so for this to have taken place it would probably indicate a congenital condition of the kidneys or renal arteries (which supply blood to the kidneys). If your son is not seeing an internal medicine specialist, you may want to schedule an appointment with one for a full physical. Blood work would reveal any kidney dysfunction. In the short term, if no one has recommended it, ask him to limit his salt intake until you all can figure out what is going on.

It sounds like your son has life plan - good for him! It is possible that the EMT approval process has led him to treatment for a medical condition he would not have known about otherwise.

Belinda Williamson


Makes sense to me since my cardiologist does a liver enzyme test twice a year on me to see how everything is working. So far, so good.

Joseph N. Myers
02-15-2007, 8:56 PM
I did a search on "high blood pressure causes" and of course, lots of information. Checked a few and kind of interesting.

90-95% of high blood pressure is because of Primary Hypertension which they really don't know what causes it (???). But they do know what contributes to it, i.e., smoking, family history, overweight, diet, etc. Changes to these and/or drugs usually helps.

In the other 5-10%, they have what is called Secondary Hypertension which is kidney, endocrine, narrowing of the aorta, etc.

Thank God I have (I guess) Primary Hypertension because I take a couple of pills a day and my blood pressure is quite good. I did stop smoking (10 years), drinking (5 years), cut back on certain things such as salt, etc. Really miss some of the stuff especially the smoking and drinking but what the heck, do feel a lot better.

In any event, thanks for the post, I now know more medical stuff then I did this morning.

Regards, Joe

Dave Fifield
02-15-2007, 9:00 PM
Hi Joe,

Get him to lay off all caffeine, that'll do it (chocolate, coffee, tea, Coca-Cola, etc.). It's amazing how bad that stuff is. From my personal experience, I found by cutting out caffeine, my blood pressure went from high back to normal, my resting heart rate dropped 10 bpm at least and my blood glucose dropped 50 points on average too.

Cheers,

Ken Garlock
02-15-2007, 9:57 PM
IMO, family doctors are the "rock and rat" filters of the medical profession. They can do the run of the mill work just fine, but they haven't specialized in any particular area of medicine where they would detect the nuances of problems.

Yes, the kidneys play a role in the control of blood pressure. Some blood pressure control medications are diuretics.

Don't wait, get an appointment with a cardiologist ASAP. He may not find anything of importance, or he may find a major problem. Either way, you have an expert opinion.

Over ten years ago, my then GP during an annual physical said he detected mitral prolapse. I had a heart echo gram, and a stress test. Neither found anything. I still have the 'tick' that the doctor detected, but I don't worry about it. The BP is 120/80 and the annual cardiogram is on the money. My point is that I got answers and didn't sit around wringing my hands or ignoring a problem.

Now get going.

Jerry Olexa
02-15-2007, 10:00 PM
I think we should show common courtesy to each other and respect each other's viewpoint. This is not a war zone like some other forums.

Rick Williams
02-15-2007, 10:45 PM
There are diseases of the kidney that elevate blood pressure, glomerulonephritis being one but the statement that the kidneys regulate BP is patently false. The concept of seeking medical advice from amateurs on a wood working forum is not a very wise choice. If you have questions, ask your cardiologist. They spent a lot of money and time acquiring the knowledge.

Dennis Peacock
02-15-2007, 11:26 PM
OK....I think we've "discussed" all this well enough.

Take good advice Joe and keep things well checked by the correct specialists in the medical profession.

Just a reminder to all of us....this thread is subject to removal and closure.

Mack Cameron
02-16-2007, 6:43 AM
To Belinda: my sincere apologies for my rant! My brain left my body for a few minutes. I promise it won't happen again and welcome to the SMC forum.

I stand corrected.

Glenn Clabo
02-16-2007, 7:20 AM
Mack...you know you can delete your post right? Here's some information from a PHD in nursing that I know...I believe it's from the American Heart Association...

The kidneys regulate the body's fluid volume, mineral composition and acidity. They do this by regulating excretion and reabsorption of water and inorganic electrolytes. This works to balance these substances throughout the body and keep their normal concentrations in the extracellular fluid. Ions regulated in this way include sodium, potassium, chloride, calcium, magnesium, sulfate, phosphate and hydrogen. The kidneys regulate body fluid volumes, which are related to blood volume and the blood pressure in your arteries. The kidneys also regulate some organic nutrients and excrete metabolic waste products and some foreign chemicals.
How does the kidney help regulate blood pressure?
Regulating blood pressure is intimately linked to the kidneys' ability to excrete enough sodium chloride to maintain normal sodium balance, extracellular fluid volume and blood volume. Kidney disease is the most common cause of secondary hypertension (high blood pressure). Even subtle disruptions in kidney function play a role in most (if not all) cases of high blood pressure and increased injury to the kidneys. This injury can eventually cause malignant hypertension, stroke or even death.
In normal people, when there's a higher intake of sodium chloride (salt), the body adjusts. It excretes more sodium without raising arterial pressure. However, many outside influences and kidney problems can lead to reduced capability to excrete sodium. If the kidneys are less able to excrete salt with normal or higher salt intake, chronic increases in extracellular fluid volume and blood volume result. This leads to high blood pressure. When higher levels of hormones and neurotransmitters that directly cause blood vessels to narrow are also present, even small increases in blood volume are compounded. (This is due to the smaller area through which the blood is forced to flow.) Although the increases in arterial pressure lead the kidneys to excrete more sodium, which restores the sodium balance, higher pressure in the arteries may persist. This shows the important link between kidney disease and high blood pressure.

Chris Barton
02-16-2007, 7:34 AM
1) The kidneys do largely regulate BP by the release of hormones but, they aren't the sole regulator of BP nor does a change in BP necessarily signify a change in renal health.

2) Doctors (internists and family practice) are professionals trained to treat a variety of diseases including hypertension, and they tend to be the very best in the world at it right here in the USA according to recent research.

3) One size doesn't fit all. What you doctor told you about your disease may not work for someone else.

4) When in doubt, get a second opinion. But, get it from a doctor.

Belinda Barfield
02-16-2007, 7:48 AM
Mr Clabo,

Thank you for so beautifully defending my position. I surely did not mean to stir the pot quite so effectively. I'm really glad I didn't check this thread for follow up last night, else I would have missed out on all that beauty rest I so desperately need.

Respectfully,

Belinda

Glenn Clabo
02-16-2007, 7:53 AM
Belinda...Glenn please.

I hope this doesn't stop you from posting...I think it was just a moment and it's been corrected.

Welcome to SMC...

Dennis Peacock
02-16-2007, 8:36 AM
Mr Clabo,

Thank you for so beautifully defending my position. I surely did not mean to stir the pot quite so effectively. I'm really glad I didn't check this thread for follow up last night, else I would have missed out on all that beauty rest I so desperately need.

Respectfully,

Belinda

I still say Thank You Belinda. As a cardiac patient. The more I learn about this stuff, the better I begin to understand my own condition.

Have a hearty Welcome to SMC!!!!

Belinda Barfield
02-16-2007, 8:40 AM
Rick,

I agree with you that questions regarding medical care should be directed to a physician. I did not recommend any medication, procedure, etc. for treatment of any condition. I simply attempted to make the case that blood pressure is not controlled by the heart. I am curious as to the basis for your claim that my statement regarding the relationship between the kidneys and blood pressure is "patently false". Can you explain to me how blood pressure is regulated?

Belinda

Seeking enlightenment

Chris Barton
02-16-2007, 9:26 AM
but the statement that the kidneys regulate BP is patently false. The concept of seeking medical advice from amateurs on a wood working forum is not a very wise choice. If you have questions, ask your cardiologist. They spent a lot of money and time acquiring the knowledge.

Rick,

The renin/angiotensin system (which is part of the hypothalamic-adrenal axis) is the single major controller of BP (renal regulation). So, like Belinda, if you have info to refute that I would like to see it. The remainder of your post is something I agree with.

Ken Fitzgerald
02-16-2007, 9:35 AM
Belinda....Welcome to the Creek! We are generally a more friendly group than this thread would indicate. :( :o

Owen Gregg
02-16-2007, 9:37 AM
I'm not asking for e-mail diagnosis, but just any information about this
recent problem with my son.

Josh (19 years-old) passed his EMT test, and was hired by a local ambulance company. In the pre-hire testing process he has to do some physical performance tests, and his blood pressure was borderline high, not
dangerous but higher than their limits to let him do the test. He went to his regular doctor and they did EKG and blood tests, and told him that one side of his heart was working harder than the other, but gave him a work release saying that he could take the test, while awaiting the test results.

He went back to the job test today and the test involves treadmill and measuring heart rate at various stages. His rate was already above the passing limit, so again he couldn't take it. As bad as that is for his job, he (and my wife and I) are getting very concerned about his health.

My wife is on hypertension medication and the doctor already said it's probably a hereditary thing. Josh wants to be a paramedic, it looks like he may have to go onto some kind of medication/diet program before he can pass this test. His plan was to work two years as an EMT to while going to college so that he will have the experience he needs to apply for the paramedic program.

Hi Joe,

I want to start off by saying I don't want to debate anything about kidneys. I can say that I was in a similar situation, but I was applying for the fire department (Here, you have to have your EMT-B to get hired on). I had what doctors called marginally high blood pressure. The good thing for me was that I knew about it about 4 months before testing. The physical test for our fire department is strenuous, and usually is for all departments across the board.

The doctor offered medication, especially as heart disease and high blood pressure run in my family, but I elected to try the diet and exercise alone routine first. To make a long story short, after cleaning up my diet and seriously hitting the gym, I was in great health 3 months later. My bp dropped to 110/70 and my resting heart rate was about 64 bpm.

Just food for thought-I was working on doing nearly the same thing Josh is. I thought I'd get my basic first and then spend a couple years in school and go through the medic program. What I didn't realize was that I could go through nursing school in that same amount of time, with a better paying career at the end of it. On top of that, there is an RN-to-EMT-P certification that only takes about 2 (Intensive) weeks for certification as a Paramedic, as well as having a Bachelor's in Nursing. And the bachelor's degree provides much more appeal to hiring agencies, on top of the pay raise. To top it all off, if and when he gets hired by a FD or ambulance company, he could also work as a nurse.

FWIW,
Owen

John Hain
02-16-2007, 10:08 AM
Hi Joe,

I want to start off by saying I don't want to debate anything about kidneys. I can say that I was in a similar situation, but I was applying for the fire department (Here, you have to have your EMT-B to get hired on). I had what doctors called marginally high blood pressure. The good thing for me was that I knew about it about 4 months before testing. The physical test for our fire department is strenuous, and usually is for all departments across the board.

The doctor offered medication, especially as heart disease and high blood pressure run in my family, but I elected to try the diet and exercise alone routine first. To make a long story short, after cleaning up my diet and seriously hitting the gym, I was in great health 3 months later. My bp dropped to 110/70 and my resting heart rate was about 64 bpm.

Just food for thought-I was working on doing nearly the same thing Josh is. I thought I'd get my basic first and then spend a couple years in school and go through the medic program. What I didn't realize was that I could go through nursing school in that same amount of time, with a better paying career at the end of it. On top of that, there is an RN-to-EMT-P certification that only takes about 2 (Intensive) weeks for certification as a Paramedic, as well as having a Bachelor's in Nursing. And the bachelor's degree provides much more appeal to hiring agencies, on top of the pay raise. To top it all off, if and when he gets hired by a FD or ambulance company, he could also work as a nurse.

FWIW,
Owen
Well, hopefully I can help out here.

The kidney's renin-angiotensin system is only one part in the collective total that your body uses to maintain and control its blood pressure. While it plays a key part in the process, it is by no means "the most important" part of the system and should never be labeled as such. Furthermore, other organ systems contribute to the renin-angiotensin mechanism; and this further complicates the issue. Simplistically, only one of the body's pressure regulatory "centers" is necessary to increase blood pressure and hold it there. Heredity and acquired etiologies can, and are, responsible for such changes from the prescribed "norm" as supplied by the American Heart Association.

That said, high blood pressure is not only an affliction of the middle-aged and elderly demographic. Many young people suffer from high blood pressure and a very high percentage are not treated. Therein lies a potential destructive process that can cause many health problems down the road. High blood pressure doesn't usually cause any health problems to the young adult that they can "sense". The issue with high blood pressure it that over time it leads to premature problems with blood vessels and organ systems. Such diseases as stroke, heart disease, heart failure, visual acuity, and especially kidney disease have all been shown to been associated with long-term untreated high-blood pressure.

So I guess my take home message is this: take your child to a specialist and get their blood pressure in the recommended target range by whatever means necessary, including medication. It does sound like your son is being diagnosed with famous "white coat" high blood pressure syndrome!

EDIT: ....and of course, as other posters have suggested...... Smoking, caffeine, stress are the big causes for high blood pressure that are easily controlled without the help of a doctor. But you want a trained professional to look things over to make sure it's not something more serious.

Chris Barton
02-16-2007, 10:31 AM
So John, are you in disagreement with the concept that the RA system provides the greatest degree of physiologic control of BP?

Joe Pelonio
02-16-2007, 10:31 AM
Hi Joe,
Just food for thought-I was working on doing nearly the same thing Josh is. I thought I'd get my basic first and then spend a couple years in school and go through the medic program. What I didn't realize was that I could go through nursing school in that same amount of time, with a better paying career at the end of it. On top of that, there is an RN-to-EMT-P certification that only takes about 2 (Intensive) weeks for certification as a Paramedic, as well as having a Bachelor's in Nursing. And the bachelor's degree provides much more appeal to hiring agencies, on top of the pay raise. To top it all off, if and when he gets hired by a FD or ambulance company, he could also work as a nurse.

FWIW,
Owen

I don't kno what kind of certifications are required or given here, what he has is an EMT certificate from the state that allows him to work for the fire department or ambulance firm.

Josh is also a volunteer EMT with the local fire department, he just can't drive until he's 21. We have spoken to him about the nursing route, as did the doctors on duty at the ER when he worked a night at Harborview Hospital during his EMT training. He so much wants to be a paramedic that he wouldn't consider it. On the other hand, during his ambulance driving training they showed a movie on what happens when an inattentive driver ignores or doesn't hear the sirens and t-bones an ambulance in an intersection, and that gave him a good scare. So we'll see. I'll share your
story with him.

John Hain
02-16-2007, 11:10 AM
So John, are you in disagreement with the concept that the RA system provides the greatest degree of physiologic control of BP?

Chris, I entered this thread to give some information where I thought a couple concepts needed to be clarified; no more, no less.

Glenn Clabo
02-16-2007, 11:14 AM
Chris, I entered this thread to give some information where I thought a couple concepts needed to be clarified; no more, no less.

Okay Docs...go to your neutral corners and come out fighting. ;) :D :D

I was actually looking forward to a discussion...I'm married to a researcher and I love it when she discusses these things...

John Hain
02-16-2007, 11:16 AM
Okay Docs...go to your neutral corners and come out fighting. ;) :D :D

I was actually looking forward to a discussion...I'm married to a researcher and I love it when she discusses these things...
Well, that's precisely the reason I thought twice (err...three times) about posting. It seems I shouldn't have posted in this thread if will only lead to arguments that don't help the actual poster.

Glenn Clabo
02-16-2007, 11:18 AM
Don't take it wrong John...I thought it was a good thing that you posted.

Belinda Barfield
02-16-2007, 11:34 AM
Dennis Peacock said it best "As a cardiac patient. The more I learn about this stuff, the better I begin to understand my own condition."

Okay, so this isn't a medical forum, but at least a few of us are leaving here a little more informed. Who would've thunk you would have a debate over the controlling mechanism of blood pressure on a woodworker's forum? I for one would be very interested in reading your opposing views. I THINK we are all adult enough to keep our emotions in check and debate the issue in a "gentlemanly" fashion. If not, I've enjoyed the match so far.

Onward . . .

Chris Barton
02-16-2007, 1:33 PM
Okay Docs...go to your neutral corners and come out fighting. ;) :D :D

I was actually looking forward to a discussion...I'm married to a researcher and I love it when she discusses these things...

No fighting here my friend. I base my statement on what has been the fundamental support of scientific research for more than a century. John appears to be speaking to potential causes and contributing factors in the development of hypertension while I am refering to the actual physiological control system (at least that's what I'm coming to believe).

Owen Gregg
02-16-2007, 4:20 PM
Joe, another interesting idea (For myself anyway-maybe Josh, too) was the flight medic. I'm lucky enough to live in an area where Lifeflight/Lifenet helicopters operate and have been able to ride in them a couple times. It's pretty fantastic and if Josh is able, he may want to explore that route too-like he doesn't have enough on his plate already:D . He should feel lucky being able to drive at 21 (I know he's only 19), some of my locales require the driver to be 25 because of insurance requirements.