High Blood Pressure: Should You See a Neurologist or Cardiologist?

Hypertension

Hello Doctor: My mother is 80 years old and has a history of stroke.
Recently, her health check revealed high blood pressure (consistently measuring between 152 and 165 over the past week).
Should we consult a neurologist or a cardiologist for her high blood pressure?

Huang, 40~49 year old female. Ask Date: 2019/09/28

Dr. Cai Zongzhang reply Neurology

Hello, I recommend that you consult a cardiologist.
Thank you.

Reply Date: 2019/09/28

More Info

When it comes to managing high blood pressure, especially in an elderly patient with a history of stroke, it is essential to consider both the cardiovascular and neurological implications. In your mother's case, given her age and medical history, it is advisable to consult both a cardiologist and a neurologist.

Why Consult a Cardiologist?
High blood pressure, or hypertension, is a significant risk factor for cardiovascular diseases, including heart attacks and heart failure. A cardiologist specializes in diagnosing and treating conditions related to the heart and blood vessels. They can assess your mother's blood pressure readings, evaluate her overall cardiovascular health, and determine if her hypertension requires medication adjustments or lifestyle changes.
In particular, the cardiologist can perform tests such as an electrocardiogram (ECG) to check for any heart rhythm abnormalities, echocardiograms to assess heart function, and possibly stress tests to evaluate how her heart responds to exertion. Given her elevated blood pressure readings (152-165 mmHg), it is crucial to determine whether she has developed any heart-related complications due to her hypertension.

Why Consult a Neurologist?
On the other hand, your mother's history of stroke makes it imperative to involve a neurologist in her care. High blood pressure is a leading cause of strokes, and managing it effectively is crucial to prevent future cerebrovascular events. A neurologist can evaluate her neurological health, assess any residual effects from her previous stroke, and monitor for signs of new neurological issues that may arise due to her elevated blood pressure.

The neurologist may recommend imaging studies, such as a CT scan or MRI, to evaluate her brain's condition and ensure that there are no new areas of concern. They can also provide guidance on how to manage her blood pressure in a way that minimizes the risk of further strokes.

Coordinated Care Approach
Given the interconnectedness of cardiovascular and neurological health, a coordinated approach is often the best strategy. Both specialists can work together to create a comprehensive treatment plan that addresses your mother's hypertension while considering her history of stroke. This may include lifestyle modifications, dietary changes (such as reducing salt intake), regular exercise, and possibly medication to control her blood pressure.

Conclusion
In summary, your mother's high blood pressure warrants attention from both a cardiologist and a neurologist. Each specialist brings valuable expertise that can help manage her condition effectively and reduce the risk of further complications. It is essential to ensure that both doctors are aware of her complete medical history and current medications to provide the best possible care. Regular follow-ups and monitoring will be crucial in managing her health as she ages.

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