Blood Pressure Medicines

What is high blood pressure?

High blood pressure, also called hypertension, is when blood puts too much pressure against the walls of your arteries. Almost half of American adults have high blood pressure, usually with no symptoms. But it can cause serious problems such as stroke, heart failure, heart attack, and kidney disease.

Healthy lifestyle changes can help reduce high blood pressure:

• Losing weight
• Being physically active
• Managing stress
• Reducing sodium in your diet
• Avoiding alcohol, tobacco, and illegal drugs
• Getting enough sleep

Sometimes lifestyle changes alone cannot control or lower your high blood pressure. In that case, your health care provider may prescribe blood pressure medicines.

The most commonly used blood pressure medicines work in different ways to lower blood pressure:

• Angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers (ARBs) keep your blood vessels from narrowing as much and allows blood to move through them with less pressure.
• Beta blockers help your heart beat slower and with less force. This means that your heart pumps less blood through your blood vessels. Beta blockers are typically used only as a backup option or if you also have certain other conditions.
• Calcium channel blockers prevent calcium from entering the muscle cells of your heart and blood vessels. This allows the blood vessels to relax.
• Diuretics remove extra water and sodium (salt) from your body. This lowers the amount of fluid in your blood. Diuretics are often used with other high blood pressure medicines, sometimes in one combined pill.

Often, two or more medicines work better than one. If these medicines do not lower your blood pressure enough, your provider may suggest that you take another type of blood pressure medicine.

While taking the medicines, it is still important to keep up with your healthy lifestyle changes. Doing both helps keep blood pressure lower than lifestyle changes or medicines alone.

NIH: National Heart, Lung, and Blood Institute

Brachial Plexus Injuries

The brachial plexus is a network of nerves that sends signals from the spine to the shoulder, arm, and hand. Damage to the brachial plexus can cause symptoms such as:

• A limp or paralyzed arm
• Lack of muscle control in the arm, hand, or wrist
• Lack of feeling or sensation in the arm or hand

Brachial plexus injuries can happen because of shoulder trauma, tumors, or inflammation. Sometimes they happen during childbirth when a baby's shoulders become stuck during delivery and the nerves stretch or tear.

Some brachial plexus injuries may heal without treatment. Many children who are injured during birth improve or recover by 3 to 4 months of age. Treatment includes physical therapy and, in some cases, surgery.

NIH: National Institute of Neurological Disorders and Stroke

Chagas Disease

What is Chagas disease?

Chagas disease, or American trypanosomiasis, is an illness that can cause serious heart and stomach problems. It is caused by a parasite. Chagas disease is common in Latin America, especially in poor, rural areas. It can also be found in the United States, most often in people who were infected before they moved to the U.S.

Chagas disease is caused by the Trypanosoma cruzi parasite. It is usually spread by infected blood-sucking bugs called triatomine bugs. They are also known as "kissing bugs" because they often bite people's faces. When one of these bugs bites you, it leaves behind infected waste. You can become infected if you rub the waste in your eyes or nose, the bite wound, or a cut.

Chagas disease can also spread through contaminated food, a blood transfusion, a donated organ, or from the pregnant parent to the baby during pregnancy.

Kissing bugs can be found throughout the Americas, but they are more common in certain areas. The people who are most at risk for Chagas disease:

• Live in rural areas of Latin America
• Have seen the bugs, especially in those areas
• Have stayed in a house with a thatched roof or with walls that have cracks or crevices

In the beginning, there may be no symptoms. Some people do get mild symptoms, such as:

• Fever
• Fatigue
• Body aches
• Headache
• Loss of appetite
• Diarrhea
• Vomiting
• A rash
• A swollen eyelid

These early symptoms usually go away. However, if you don't treat the infection, it stays in your body. Later, it can cause serious intestinal and heart problems such as:

• An serious arrhythmia (a problem with the rate or rhythm of your heartbeat) that can cause sudden death
• An enlarged heart that doesn't pump blood well
• Problems with digestion and bowel movements
• An increased chance of having a stroke

To find out if you have Chagas disease, your health care provider:

• Will do a physical exam
• Will take your medical history, including asking about your symptoms and where you have lived and traveled
• Will run a blood test for Chagas disease
• May run tests to see whether the disease has affected your intestines and heart

Medicines can kill the parasite, especially early on. You can also treat related problems. For example, a pacemaker can help with some heart complications.

There are no vaccines or medicines to prevent Chagas disease. If you travel to areas where it occurs, you are at higher risk if you sleep outdoors or are staying in poor housing conditions. It is important to use insecticides to prevent bites and practice food safety.

Centers for Disease Control and Prevention

Chiari Malformation

Chiari malformations (CMs) are structural defects in the cerebellum. The cerebellum is the part of the brain that controls balance. With CM, brain tissue extends into the spinal canal. It can happen when part of the skull is too small, which pushes the brain tissue down. There are several types of CM. One type often happens in children who have neural tube defects. Some types cause no symptoms and don't need treatment. If you have symptoms, they may include:

• Neck pain
• Balance problems
• Numbness or other abnormal feelings in the arms or legs
• Dizziness
• Vision problems
• Difficulty swallowing
• Poor hand coordination

Doctors diagnose CM using imaging tests. Medicines may ease some symptoms, such as pain. Surgery is the only treatment available to correct or stop the progression of nerve damage.

NIH: National Institute of Neurological Disorders and Stroke

Chronic Pain

What is chronic pain?

Pain is a signal from your nervous system that something may be wrong. It is an unpleasant feeling, such as a prick, tingle, sting, burn, or ache. Pain may be sharp or dull. You may feel pain in one area of your body or all over. Each person feels pain differently, even if the reason for the pain is the same.

Pain might be acute or chronic. The type of pain is based on how long and how often you have pain. Acute pain starts suddenly and goes away when the cause is treated or healed. This pain lets you know that you may be injured or have a problem you need to take care of. Chronic pain lasts longer than three months or the time in which you should have healed.

If you have chronic pain, it can occur most days or every day and may last for weeks, months, or even years. It can affect all aspects of daily life, including your mood and relationships. Treatment may not get rid of chronic pain, but it can help with your symptoms.

Sometimes, acute pain can become chronic pain. The original cause may have been an injury or infection, or you may have an ongoing cause of pain, such as arthritis or cancer. In some cases, there is no clear cause. Environmental factors and psychological factors such as mood and stress can make chronic pain worse.

Since people feel pain in different ways, two people could have the same issue, but each may have different symptoms. Chronic pain can occur anywhere in your body and may cause other symptoms such as fatigue, mood changes, or difficulty sleeping. If you have depression or stress, it may make chronic pain worse.

Many older adults have chronic pain. Women also report having more chronic pain than men, and they are at a greater risk for many pain conditions. Some people have two or more chronic pain conditions. You may be more likely to have chronic pain if you have certain medical conditions such as:

• Headaches or migraines
• Cancer
• Fibromyalgia
• Arthritis
• Nerve damage
• Back problems

Chronic pain lasts three months or longer or when pain continues after your body has healed. If the cause of your pain is unknown, your health care provider may:

• Ask you about your medical history
• Ask you to describe the pain and how it affects your life
• Do a physical exam
• Order blood tests or other medical tests

Chronic pain is not always curable, but treatments can help. Treatments may include medicines, including pain relievers. There are also non-drug treatments, such as acupuncture, physical therapy, and sometimes surgery.

Depending on the cause of your pain and your symptoms, your provider may also recommend lifestyle changes which may include suggestions for:

• Improving mental health
• Managing stress
• Getting to and staying at a healthy weight
• Adding low-impact exercise