As a member of the health care team, I am very concerned about hypertension (high blood pressure) and vascular disease (heart and circulatory problems). There are several reasons for this concern. First, because you are a patient, your podiatric physician and surgeon areI am interested in all aspects of your health and your treatment program. Second, I want to support the goals of high blood pressure detection, treatment, and control.
Hypertension and/or cardiovascular disease- Hypertension sometimes causes decreased circulation. A careful examination is required to determine if there is a lower than normal skin color, or diminished pulse in feet. The concern is that these are signs of arterial insufficiency (reduced blood flow). Increased or periodic swelling in the lower extremities is important because it may mean that hypertension has contributed to heart disease.
Rheumatic heart disease- Persons who have had rheumatic heart disease must be protected with prophylactic antibiotics prior to any surgical intervention. Any medication you may b taking for high blood pressure, a heart condition, or any other reason should be listed to ensure that it does not conflict with medications that may be prescribed in the treatment of your feet.
Diabetes- This condition frequently affects the smaller arteries, resulting in diminished circulation and decreased sensation in the extremities. It’s important to let me know if you have ever been told you have diabetes, particularly if you are taking medication or insulin for this condition.
Ulceration- Open sores that do not heal, or heal very slowly, may be symptoms of certain anemias, including skin cell disease. Or they may be due to hypertension or certain inflammatory conditions, but be sure to mention if you have ever had this problem.
Swollen feet- Persistent swelling of one or both feet may be due to kidney, heart, or circulatory problems.
Burning Feet- Although it can have a number of causes, a burning sensation of the feet is frequently caused by diminished circulation.
Control of High Blood Pressure
High blood pressure is a major risk factor for cardiovascular disease. Uncontrolled high blood pressure can cause fatal strokes and heart disease. There are three major areas in which I can provide this important public service:
Detection- Routinely take every patient’s blood pressure and determine if it is elevated.
Treatment- After confirming that blood pressure is elevated and making this information part of the patient’s record, referring all patients with elevated blood pressure to their primary care physician for elevation, diagnosis and treatment.
Long Term control- By encouraging patients in every visit to adhere to treatment, and by monitoring reductions in blood pressure, side effects of treatment, and referring for reevaluation as needed, facilitating long term control.