A team of doctors from a Chembur hospital revived a 35-year-old man with severely collapsed blood pressure, which also led to a drop in his pulse rate, oxygen saturation, and kidney dysfunction. It turned out that the patient, a peon, was frustrated due to his uncontrolled hypertension and in a fit of rage, consumed 40 anti-hypertensive pills on the night of September 23.
He was first rushed to a local clinic where the doctor advised that he should be admitted to a better-equipped hospital. “When he was brought to us, his BP levels were so low that we could only measure the systolic BP, which had dropped to 40. His diastolic BP could not be recorded,” said cardiologist Dr. V.T. Shah, from Surana Hospital, who treated the patient.
According to Dr. Shah, the normal level of systolic BP is 120. Those in the range of 120-129 are identified as pre-hypertensive and those above 140 are said to be stage one hypertensives.
“The patient’s condition was so critical that we had to put him on a ventilator. We aspirated the contents of his stomach to ensure that the remains of the tablets don’t cause further trouble and also put him on medication to increase the BP. A nephrologist was called in and the patient was put on medication to improve kidney function as well,” Dr. Shah said.
Dopamine and adrenaline-based drugs were administered along with intravenous fluids to increase the BP levels. “We were worried that the low BP would lead to a cardiac arrest or a multi-organ failure,” he said.
After 48 hours on a ventilator, the patient gradually regained consciousness. When doctors probed him, he confessed about being upset with his uncontrolled hypertension and the headaches it triggered.
“He had been on medication for high BP since the past four years. The number of pills had increased gradually but his BP was not in control. He was currently on five tablets in the morning and two in the evening every day,” Dr. Shah said. He has now changed the drug molecule and prescribed the patient only two tablets a day instead of seven that he was taking daily, and has also referred him for counselling.
“We will monitor his BP and change the molecule or dosage accordingly once he gets back to his daily routine,” Dr. Shah said.
Young hypertensives
Dr. Shah said as compared to the West, India is seeing an increasing number of hypertensives a decade earlier. “Sustained changes in diet and lifestyle can bring about a lot of difference. For example, in obese patients, reducing 1 kg would bring down BP by one point. But lack of discipline is a major problem,” he said.
According to him, doctors can also prescribe newer molecules to reduce the pill burden on patients and educate them about reducing salt intake, exercise, and other precautions.
