The Podiatric Physician and
As a member of the health
care team, your doctor of podiatric medicine (DPM) is vitally 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
is interested in all aspects of your health and your treatment program.
Second, he or she supports the goals of high blood pressure detection,
treatment, and control.
Your podiatric physician
should know if you have any of the following cardiovascular or related
cardiovascular disease -- Hypertension sometimes causes
decreased circulation. A careful examination is required to determine if
there is lower than normal temperature in any of the extremities,
absence of normal skin color, or diminished pulse in the 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
Rheumatic heart disease
-- Persons who have had rheumatic heart disease must be protected
with prophylactic antibiotics prior to any surgical intervention. If you
take medication for this condition, tell your podiatric physician. Any
medication you may be taking for high blood pressure, a heart condition,
or any other reason should be reported to the DPM to ensure that it does
not conflict with medications that may be prescribed in the treatment of
Diabetes -- This
condition frequently affects the smaller arteries, resulting in
diminished circulation and decreased sensation in the extremities. Let
your podiatric physician know if you have ever been told that you have
diabetes, particularly if you are talking medication or insulin for this
Ulceration -- Open
sores that do not heal, or heal very slowly, may be symptoms of certain
anemias, including sickle cell disease. Or they may be due to
hypertension or certain inflammatory conditions of the blood vessels.
Your DPM is on the alert for such 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
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. As a health care
provider, your podiatric physician assists in controlling this public
health problem. There are three major areas in which he or she provides
this important public service:
Detection -- Many
podiatric physicians 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 each patient's record, the DPM refers all patients with elevated
blood pressure to their primary care physicians for evaluation,
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, the podiatric physician
facilitates long-term control.