15/10/2023
4 Things to Know to Prevent Hypertension Complications
4 THINGS TO KNOW TO PREVENT HYPERTENSION
A middle aged known hypertensive woman walks into the pharmacy, complains of a persistent headache and requests for a blood pressure check. The pharmacist checks and finds out her blood pressure is indeed very high.
Another man comes in to get some over-the-counter medications. He is a bit on the obese side and the pharmacist proactively clerks this customer about when last he checked his blood pressure. The pharmacist finds out that he has had a high blood pressure reading in the past but is currently not on any medication. A check confirms that his blood pressure is high.
These are just two case scenarios that are seen almost everyday in the community pharmacy practice. These patients actually pay little attention to their diagnosis of hypertension. Unfortunately, this nonchalance has also caused preventable complications, and sometimes death.
From our experience clerking and counseling patients for the past 6 years, I am sharing here some deliberate actions that can be taken by patients, as well as mindsets they need to develop about hypertension in order to prevent these complications (cardiovascular and cerebrovascular accidents).
1. Hypertension treatment is not a one-time affair
There is a lack of proper education of patients at diagnosis, about the fact that hypertension management is potentially lifelong, especially if it is what we call primary hypertension.
Hypertension is classified as primary or essential hypertension when there is no identifiable cause, like a disease or other conditions. In this case treatment is usually lifelong.
On the other hand, if there is an identifiable disease or condition that is having high blood pressure as one of its symptoms, it is usually referred to as secondary. In this case a proper management of the disease can also address the attendant high blood pressure.
Conditions that could cause secondary hypertension include kidney disease, adrenal disease, thyroid problems, sleep apnea, some medications, etc.
So quite a few patients actually perceive a diagnosis of high blood pressure to be similar to a diagnosis of malaria, for example, in which case you treat to cure. So they take the prescribed medications at diagnosis and stop, believing all will now be well.
Unfortunately because mild to moderate hypertension, which is described as a silent killer, does not show symptoms, patients often move on with their lives until the unexpected happens.
2. A normal Blood Pressure Check result does not mean you are cured.
This is also one of the frequent responses from patients when being counselled. They stop taking medications once they record a normal reading, not knowing that they need to continue treatment in spite of that.
Again, inadequate education about the disease is also the reason why this happens. Once a diagnosis of hypertension is made, treatment is lifelong, unless as stated earlier, it is a case of secondary hypertension.
3. Treatment can be for life, thus saving your life
I agree that it can be daunting and unimaginable to take medications for the rest of one's life. Hence, quite a few patients tend to see taking orthodox medicine chronically as being more risky than the high blood pressure itself, because of the potential for both acute and chronic side effects.
More often than not, some actually become their own doctors and pharmacists, deciding when to take their medications or not. I have heard responses like: "I only take my medications when I feel some headache", "Herbal preparations are better than orthodox medicines as they do not have side effects", etc.
Persistent headaches in a patient already diagnosed with high blood pressure is probably a sign that all is really not well with the management. Again, majority of supplements and herbal preparations have not been studied in clinical trial settings to ascertain their efficacy and safety. They should be used as adjunct to antihypertensive medications prescribed by your doctor.
4. Experience of side effects does not justify treatment discontinuation
Generally speaking, compliance with medication prescribed to patients by doctors is also a major challenge when it comes to treatment and outcomes. Patients do not comply whether they perceive that the medication is working or not. Unfortunately, non-compliance in itself is a major cause of poor treatment outcomes.
Another reason for non-compliance is side effects. For example, a man being counselled revealed the reason he stopped taking the medication was because it reduces his libido and er****on.
Some other class of anti-hypertensives also cause persistent dry cough and some patients discontinue treatment because of this side effect.
The point is, not everyone experiences these side effects and for those who do, there is always an alternative anti-hypertensive that will be equally effective and without the undesirable side effect. You just need to talk to your doctor.
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