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Study finds many older adults not taking their high blood pressure medication – increasing risk of stroke and heart attack

Study finds many older adults not taking their high blood pressure medication – increasing risk of stroke and heart attack

By JOANNA HAYDEN, PHD, CHES

bloodpressuremed A study reported in the CDC publication Morbidity and Mortality Weekly Report (MMWR) reveals that 26% of people 65 and over with high blood pressure either don’t take their medication as directed or stop taking it altogether, increasing their risk of stroke  and heart attack.

For the complete report: http://www.cdc.gov/mmwr/volumes/65/wr/mm6536e1.htm?s_cid=mm6536e1_w

According to the American Hospital Association (2016) about 70% of people 65 and older have high blood pressure (hypertension). High blood pressure is diagnosed when the systolic (top number) reading is above 140 and/or the diastolic (bottom number) is above 90. Blood pressure between 120 –139 systolic and/or 80-89 diastolic is considered pre-hypertensive with normal blood pressure at 120/80 or less.

Blood pressure is the force of the blood pushing blood_presure_medagainst the walls of arteries in the body when the heart beats (top number or systolic) and when it’s at rest in between beats (bottom number or diastolic).

Keep in mind that high blood pressure does not cause symptoms, which is why it’s called “the silent killer.”  Therefore, keeping blood pressure as close to normal as possible is necessary to  prevent the consequences of high blood pressure, which include:

Getting high blood pressure under control consists of making lifestyle changes and if they don’t work, medications. Although lifestyle changes can bring high blood pressure down,  they don’t work for everyone.
To reduce blood pressure through lifestyle changes the Mayo Clinic suggests the following:

Weight loss – If you are over weight or obese, losing as little as 10 pounds can make a difference especially if you carry extra weight around your waist.

Exercise – Regular physical activity 30 minutes on most days helps to control high blood pressure. Good activities include walking, dancing, jogging, swimming or cycling.

Healthy eating – A diet with lots of whole grains, fruits, vegetables and low-fat dairy products can help with weight loss as well as high blood pressure control.

Sodium reduction: – Not everyone is created equal when it comes to the effect of sodium on blood pressure. Limiting sodium to no more than 2300 mg/day (the amount of sodium in 1 teaspoon of salt) can help lower blood pressure in some people. In people who are “salt sensitive,” limiting sodium to 1500 mg is advisable.

Limited alcohol – A little alcohol (1 drink a day for men and women over 65, or two drinks for men under 65) may actually lower blood pressure slightly. However, more than the 1-2 drinks a day increase blood pressure and can interfere with the effectiveness of blood pressure medications.

Smoking cessation– The nicotine in tobacco smoke narrows the arteries which increases blood pressure.  The effect of nicotine on blood pressure last for about 20 minutes after each cigarette.

Caffeine reduction – Although caffeine doesn’t seem to affect blood pressure in people who regularly drink it, it can does raise it in those who  rarely drink it.

Stress management –

Identify your stress triggers and avoid those you can.
Give yourself time to get things done.
Learn to say no.
Think about problems under your control and make a plan to solve them.
Make time to relax and do things you enjoy.
Breathe – Take 15 to 20 minutes a day to sit quietly and breathe deeply.
Practice gratitude. Expressing gratitude to others can help reduce stressful thoughts.

When lifestyle changes don’t bring blood pressure down to more normal levels, a number of different types of medications can be used.  Below is an explanation of how the different medications types work from theNational Health, Lung and Blood Institute of Health.

  • Diuretics (Water or Fluid Pills):Flush excess sodium from your body, which reduces the amount of fluid in your blood and helps to lower your blood pressure. Diuretics are often used with other high blood pressure medicines, sometimes in one combined pill.
  • Beta Blockers:Help your heart beat slower and with less force. As a result, your heart pumps less blood through your blood vessels, which can help to lower your blood pressure.
  • Angiotensin-Converting Enzyme (ACE) Inhibitors: Angiotensin-II is a hormone that narrows blood vessels, increasing blood pressure. ACE converts Angiotensin I to Angiotensin II. ACE inhibitors block this process, which stops the production of Angiotensin II, lowering blood pressure.
  • Angiotensin II Receptor Blockers (ARBs):Block angiotensin II hormone from binding with receptors in the blood vessels. When angiotensin II is blocked, the blood vessels do not constrict or narrow, which can lower your blood pressure.
  • Calcium Channel Blockers:Keep calcium from entering the muscle cells of your heart and blood vessels. This allows blood vessels to relax, which can lower your blood pressure.
  • Alpha Blockers:Reduce nerve impulses that tighten blood vessels. This allows blood to flow more freely, causing blood pressure to go down.
  • Alpha-Beta Blockers:Reduce nerve impulses the same way alpha blockers do. However, like beta blockers, they also slow the heartbeat. As a result, blood pressure goes down.
  • Central Acting Agents:Act in the brain to decrease nerve signals that narrow blood vessels, which can lower blood pressure.
  • Vasodilators:Relax the muscles in blood vessel walls, which can lower blood pressure.

In order for any of the blood pressure medications to work, they have to be taken as prescribed –  which unfortunately, the above study found many people are not doing. If you are one of these people, talk to your health care provider about why you aren’t taking your medication. If it’s because of side effects, a different type of medication might work for you. If it’s because of the medication cost, perhaps a generic version is available. You and your health care provider need to work together to prevent the consequences of uncontrolled high blood pressure.

September 21, 2016 Published

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