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Jay Koovarjee

 92 Pitt St
Sydney NSW 2000
ph: (02) 9221 0091
fax: (02) 9221 0090

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:: In Brief

 

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:: Hypertension
Disease Management - Hypertension
  Disease Management
  Hypertension

When blood pressure stays elevated over time, it is called high blood pressure or Hypertension.

Hypertension or high blood pressure affects almost three million Australians over the age of 25 and can cause serious and irreversible damage. Yet, sufferers can be completely unaware they have a problem.

Over time, raised blood pressure can cause gradual damage to many organs in the body. This damage may be serious and irreversible.  Hypertension is one of the causes of stroke, heart disease, and kidney failure.

It's important that high blood pressure is detected and kept under control. The earlier the age at which it's detected and treated, the less the damage.

Blood pressure levels in adults:

     Disease Management - Blood Pressure
 

Signs & Symptoms:

How do I know if I have high blood pressure?

High blood pressure often runs in families. It's more common in older people and in people who:

  • are obese
  • don't exercise
  • eat a diet high in salt
  • drink a lot of alcohol

If you have certain symptoms, including fatigue, nausea, shortness of breath, lightheadedness, headache, excessive sweating, problems with your vision, or confusion. These may be serious and should warrant prompt medical attention. They could be from uncontrolled hypertension or from medication side effects.

  • Headache
  • Seizure
  • Chest pain
  • Shortness of breath
  • Swelling or edema (fluid buildup in the tissues) 

Medication:

Medicines can control, but do not cure, high blood pressure. Take your blood pressure medication regularly as directed. If you're not sure, ask Your Pharmacist

  • Diuretics - (water pills, eg, Lasix, Aldactone) - increase the kidney's secretion of salt and water, decreasing volume of fluid in the bloodstream and the pressure on arteries
  • Beta Blockers - (eg. Tenormin, Noton, Betaloc) - decrease vigor of the heart's contractions, thereby decreasing the force used to pump blood into arteries. They are also used in patients with congestive heart failure and coronary artery disease - potential side effect - lowers heart rate excessively
  • Calcium Channel Blockers - eg.Cardizem, Isopti, lover blood pressure by decreasing vigor of the heart's contractions while also dilating arteries decreasing resistance to blood flow. New Ca Channel Blockers, eg. Norvasc, Plendil primarily dilate the arteries and have little effect of forcefulness of the heart's contractions. Many of the channel blockers can cause headache and oedema (swelling) in ankles and feet
  • Ace Inhibitors - eg. Zestril, Monopril - decrease resistance to blood flow and have other beneficial effects to congestive heart failure. Approximately 10% of patients develop a non-productive cough
  • ARBs - new class similar to Ace Inhibitors, eg, Atacand, Avapro - do not commonly produce significant side effects

Treatment:

If the blood pressure is elevated (160/100 mm Hg or less), it can often be successfully treated by adopting some lifestyle changes. These include:

  • Maintain a normal weight for your height
  • Exercise regularly. This can help prevent you from becoming overweight or help you in losing pounds if you need to. Exercise also helps keep your heart and blood vessels strong and healthy
  • Eat a healthy diet that includes lots of fruits and vegetables
  • Don't smoke. Smoking and high blood pressure are major risk factors for having a heart attack or stroke later in life
  • Keep your stress levels in check. It may help to practice relaxation techniques such as deep breathing exercises
  • Decrease your sodium (salt) intake. Consuming less sodium has been proven to help lower blood pressure in some people and may prevent some from developing high blood pressure in the first place
  • Avoid drinking too much alcohol, which is associated with high blood pressure
  • Know your blood pressure. Have it checked regularly because, although high blood pressure is more common in adults, hypertension can occur at any age.

     

In about a third of cases this will be enough to bring it back to normal. If not, the next step is for a doctor to prescribe drugs to lower the blood pressure. There's a fairly wide range of drugs available, with differing mechanisms of action. Some relax the heart, others relax the smooth muscles in the small arteries so they widen and allow blood to pass more easily, thus lowering the blood pressure.

One drug is usually given in low dose at first and the dose gradually increased until the blood pressure is brought under control.

Sometimes, another, or several more drugs will need to be added to bring it under control. Finding the right drug, or combination of drugs is a trial and error process.

A drug may produce side effects in some people or may have adverse interactions with other drugs and so may need to be discontinued and another drug substituted. For some people, after a period of months or years, the drug(s) can be stopped, and if the blood pressure stays down, they won't need to be taken again. But more usually, they have to be continued for life.

More Information:

Heart Foundation Australia - www.heartfoundation.com.au
High Blood Pressure Council of Australia  - www.hbprca.com.au

Ask Your Pharmacist about:

  • blood pressure monitors
  • help with giving up smoking

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