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Medications and Diet for Hypertension

Posted Aug 24 2008 1:49pm
ANNOUNCER: If you've been diagnosed with high blood pressure, also known as hypertension, you're not alone

SUZANNE HUGHES, MSN, RN: In the summer of 2004, we saw the release of new data that told us that what we previously knew was the number of Americans with hypertension, 50 million, had risen to 65 million since the last reporting period. So we know now that one out of every three adult Americans has hypertension or high blood pressure, which is a risk factor not only for heart disease, but, importantly, for stroke.

ANNOUNCER: As blood pressure rises, the risk of developing adverse cardiovascular conditions increases, so it's important to control high blood pressure immediately to avoid further complications. Fortunately, there are many treatment options available to help get your blood pressure back on track.

SUZANNE HUGHES, MSN, RN: There are certain lifestyle changes one can make, particularly in the early stages of prehypertension, that might be able to lower the blood pressure adequately enough to not even require medication, and these would be following what we call the DASH diet. DASH stands for Dietary Approaches to Stop Hypertension. It's a diet that's very high in fruits and vegetables, it's low in fat, and it also has two to three servings per day of low-fat dairy products. That, combined with lowering the sodium in the diet, can make a big difference in the blood pressure.

Also, adherence to the recommendations of 30 minutes of exercise every single day can also make a nice difference in the blood pressure.

Very important that people with hypertension or pre-hypertension absolutely avoid tobacco products. And if they do choose to drink alcohol, that that be kept to one drink per day for women and two drinks per day for men.

Now, should lifestyle measures alone not be enough to normalize blood pressure, medication may indeed be necessary.

The good news is, we have a wonderful, large armamentarium of medications now that lower blood pressure. We do know, however, that if one has hypertension, it will require an average of 2.7 medications to get that blood pressure to normal. And that surprises a lot of people. A lot of people will be started on a blood pressure medication, go back and follow up with their physician maybe a few weeks or months later and find out that that one medicine alone isn't enough, and then another medication is introduced. And I think sometimes patients perceive that that's a failure on their part or on their health care provider's fault, when at the outset we know that it may indeed require several medications.

When several medications are used, each of those medications can be then used in smaller doses, which helps to minimize the side effects.

A very important group of medications to lower blood pressure are diuretics, and these are medications that lower blood pressure by kind of lowering the circulating fluid volume in the body. These are very important, and in many cases, when there's more than one medicine needed, a diuretic will be one of those.

A second important group of medications are the beta blockers. These are particularly important in a group of patients that have already suffered from a heart attack. They're very important players in our toolbox against hypertension.

We also have what we call the calcium channel blockers, a group of medicines that actually work on the arterial wall to relax the wall and drop the blood pressure.

We have a group of medications called the angiotensin converting enzyme inhibitors -- a big name -- the ACE inhibitors that lower blood pressure.

And we also have the angiotensin receptor blockers, or the ARBs group. So those are kind of the main groups of medications that lower blood pressure.

And what your particular health care provider may choose to use in your case can be dictated by several different things, whether or not you have diabetes, whether you've already had a heart attack or heart disease. Sometimes whether you're a man or a woman, what age you are, what race you are. So all these things kind of play in. But we do know that the actual lowering of the blood pressure, no matter what agent, has profound impact on the development of heart attack, on the prevention of stroke, as well as the prevention of heart failure.

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