The major types of medication used to control high blood pressure include:
Thiazide diuretics. These water pills act by removing the excess water and salt from the body. These drugs are the first line for treatment of high blood pressure; they are cheap, effective and have minimal side effects. In the majority of individuals are very effective and should be the first line drugs of choice.
Beta blockers. These medications act by decreasing the work of the heart and dilating (opening) up the blood vessels. They have been around for more than 50 years. Unfortunately, they are not very effective in African Americans but otherwise work in all ethnic groups. The side effects include decreased libido and glucose intolerance.
Angiotensin-converting enzyme (ACE) inhibitors. These drugs have today become the gold standard and are very effective in the treatment of high blood pressure. They also protect the heart and are useful in all groups of patients. They are useful in individuals with diabetes, heart failure or those who have angina (chest pain). They are readily available but some are expensive and do have a tendency to produce a persistent dry cough.
Angiotensin II receptor blockers. These latest medications open up the blood vessels and decrease the blood pressure. However they are very expensive and are not first line treatment. They are to be used in individuals who do not respond to the other drug treatments. Some clueless physicians routinely prescribe these drugs as first line therapy for hypertension.
Calcium channel blockers. These drugs have been around for many years and work well in African Americans. They are very effective in the treatment of blood pressure. They are reasonably priced but should not be used in patients with a weak heart. They do tend to cause swelling in the feet.
Renin inhibitors. These are the latest drugs available to treat blood pressure. They act by inhibiting a chemical (renin) which is known to cause high blood pressure. The new drug, Tekturna (aliskiren) is a renin inhibitor. The drug is very expensive and is not a first line drug. The drug is most effective when used in combination with other drugs.
Alpha blockers. These medications have been around for decades but are rarely used to treat high blood pressure because of their side effects
Central-acting agents. There are some medications which act in the brain to decrease the nerve impulses to the blood vessel. They are quite effective in decreasing blood pressure and widely used (e.g. clonidine, Aldomet)
Vasodilators. There are a variety of medications which can open up narrowed blood vessels and decrease blood pressure. These medications are often used intravenously in the ICU for emergent use in the treatment of hypertension.
Once your blood pressure is under control, your doctor may add aspirin and/or a medication to lower your cholesterol to your regimen to further decrease the risk of a heart attack.
Resistant hypertension
In some cases, high blood pressure may be resistant to a single drug and a combination of 2-3 drugs may be required. Many of these combination therapies are done on a trial and error basis. In some cases, the individual will be referred to a heart specialist who deals with blood pressure treatment.
FOR more on blood pressure monitoring devices, please visit www.medexsupply.com
Tuesday, June 30, 2009
How is high blood pressure treated? part 1
Once the diagnosis of high blood pressure is made, it is important to start treatment even if one has no symptoms. Because there are no symptoms, many individuals delay treatment and then it is too late to reverse any of the complications. The treatment is life long.
Blood pressure goals aren't the same for everyone. Although everyone should strive for blood pressure readings below 140/90, doctors recommend lower readings for people with certain conditions.
Blood pressure treatment goals
140/90- for the health adult
130/80- for those with chronic kidney disease, diabetes or heart disease
120/80- for those with a weak heart
Drug treatment
The treatment of hypertension is straightforward. Over the last three decades various guidelines have been established. There are also numerous types of drugs used to treat hypertension and which drug the physician selects is based on his/her experience. For most individuals, a single drug may suffice, and in others multiple drugs may be required to control the blood pressure.
Blood pressure goals aren't the same for everyone. Although everyone should strive for blood pressure readings below 140/90, doctors recommend lower readings for people with certain conditions.
Blood pressure treatment goals
140/90- for the health adult
130/80- for those with chronic kidney disease, diabetes or heart disease
120/80- for those with a weak heart
Drug treatment
The treatment of hypertension is straightforward. Over the last three decades various guidelines have been established. There are also numerous types of drugs used to treat hypertension and which drug the physician selects is based on his/her experience. For most individuals, a single drug may suffice, and in others multiple drugs may be required to control the blood pressure.
Monday, June 29, 2009
How do i treat my high blood pressure? part 2
Avoid stress. For those with high stress, one should try and avoid or decrease the stress levels. Rest, relax and exercise.
Coping skills
There is no cure for high blood pressure and thus life long treatment is required. To help cope with the management of blood pressure, one should do the following:
Home blood pressure monitoring. This is useful tool for home use and one can monitor the treatment and see if the medications are working.
Take the medications regularly. Do not skip medications, sometimes rebound hypertension can occur.
See the doctor regularly. At least once a year, see your physician and get your blood pressure measured and make sure that it is well controlled.
Hypertension is not a fun disorder; it has no symptoms and yet requires life long treatment and there are a lot of Dos and Don’ts associated with this disorder. Many people question why they have to take drugs if they do not have any symptoms plus the medications can be expensive. But on the plus side, well controlled blood pressure will add years to your life. On the negative side, one may end up with one eye, have a weak heart, remain with one kidney and be demented- the choice is very simple- you better take the medications as prescribed and quit complaining.
for more on blood pressure devices, please visit www.medexsupply.com
Coping skills
There is no cure for high blood pressure and thus life long treatment is required. To help cope with the management of blood pressure, one should do the following:
Home blood pressure monitoring. This is useful tool for home use and one can monitor the treatment and see if the medications are working.
Take the medications regularly. Do not skip medications, sometimes rebound hypertension can occur.
See the doctor regularly. At least once a year, see your physician and get your blood pressure measured and make sure that it is well controlled.
Hypertension is not a fun disorder; it has no symptoms and yet requires life long treatment and there are a lot of Dos and Don’ts associated with this disorder. Many people question why they have to take drugs if they do not have any symptoms plus the medications can be expensive. But on the plus side, well controlled blood pressure will add years to your life. On the negative side, one may end up with one eye, have a weak heart, remain with one kidney and be demented- the choice is very simple- you better take the medications as prescribed and quit complaining.
for more on blood pressure devices, please visit www.medexsupply.com
How should I manage my high blood pressure? part 1
Compliance
The major problem with the treatment of hypertension is that because individual has no symptoms, he/she refuses to take the medications. Compliance with blood pressure medications is a difficult problem and it is important for the individual to understand the importance of treatment. One may skip a day, but routine skipping of blood pressure medications is only waiting for a disaster to happen.
Self-care
Changes in lifestyle are not only a key to improving blood pressure, but are important for general good health. In addition to losing weight, one should make efforts to control the blood sugar, stop smoking, live an active life style and eat well.
Eat healthy. One should eat healthy and change the diet from eating too much meat to a more vegetable oriented diet. Limiting salt may help some individuals in the control of blood pressure.
Maintain a healthy weight. Make efforts to lose weight. Obesity is associated with other problems besides hypertension also.
Exercise: “Couch potatoes” better move along. Inactivity leads to higher blood pressure and worsens obesity.
Don't smoke. This is the ultimate taboo for many medical disorders. One should try to stop smoking. There are no magical drugs to help one quit smoking- cold turkey is still the best treatment.
The major problem with the treatment of hypertension is that because individual has no symptoms, he/she refuses to take the medications. Compliance with blood pressure medications is a difficult problem and it is important for the individual to understand the importance of treatment. One may skip a day, but routine skipping of blood pressure medications is only waiting for a disaster to happen.
Self-care
Changes in lifestyle are not only a key to improving blood pressure, but are important for general good health. In addition to losing weight, one should make efforts to control the blood sugar, stop smoking, live an active life style and eat well.
Eat healthy. One should eat healthy and change the diet from eating too much meat to a more vegetable oriented diet. Limiting salt may help some individuals in the control of blood pressure.
Maintain a healthy weight. Make efforts to lose weight. Obesity is associated with other problems besides hypertension also.
Exercise: “Couch potatoes” better move along. Inactivity leads to higher blood pressure and worsens obesity.
Don't smoke. This is the ultimate taboo for many medical disorders. One should try to stop smoking. There are no magical drugs to help one quit smoking- cold turkey is still the best treatment.
Sunday, June 28, 2009
Risk factors for high blood pressure: part 2
Modifiable risk factors:
- Obesity: if there is one risk factor which worsens
hypertension, it is weight gain. The excess weight
means that the heart has to work much harder to pump
blood around the body. By decreasing weight, blood
pressure can be significantly decreased. Weight loss
is one key factor which can help reduce high blood pressure
- Non active lifestyle: Individuals who are not active
or couch potatoes generally tend to develop higher heart
rates and high blood pressure. Physical inactivity also
increase weight and is generally not a recommended life style
goal.
- Smoking is the universal factor for most health problems.
If people stopped smoking, more than 50% of the physicians
would be out of a job. Smoking is bad not only for the
blood vessels, but bad for health in general
- Sodium intake. For some individuals too much intake of salt
(sodium) may cause an increase in blood pressure. Salt
causes water retention which in turn causes an increase
in body fluids. Even though salt induced high blood pressure
is rare, one should avoid too much salt
- Stress is known to be associated with high blood pressure.
Most individuals have different levels of stress and should
try and avoid it.
- Medical conditions: Certain chronic conditions also may
increase your risk of high blood pressure, including high
cholesterol, diabetes, kidney disease and sleep apnea.
- Pregnancy: In some females the blood pressure may increase
during the later part of the pregnancy (eclampsia). This is
a serious condition which needs urgent treatment. The blood
pressure resolves after delivery of the infant
To lower blood pressure, one should make an attempt to lose weight. With weight loss one can also have a lowering of blood sugars and cholesterol. Finally, cessation of smoking is highly recommended. Besides saving you money, quitting smoking will give you a new lease on life.
for more on supplies for monitoring your blood pressure, please visit www.medexsupply.com
- Obesity: if there is one risk factor which worsens
hypertension, it is weight gain. The excess weight
means that the heart has to work much harder to pump
blood around the body. By decreasing weight, blood
pressure can be significantly decreased. Weight loss
is one key factor which can help reduce high blood pressure
- Non active lifestyle: Individuals who are not active
or couch potatoes generally tend to develop higher heart
rates and high blood pressure. Physical inactivity also
increase weight and is generally not a recommended life style
goal.
- Smoking is the universal factor for most health problems.
If people stopped smoking, more than 50% of the physicians
would be out of a job. Smoking is bad not only for the
blood vessels, but bad for health in general
- Sodium intake. For some individuals too much intake of salt
(sodium) may cause an increase in blood pressure. Salt
causes water retention which in turn causes an increase
in body fluids. Even though salt induced high blood pressure
is rare, one should avoid too much salt
- Stress is known to be associated with high blood pressure.
Most individuals have different levels of stress and should
try and avoid it.
- Medical conditions: Certain chronic conditions also may
increase your risk of high blood pressure, including high
cholesterol, diabetes, kidney disease and sleep apnea.
- Pregnancy: In some females the blood pressure may increase
during the later part of the pregnancy (eclampsia). This is
a serious condition which needs urgent treatment. The blood
pressure resolves after delivery of the infant
To lower blood pressure, one should make an attempt to lose weight. With weight loss one can also have a lowering of blood sugars and cholesterol. Finally, cessation of smoking is highly recommended. Besides saving you money, quitting smoking will give you a new lease on life.
for more on supplies for monitoring your blood pressure, please visit www.medexsupply.com
What are risk Factors for high blood pressure?
High blood pressure is common in our society. Some individuals have a number of risk factors that increase the risk of developing high blood pressure. The risk factors that may influence blood pressure are categorized into either modifiable or non modifiable.
Not Modifiable Risk Factors
- Age. Blood pressure will occur once all individuals
reach a certain age. Men tend to develop high blood
pressure much earlier than female, but by the 6/7th
decade of life, most elderly people have some degree
of hypertension.
- Race. High blood pressure is particularly more common
among blacks, and occurs at a much earlier age compared
to Caucasians. Serious complications, such as stroke
and heart attack, also are more common in blacks.
- Family history. High blood pressure is more common in
families with a history of hypertension.
Not Modifiable Risk Factors
- Age. Blood pressure will occur once all individuals
reach a certain age. Men tend to develop high blood
pressure much earlier than female, but by the 6/7th
decade of life, most elderly people have some degree
of hypertension.
- Race. High blood pressure is particularly more common
among blacks, and occurs at a much earlier age compared
to Caucasians. Serious complications, such as stroke
and heart attack, also are more common in blacks.
- Family history. High blood pressure is more common in
families with a history of hypertension.
Sunday, May 17, 2009
Do I need a pacemaker?
The world of pacemakers is quiet complex. Some people develop abnormal heart rhythms- the heart may suddenly go fast or too slow. When the heart rate is fast, one can take medications. However, when the heart rate is too slow, there are no medications that can be used on a daily basis at home. Slow heart rate can be treated in a hospital setting with intravenous drugs. There is no pill that can effectively increase heart rate.
So now, we have pacemakers. There are many types of pacemakers and they can cost anywhere from $8,000-$30,000. The type of pacemaker you need is determined after studies on your heart. Pacemakers are life saving. The procedure to insert a pacemaker is very simple and rarely takes more than 30-45 minutes (unless your doctor is incompetent). The procedure can be done under local anesthesia and is not painful at all. It involves placing a small thin wire (electrode) in one of the chambers of your heart. The procedure is always done using x rays to ensure that the electrode is inserted into the correct anatomical position. Then a miniature pacemaker (about the size of a credit card) is inserted beneath the skin in the chest. The electrode is then connected to the pacemaker. The pacemaker is programmed and you are all set. Today, pacemakers have saved countless lives and work well for 7-12 years. Only the battery needs to be changed every 5-10 years.
Pacemakers can be inserted at any age and the risks are minimal. In the past, there have been a few doctors who allegedly have inserted pacemakers for trivial reasons (like making more money). Today, there are strict Medicare rules on who can receive a pacemaker. If you have been told by your physician you need a pacemaker, discuss the issues with a cardiologist (heart doctor). After a pacemaker, you will definitely notice a difference in your overall health.
So now, we have pacemakers. There are many types of pacemakers and they can cost anywhere from $8,000-$30,000. The type of pacemaker you need is determined after studies on your heart. Pacemakers are life saving. The procedure to insert a pacemaker is very simple and rarely takes more than 30-45 minutes (unless your doctor is incompetent). The procedure can be done under local anesthesia and is not painful at all. It involves placing a small thin wire (electrode) in one of the chambers of your heart. The procedure is always done using x rays to ensure that the electrode is inserted into the correct anatomical position. Then a miniature pacemaker (about the size of a credit card) is inserted beneath the skin in the chest. The electrode is then connected to the pacemaker. The pacemaker is programmed and you are all set. Today, pacemakers have saved countless lives and work well for 7-12 years. Only the battery needs to be changed every 5-10 years.
Pacemakers can be inserted at any age and the risks are minimal. In the past, there have been a few doctors who allegedly have inserted pacemakers for trivial reasons (like making more money). Today, there are strict Medicare rules on who can receive a pacemaker. If you have been told by your physician you need a pacemaker, discuss the issues with a cardiologist (heart doctor). After a pacemaker, you will definitely notice a difference in your overall health.
Saturday, May 16, 2009
Is dark chocolate good for the heart?
For lovers of chocolates there is good news. Yes, dark chocolates are good for you in small amounts. There have been several small studies showing that eating dark chocolates may actually have benefits for the body. It is believed that dark chocolates made from cocoa are known to contain flavnoids- which are potent anti oxidants. In these studies, individuals were who given a very small piece of dark chocolate everyday developed a persistent drop in blood pressure.
So should consumers start to consume dark chocolates? Well, there have only been a few such studies and the numbers of individuals followed have been minuscule. The field of medicine is known for its ability to hype up news about everything positive- negative news is always hidden.
One should always be aware that eating too many chocolates can lead to excess sugars, weight gain and an increase in blood pressure. Further, dark chocolates have been consumed in some European countries for decades and citizens in these nations still develop high blood pressure and serious heart disease. Individuals who have high blood pressure should not chuck their blood pressure medications yet. No chocolate has been found to be a replacement for the conventional blood pressure medications.
If you really want to control your blood pressure better, try walking and reduce your weight. Eat a healthy diet and avoid too much of everything. This approach is safe, cheap, and free of side effects.
So should consumers start to consume dark chocolates? Well, there have only been a few such studies and the numbers of individuals followed have been minuscule. The field of medicine is known for its ability to hype up news about everything positive- negative news is always hidden.
One should always be aware that eating too many chocolates can lead to excess sugars, weight gain and an increase in blood pressure. Further, dark chocolates have been consumed in some European countries for decades and citizens in these nations still develop high blood pressure and serious heart disease. Individuals who have high blood pressure should not chuck their blood pressure medications yet. No chocolate has been found to be a replacement for the conventional blood pressure medications.
If you really want to control your blood pressure better, try walking and reduce your weight. Eat a healthy diet and avoid too much of everything. This approach is safe, cheap, and free of side effects.
Tuesday, May 12, 2009
I was told to take antibiotics before my dental cleaning, Why? part 2
Now the American Heart Association has come up with new guidelines and recommend a short-term course of antibiotics only for individuals who are at a high risk for developing a bacterial infection of the valves. These include people with:
- A mechanical prosthetic heart valve
- Natural prosthetic heart valves obtained from animals
or cadavers
- Valve repair using prosthetic material
- A prior history of infective endocarditis
- Most congenital (from birth) heart abnormalities,
even if the abnormality has been repaired
Individuals who are at low risk and do not require antibiotics include the following?
- Those with innocent heart murmurs
- Mitral valve prolapse without regurgitation
or valvular leaflet thickening
- Mild tricuspid regurgitation
- Individuals with Coronary artery disease or
those who have undergone bypass surgery
- Simple atrial septal defect (hole in the heart)
- Individuals who undergo angioplasty or ballooning
of their coronary vessels
- Those with prior history of rheumatic fever but
normal valves
- Those who have pacemakers or other similar devices
In the low risk group, it is now believed that antibiotics are unnecessary and may cause more health problems such as allergies.
Individuals who are at risk of developing infective endocarditis should maintain good oral and dental hygiene. This may include a visit to the dentist for a check up, regular tooth brushing and use of dental floss. These preventive measures can prevent plaque-forming bacteria from sticking to your gums and teeth
- A mechanical prosthetic heart valve
- Natural prosthetic heart valves obtained from animals
or cadavers
- Valve repair using prosthetic material
- A prior history of infective endocarditis
- Most congenital (from birth) heart abnormalities,
even if the abnormality has been repaired
Individuals who are at low risk and do not require antibiotics include the following?
- Those with innocent heart murmurs
- Mitral valve prolapse without regurgitation
or valvular leaflet thickening
- Mild tricuspid regurgitation
- Individuals with Coronary artery disease or
those who have undergone bypass surgery
- Simple atrial septal defect (hole in the heart)
- Individuals who undergo angioplasty or ballooning
of their coronary vessels
- Those with prior history of rheumatic fever but
normal valves
- Those who have pacemakers or other similar devices
In the low risk group, it is now believed that antibiotics are unnecessary and may cause more health problems such as allergies.
Individuals who are at risk of developing infective endocarditis should maintain good oral and dental hygiene. This may include a visit to the dentist for a check up, regular tooth brushing and use of dental floss. These preventive measures can prevent plaque-forming bacteria from sticking to your gums and teeth
I was told to take antibiotics when I go for dental cleaning, WHY?
Bacteria thrive in the oral cavity. During dental cleaning, these bacteria are often released and can easily enter the blood stream. This is a common occurrence. In normal people, this is of no consequence. However, there are some individuals who have a deformed heart valve, a congenital heart problem, a hole in the heart or some type of heart defects- for reasons not understood, bacteria, which are released from the mouth, can move, and attach themselves to heart valves.
The valves are like a magnet and attract these bacteria. Once the bacteria stick to valves, they set about an inflammatory process and gradually destroy the valve. This is known as infective endocarditis. Therefore, all individuals who have heart valve defects are advised to take antibiotics prior to any procedure that will release bacteria into the blood stream.
However, there have been many studies of showing that antibiotics do not always prevent infective endocarditis. Other studies reveal that antibiotics may not be required for all individuals with heart problems.
The valves are like a magnet and attract these bacteria. Once the bacteria stick to valves, they set about an inflammatory process and gradually destroy the valve. This is known as infective endocarditis. Therefore, all individuals who have heart valve defects are advised to take antibiotics prior to any procedure that will release bacteria into the blood stream.
However, there have been many studies of showing that antibiotics do not always prevent infective endocarditis. Other studies reveal that antibiotics may not be required for all individuals with heart problems.
Monday, May 11, 2009
Can I double up my dose of statin when I miss a dose?
Most people forget to take their medications at some point in their lives. In most cases, nothing really happens. Statin are drugs used to lower your cholesterol and have to be taken for many years, perhaps lifelong. Therefore, it is understandable if a dose is missed occasionally.
However, if a medication is missed for any reason, doubling up is not a great idea. Statins are generally very safe drugs and most individuals are prescribed low doses. Therefore, if you miss a dose of statin on a single day, it will not do you any harm. Statins do not work immediately and their benefits are derived over many months. In any case, to be on the safe side, do not double up the dose if you miss a pill. Nothing will happen and rest assured you will not get clogged up vessels by missing a single pill.
There are many drugs that can cause serious side effects if the dose is doubled up.
Overall statins are very safe and one can even miss a couple of days with no harm. However, that does not mean that you should continue with this erratic drug compliance. For best benefit of statins, one should take the pill everyday. If you routinely miss taking your statin, then use a calendar, a visual reminder, an automatic pill dispenser or get someone in the family to remind you. If you do not want to take the drug, talk to your health care provider and get your cholesterol levels rechecked. One of the best ways to reduce cholesterol levels is by changes in diet and exercise- and this is where you should have started in the first place.
However, if a medication is missed for any reason, doubling up is not a great idea. Statins are generally very safe drugs and most individuals are prescribed low doses. Therefore, if you miss a dose of statin on a single day, it will not do you any harm. Statins do not work immediately and their benefits are derived over many months. In any case, to be on the safe side, do not double up the dose if you miss a pill. Nothing will happen and rest assured you will not get clogged up vessels by missing a single pill.
There are many drugs that can cause serious side effects if the dose is doubled up.
Overall statins are very safe and one can even miss a couple of days with no harm. However, that does not mean that you should continue with this erratic drug compliance. For best benefit of statins, one should take the pill everyday. If you routinely miss taking your statin, then use a calendar, a visual reminder, an automatic pill dispenser or get someone in the family to remind you. If you do not want to take the drug, talk to your health care provider and get your cholesterol levels rechecked. One of the best ways to reduce cholesterol levels is by changes in diet and exercise- and this is where you should have started in the first place.
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