Ask Your Pharmacist

April 11, 2019
Q:

I was diagnosed with high blood pressure and told I’d have to take pills for the rest of my life. I’m only 41 years old, and I feel great so how important is this medication really?

A:

High blood pressure (hypertension) has been referred to by some as “the silent killer” for just the reason you’ve mentioned. You may feel perfectly well, and even if you choose not to take medication, you will continue to feel fine. But what you won’t feel is the damage that high blood pressure is causing over time inside your body. Let’s talk about what is really happening inside your body when your blood pressure is high and what the long-term and short-term complications of this can be. Then, we can discuss what you can do to help lower your blood pressure and improve your heart health and how medication can assist with that.

You may not feel any different on a blood pressure medication, but your heart and blood vessels are feeling the relief of lower blood pressure. Think of your heart as the muscle that acts as a pump that sends blood containing nutrients and oxygen to every cell in the body. Sound easy? There are 37 trillion cells in your body. Blood is pumped through the vascular system (arteries, veins, etc.) like pumping water through a hose. In healthy individuals, the heart can comfortably perform its job, but there are situations where blood flows less easily through the vasculature, which increases the amount of pressure the heart has to generate to keep blood flowing. Your heart does this by beating faster or contracting harder. This leads to two problems. The extra pressure can damage the blood vessels, making the problem worse or even rupture an artery causing hemorrhagic stroke. With the extra work required, the next problem is the heart muscle grows to become stronger (ventricular hypertrophy). As a result, it requires more oxygen to keep pace. If the heart does not get the oxygen It needs, heart cell tissue can be damaged in the form of a heart attack. Also, over time, the muscle can become too large to contract properly, resulting in heart failure, meaning only a fraction of the blood that enters the heart is pumped out.

Generally, this is what can occur long term by ignoring elevated blood pressure. Many other factors come into play such as genetics, cholesterol and cardiovascular strength (gained from regular exercise). Other factors such as stress, caffeine, nicotine, alcohol and medication send hormonal signals to the heart to pump faster, increasing blood pressure. These are areas over which you have some control to improve blood pressure and heart health. Other medical conditions like diabetes, vascular disease, cholesterol deposits, varicose veins, and obesity can increase the resistance to flow and increase the volume of blood required to fuel the body, requiring the heart to pump with more physical force.

I think patients who have a better understanding of what elevated blood pressure can cause unknowingly over time are more apt to take the medication as prescribed. It is important for patients to take their medications at the prescribed dose and frequency. Taking a daily medication every second day may not provide the desired effect as the drug is likely not in the system at a high enough level to provide the intended effect after 24 hours. This rule applies to almost any medication, including blood pressure medication. Be sure to speak to your pharmacist if you have questions about your medication. If you take several medications, you may benefit from a medication review to help give you a better understanding of what benefits they provide (ex. prevent heart attack) and the best way to take your medications.

Jared Mactavish (BSc., Pharm) is a pharmacist in Hampton and St. Stephen. His opinions expressed in this newspaper are published for educational and informational purposes only, and are not intended as a diagnosis, treatment or as a substitute for professional medical advice, diagnosis or treatment. Send your questions to AskYourNBPharmacist@gmail.com.