“Mainstream medicine would be way different if they focused on prevention even half as much as they focused on intervention…” ~Anonymous. Jay Harold agrees with this quote about the American healthcare system.
What do you do when you have a disease such as high blood pressure? High blood pressure can lead to heart disease, stroke, kidney disease, and death. About 70% of US adults age 65 or older have high blood pressure, and only about half have it under control (less than 140/90 mmHg)1 . Blood pressure medicine (along with a healthy diet and exercise) can protect the heart, brain, and kidneys, but only if patients take it and keep their blood pressure controlled.
However, at least 25% of adults, ages 65 or older, with Medicare Part D prescription drug insurance are not taking their blood pressure medicine as directed. This means they may skip doses or stop taking it altogether. Health care systems, including providers, medical practices, pharmacies, hospitals, community health workers, and insurers are working on systems to improve patient compliance.
The bottom line is that it’s your decision to take high blood pressure medications correctly. Jay Harold has provided a brief description of some high blood pressure medications to help you make an informed decision.
What Drugs are for High Blood Pressure?
If you are an African-American with high blood pressure, The American Medical Association’s Eighth Joint National Committee has put out its recommendations for the different types of medications that you can use as a guide to getting it under control. Please read the Jay Harold article on the New African-American High Blood Pressure Guidelines for additional information. Below is a compiled list of their recommendations for Calcium Channel Blockers (CCB’s), Thiazide Diuretics, ACE Inhibitors, and Angiotensin Receptor Blockers (ARB’s). This is not a complete list of medications!
Calcium Channel Blockers (CCB’s)
Calcium Channel Blockers2 lowers blood pressure by relaxing the blood vessels, so the heart does not have to pump as hard. It controls chest pain by increasing the supply of blood to the heart.
Calcium Channel Blockers (CCB’s) are recommended for first-line use for African Americans by JNC 8. They should be used in combination with Thiazide Diuretics.
Some are listed below by generic name:
- Nifedipine
- Diltiazem
- Amlodipine
- Verapamil
- Nisoldipine
Taking high blood pressure medicines is a way of life for many African-Americans.
- Isradipine
Thiazide Diuretics
Thiazide Diuretics3 are recommended for first-line use for African Americans by JNC 8. They should be used in combination with Calcium Channel Blockers (CCB’s).
Some are listed below by generic name:
- Indapamide
- Chlorthalidone
- Hydrochlorothiazide
- Chlorothiazide
- Metolazone
ACE Inhibitors
ACE inhibitors4 are used to treat heart disease. These medicines make your heart work less hard by lowering your blood pressure. This keeps some kinds of heart disease from getting worse. Most people who have heart failure5 take these medicines.
ACE Inhibitors are used with Calcium Channel Blockers and Thiazide Diuretics for chronic kidney disease and high blood pressure in African Americans.
Some are listed below by generic name:
- Lisinopril
- Ramipril
- Enalapril
- Quinapril
- Captopril
- Benazepril
Angiotensin Receptor Blockers (ARB’s)
Nearly 25% of new prescriptions for blood pressure medicine are never filled.
Angiotensin Receptor Blockers (ARB’s) are used with Calcium Channel Blockers and Thiazide Diuretics for chronic kidney disease and hypertension in African Americans.
Angiotensin receptor blockers6 work by inhibiting the effects of a hormone called angiotensin 2, which produces a number of effects in the body: Constriction of blood vessels, increased salt and water retention, activation of the sympathetic nervous system, stimulation of blood vessel and heart fibrosis (stiffening), and promotion of heart cell growth.
Some are listed below by generic name:
- Losartan
- Valsartan
- Olmesartan
- Candesartan
- Telmisartan
- Irbesartan
Medicines don’t work if people don’t take them
The reasons people don’t take their blood pressure medication as directed vary:
- Not filling the prescription – Nearly 25% of new prescriptions for blood pressure medicine are never filled.
- No symptoms – People with high blood pressure often don’t have symptoms so some may not treat a problem they don’t notice.
- Complexity – People don’t know when to take which pills when they have multiple medicines.
- Side effects – Medicines may have unwanted side effects.
- Forgetting – People forget to take their medicine or refill prescriptions on time.
- Cost – Medicine costs may be too high for some people.
7 Steps to Improve Medication Compliance
- Follow your healthcare team’s instructions on how much medicine to take, how often, and how long to take it.
- Ask questions about how to correctly take your medicine and why you need them.
- Use a blood pressure monitor at home to keep track of your blood pressure between medical appointments.
- Use weekly pill boxes or a mobile app to keep track of when to take medicine.
- Help loved ones take blood pressure medication as directed.
- Ask for 90-day refills and coordinate pill refills for the same date.
- Ask the doctor for generic medicines.
Jay Harold knows that most people dislike taking medications. Difficult decisions sometimes need to be made concerning the health of you or your loved ones. Will the high blood pressure medications reduce my blood pressure? If they do help, will you take them correctly?
Click this link to get free Health and Wealth information to improve your life. Enjoyed this post? Share it and read more here. Questions? “Ask the Pharmacist a Question!” Jay Harold is always looking out for your health and wealth.
Bibliography
- http://www.cdc.gov/vitalsigns/blood-pressure/index.html
- https://medlineplus.gov/druginfo/meds/a692044.html
- https://livertox.nlm.nih.gov/ThiazideDiuretics.htm
- https://medlineplus.gov/ency/patientinstructions/000087.htm
- https://medlineplus.gov/ency/article/000158.htm
- http://circ.ahajournals.org/content/107/24/e215
