High Blood Pressure Treatment (cont.)
John P. Cunha, DO, FACOEP
John P. Cunha, DO, is a U.S. board-certified Emergency Medicine Physician. Dr. Cunha's educational background includes a BS in Biology from Rutgers, the State University of New Jersey, and a DO from the Kansas City University of Medicine and Biosciences in Kansas City, MO. He completed residency training in Emergency Medicine at Newark Beth Israel Medical Center in Newark, New Jersey.
In this Article
- What is high blood pressure (hypertension)?
- Which lifestyle modifications are beneficial in treating high blood pressure?
- Coffee and caffeinated beverages
- Other dietary considerations
- Exercise and stress reduction
- How is high blood pressure treated?
- Starting treatment for high blood pressure
- Treatment with combinations of drugs for high blood pressure
- Emergency treatment for high blood pressure
- Treatment during pregnancy
- Which medications are used to treat high blood pressure
- Angiotensin converting enzyme inhibitors (ACE inhibitors) and angiotensin receptor blockers
- Beta blockers
- Calcium channel blockers (CCBs)
- Alpha blockers
- Renin inhibitors
- Aldosterone blockers
- Combining agents
- What about the patient's compliance with medication regimens?
- Is alternative medicine used to treat high blood pressure?
- What are the complications of high blood pressure?
- Can high blood pressure be prevented?
- What's new in high blood pressure?
- Find a local Internist in your town
What about the patient's compliance with medication regimens?
When uncomplicated hypertension has not caused symptoms, as often happens, some patients tend to forget about their medications. Patients also tend to fail to take their medications as prescribed (noncompliance or nonadherence) if they cause side effects. These quality of life issues are very important, especially with regard to compliance with prescribed blood pressure medications. Certain antihypertensive medications may cause such side effects as fatigue and sexual impotence which can have profound effects on a patient's quality of life and compliance with treatment. More resistant cases of hypertension that require higher doses of medication may cause more adverse effects, and therefore, less compliance.
In dosing schedules that require taking medication two to four times a day (split dose), some patients will remember to take their medicine only some of the time. In contrast, medications that can be given once daily tend to be remembered more regularly.
Expensive blood pressure medications, especially if insurance does not cover the costs, may also reduce compliance. People attempt to save money by skipping doses of the prescribed medication. The least expensive medication regimes use generic drugs, which are readily available for some of the diuretics and beta blockers. Lifestyle changes such as losing weight, reducing dietary sodium, decreasing consumption of alcohol, and exercising regularly, reduce the need for some medications.
Is alternative medicine used to treat high blood pressure?
Alternative medicine, also called integrative or complementary medicine, features the use of nontraditional (at least in the Western world) techniques for treatment. For example, self-relaxation approaches to the therapy of hypertension include yoga, biofeedback, and meditation. These techniques can be effective in lowering blood pressure, at least temporarily. In order to produce sustained reductions in the blood pressure these techniques may require hours of diligent adherence daily. They are generally practical only for a few highly motivated individuals with hypertension. Acupuncture has not yet been established as a standard or proven therapy for hypertension in the Western world.
Certain herbal remedies have blood pressure-lowering components that may well be effective in treating hypertension. Most herbal remedies are available as food supplements and the Food and Drug Administration (FDA) does not approve them as drugs. Therefore, herbal treatments for hypertension have not yet been adequately evaluated in scientifically controlled clinical trials for effectiveness and safety. In particular, their long-term side effects are unknown. A major problem with most herbal treatments is that their contents are not standardized. The ways in which herbal treatments work to lower blood pressure are not known. For all of these reasons, herbal remedies usually are not recommended for the treatment of hypertension.
As mentioned previously, some supplements, such as garlic and flaxseed have been shown in studies to lower blood pressure. Some small-scale studies have shown that coenzyme Q10 (CoQ10) may lower blood pressure, but further studies are needed. Other home remedies, such as calcium, magnesium, and fish oil have been shown in studies to lower blood pressure. Patients should consult their physicians before taking any supplement or home remedy.
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