I am Dr.John from Think Your Health.This video is part 4 in a series on blood pressure.
If you are interested in a playlist to catch up on the previous videos, click right here.
The first looks at how health care providers choose a blood pressure medication depending
on your medical history and co-morbidities.
There are multiple blood pressure medications and different classes.
Beta blockers, ACE-inhibitors, diuretics, combinations pills, alpha blockers, calcium
channel blockers, angiotensin 2 receptor blockers, central agonists, renin inhibitors, aldosterone
antagonists, vasodilators….
Even I am getting confused.
With all that around there …. What is the right medication for you?
Remember a medication that works for your friend, let’s call her Susan might not be
the right medication for you.
You are saying the medication really works
for Susan and I want a piece of that blood pressure
goodness.
Not so fast it is not as simple as that.
When health care providers prescribe blood pressure medications here are some of the
factors they consider: 1) Age
2) Gender 3) General overall health
4) Underlying co-morbidities 5) Falls & balance
6) Blood pressure medications you have tried in the past.
7) Possible drug -drug interactions with other medications you are on.
8) Even your race.
Patients with an African heritage on Lisinopril, an ACE-inhibitor, have an increased risk of
angioedema compared to non-Africans and increased risk of stroke.
9) One other factor to mention are side effects.
Any medication has side effects, and blood pressure medications are no exception.
Partner with your health care provider to lessen side effects or even switch to a different
class of medication if side effects can’t be tolerated.
My next video will look at the 5 most prescribed blood pressure medications including their
side effects.
Having said all this the most important thing you can do…please come in closer…even
closer.
Not that close.
Ok are you ready for it.
Lifestyle changes.
Yes, as I have preached in numerous other videos on my channel losing weight, giving
up on vices such as smoking, healthy nutritional choices and exercise.
Yes, you need to move.
I am not asking you do run a marathon just move, go for a walk.
It will up your energy level and you will feel better.
Stay active at least 30 minutes a day at least 5 days a week.
Oh yes, limit the amount of alcohol you drink.
For women not more than a drink a day, men not more than 2 a day.
Here are some examples of the thinking process
a health care provider will take into consideration
before prescribing you a blood pressure medication.
If your provider thinks he can not only treat your medical condition but another condition
you have let’s say diabetes this will determine their choice of medication.
For example, your provider might have placed you on an ACE-inhibitor like Lisinopril because
you are a diabetic and you are losing protein in your urine.In this way your provider is
not only treating your high blood pressure but using the “feature” of Lisinopril
to help with a diabetes complication.
Ace-inhibitors are also recommended after
a heart attack or with congestive heart failure.But
if your kidney parameters are suddenly worsening on this medication your Doctor might want
to switch you to some other class of medication.
Beta blockers such as Metoprolol are often used by providers after a heart attack or
with congestive heart failure.They are also used if you have a very fast heart rate or
an irregular heart rate called atrial fibrillation.
You might be telling your health care provider that you have chest pain related to your coronary
artery disease (also referred to as angina).
Your doctor might choose a beta blocker not only to help your chest pain, but treat your
blood pressure and reduce your heart rate.
All of these have been associated with decreasing your mortality risk.
However, if you also have COPD, peripheral vascular disease or glucose intolerance beta
blockers might not be the best choice as the 3 disease entities I described can be exacerbated.
Unfortunately, sometimes your health care providers
hands might be tied up and they might consider that the benefits of beta blockers outweigh
some potential clinical risks.
Thiazide diuretics such as HCTZ are used especially
in isolated systolic hypertension in older
adults as well as with patients of African descent.
The same considerations are given with calcium channel blockers such as Diltiazem.
So as you can see when choosing a blood pressure medication its not as simple as ABC as a lot
videos on each medication.
• Here is a video looking at how to treat
blood pressure without medications and this is a video on the most common blood pressure
symptoms.
Think your health and your blood pressure. •
•