Posts Tagged ‘high blood pressure’

HIGH BLOOD PRESSURE PILLS AND OTC’S

By Trevor Shewfelt, Pharmacist at the Dauphin Clinic Pharmacy

 

The moustache is gone.  It went from barely noticeable to itchy over the first two weeks.  Over the next two weeks it started catching food and now it is gone.  My upper lip does feel a little cold and naked, but I wasn’t really happy with how grey my whiskers were coming in anyway.  I was feeling kinda old.  In case you missed Barret’s talk last week and all the hairy lips around town the last month, Movember has just come to an end.  Now we are onto the season of Santa, kid’s Christmas concerts, and eating and drinking too much.   I have to remember to be nice to my wife and be helpful with the kids so the holiday season doesn’t make Doris’s blood pressure go up too much.

 

If you are on high blood pressure pills and the holidays or the holiday parties give you a headache, what medication should you reach for?  Without a prescription, the most common choices in the pharmacy are ibuprofen, naproxen sodium, ASA and acetaminophen.  Let’s look at how they affect blood pressure and blood pressure pills.

 

The safest choice is acetaminophen.  The brand name for acetaminophen is Tylenol.  Acetaminophen won’t make your blood pressure go up.  Acetaminophen is very unlikely to interact with your blood pressure medications.  The only time we really worry about acetaminophen is if a person has liver problems.  Acetaminophen is broken down by the liver so if a person has liver problems it might need to be avoided.

 

If acetaminophen is so safe, why would someone with high blood pressure take anything else?  Acetaminophen treats pain, but doesn’t treat inflammation.  Some headaches have an inflammatory component.  So some people find acetaminophen doesn’t work that well for their headaches.  What about ASA?

 

ASA or aspirin or acetylsalicylic acid treats both pain and inflammation.  Some people find ASA works very well one their headaches.  The downside to ASA is the blood thinning.  Many people on high blood pressure medications are also on blood thinners.  So if they take ASA with their blood thinners, their blood make get too thin and cause bleeding problems.  What else could someone use?

 

Ibuprofen which goes by the brand name Advil or Motrin, and naproxen sodium which goes by the brand name Aleve are called NSAIDs.  NSAIDs or non-steroidal anti-inflammatories are very good at treating pain and inflammation.  They can be very effective for treating headaches.  The problem with NSAIDs is that they can increase your blood pressure.  NSAIDs are more likely to increase your blood pressure if you are older, male, overweight, have diabetes or certain heart, liver or kidney conditions.

 

Now stop panicking.  I know some of you are on blood pressure pills and have taken an NSAID once in a while for a headache already.  That’s okay.  If you take an NSAID for 2-3 days for a headache, a sore tooth or a sore knee, that won’t be a problem.  But if you have to start using an NSAID everyday for a week or more, let your pharmacist or doctor know.  They may want you to monitor your blood pressure to see what is going on.  How much NSAIDs will affect your blood pressure can depend on which blood pressure pill you are on too.  Calcium channel blockers like nifedipine and amlodipine should be the least affected by NSAIDs.  However, if you are on an ACE inhibitor like ramipril or an ARB like telmisartan plus a diuretic like hydrochlorothiazide, you should probably avoid NSAIDs without checking with your doctor first.

 

Just like itchy lips in Movember, headaches during the holiday season are common.  If you have high blood pressure, acetaminophen is the safest way to treat a headache just like shaving December 1st is the best cure for an itchy mustached lip.  During a board meeting of the MS Society we were discussing, with a little envy, how Movember is close to the perfect fund raiser.  Other than a website, there is no overheard like making meals or supplying safety vehicles like we need to do for the MS Bike Tour.  You don’t have to gather all the participants in one place.  For Movember the participants are all over the world.  And all the monetary pledges are done online.  You don’t have to mail out pledge forms, or collect and count money.  The whole Movember idea is just fabulous from a fund-raising point of view.  And it is fun to look like a 70’s adult film star for a month knowing your wife can’t complain.

 

 

As always if you have any questions or concerns about these or other products, ask your pharmacist.  

 

The information in this article is intended as a helpful guide only.  It is not intended to be used as a substitute for professional advice.  If you have any questions about your medications and what is right for you see your doctor, pharmacist or other health care professional.

 

We now have this and most other articles published in the Parkland Shopper on our Website.  Please visit us at www.dcp.ca

Blood Pressure

By Trevor Shewfelt, Pharmacist at the Dauphin Clinic Pharmacy

This summer we were lucky enough to camp at Wellman Lake in the Duck Mountains.  My unruly brood and a few other families were graciously hosted by Chad and Lori Bicklmeier.  We camped in the yard of their cabin.  The weather was beautiful, so we spent our time fishing  and swimming.  My six year old, Eric even got to paddle in the Roncin’s kayak.  He was surprisingly adept and left shore in a big hurry.  Good thing we attached a rope to the kayak so I could reel him back in.  Later in the evening, we sat around the fire, listened to the loons and swapped stories.  Chad told us how a few years earlier they had hosted an exchange student from Hong Kong.  They had brought her up to their cabin at Wellman Lake as well.  When she heard the loons, the Hong Kong exchange student nearly jumped out of her skin.  When Chad finally calmed her down, she told him loon calls were the noises that were always played in Hong Kong horror movies before the killer struck.  Later on Chad got to show her loons swimming around and making their previously terrifying noises.  Seeing the loons in person gave her a new point of view on their calls.

It is fascinating how different people look at the world.  I grew up in Eastern Manitoba and heard lots of loons.  I found their calls to be quite soothing.  As a teenager I used to be able to make a decent loon call with my cupped hands.  Yet this girl from Hong Kong found the loon call terrifying.  It is all about your point of view.  I bet if I told you that there is a 90% chance you will get a condition that will require you to take a medication everyday for the rest of you life, you would be very concerned.  But, from my point of view, I am more concerned that if you don’t treat that condition, you have a greater chance of having a heart attack or a stroke.

About 1 in 5 Canadians has high blood pressure right now.  Over your lifetime, you have a 90% chance of getting high blood pressure.    What is high blood pressure?  Your heart is a pump.  It squeezes blood through pipes we call blood vessels.  These pipes take blood out to the top of your head and the tips of your toes.  The blood does lots of important things, but some of its most important jobs are to get food and oxygen out to all the cells and bring back all the waste and carbon dioxide for disposal.  To get the blood moving through the blood vessels, the heart has to squeeze the blood.  We call this blood pressure.  But you will notice the doctor always talks about two blood pressure numbers.  They will say things like your blood pressure is 125 over 85.  The top number is the amount of pressure the heart has to exert to get the blood through the pipes when it squeezes.  This top number is called the systolic blood pressure.  The amount of pressure left over in the pipes as the heart muscle relaxes is called the diastolic blood pressure.  Unlike the pipes in your house, blood vessels are flexible.  They are designed to expand and contract as pulses of blood go through them.  But, blood vessels can harden and get plugged.  When this happens, the amount of force the heart must exert to get the blood to flow goes up.  This is called high blood pressure or hypertension.  Why should you care about if you get high blood pressure?  Well high blood pressure increases your chance of a stroke, a heart attack, heart failure and kidney disease among other problems.

Blood pressure pills are some of the most common medications we dispense in the pharmacy.  Unfortunately, about 1 in 4 people who are put on blood pressure pills stop taking them within six months.  About 1 in 2 people stop their blood pressure pills within a year of starting them.  It is unfortunate, but understandable why so many people quit their blood pressure pills.  They went to the doctor feeling good.  Their doctor checked their blood pressure, found it was high, and wrote them a prescription for a pill.  In the best case scenario, that pill costs them money every month and they feel no different.  In a worst case scenario, the pill costs them money, and gives them some annoying side effects.  So within six months the patient goes from feeling well to spending money every month on something that makes them feel worse.  Again, no wonder they quit.  But, if you are put on a blood pressure pill, you shouldn’t quit because although high blood pressure doesn’t hurt, if you take that blood pressure pill, you reduce your chance of having a heart attack or a stroke.

So before you accuse me of being my normal pill pushing self, let’s talk about how we can treat high blood pressure without medication.  If you lose weight loss, exercise, and change your diet you can reduce your blood pressure.  Diet changes to reduce blood pressure include reducing the amount of salt, alcohol and high fat dairy you consume, and increasing the amount of fruit and vegetables you eat.  But going back to my drug pushing ways, studies show most people will not be able to lower their blood pressure enough by life style changes alone.  In fact most people with high blood pressure will need at least two different blood pressure pills to get their pressure to target.

I know many people are afraid of taking medications everyday.  They cost money, they can have side effects, and people associate taking pills with being sick.  But, people with high blood pressure don’t feel sick.  I think if you are afraid of taking pills every day, you are afraid of the wrong thing.  If you have high blood pressure and are afraid of taking pills, that like being afraid of loon calls.  You need a new point of view.  If you have high blood pressure, you should be afraid of heart attacks and strokes and do what you can to avoid them.

 

As always if you have any questions or concerns about these products, ask your pharmacist.

We are always looking for new ideas for these articles.  If you have any topic suggestions, please email us at dcp@mymts.net.

The information in this article is intended as a helpful guide only.  It is not intended to be used as a substitute for professional advice.  If you have any questions about your medications and what is right for you see your doctor, pharmacist or other health care professional.

We now have this and most other articles published in the Parkland Shopper on our Website.  Please visit us at www.dcp.ca

Hypertension Canada has developed a website for Canadians with high blood pressure. www.myBPsite.ca

 

Diuretics: Get Rid of the Water

By Barret Procyshyn, Pharmacist at the Dauphin Clinic Pharmacy

After a long winter with lots of snow, there is again water lying everywhere. Creeks are overflowing and worst of all; it is ending up in people’s basements. Just like a farmer can have too much water in the fields, we can have too much water in our bodies. Fluid buildup in the body can contribute to hypertension or high blood pressure. Simply, if you have more water in the pipes you have a higher amount of pressure. Fluid buildup can also occur, most commonly in the feet. Complications can occur with circulatory problems or in diabetic patients.  Fluids can even buildup in the pulmonary area, which can be very dangerous.

Diuretic medications, more commonly known as water pills, are a good treatment option for removing fluid from the body. Diuretic drugs are substances which increase the rate of urination and provide a means of forced diuresis. Simply they force excess fluid out of the body. Diuretics are a first line treatment option for uncomplicated hypertension or high blood pressure. They are inexpensive and very well tolerated. Most importantly they have good data supporting their effectiveness.

Diuretic medications work in the kidney, an organ in our body responsible for filtering our body fluid and forming urine. As blood flows through the kidney it filters water and electrolytes, such as sodium and potassium. Through a filtration process in various loops and tubes, the kidney determines how much water and sodium will be sent out of the body in the urine. A diuretic works by altering how the kidney handles the sodium in our body. If our kidney sends out more sodium into the urine, more water will follow as it is drawn to the sodium.

Several categories of diuretics exist, each with their own specific set of characteristics and a slightly different mechanism of action. However; they all work to increase the excretion of water from bodies, although different diuretics do it in their own distinct fashion.

Furosemide or Lasix belong to a group called loop diuretics. It is very effective in removing excess fluid in the body and does so rather quickly. This drug works by inhibiting the body’s ability to eliminate sodium. Once again, if we force the sodium to stay in the urine, more water will follow it. The sodium and water is removed from the body as urine. Loop diuretics are very powerful and can promote significant sodium loss. In an attempt to save sodium, your body trades potassium for the sodium. For this reason furosemide use often leads to potassium depletion, so patients are often also prescribed potassium supplements. Potassium levels will be monitored closely via blood tests.

Thiazide diuretics are the most common class of diuretics used because of their effectiveness and minimal side effects. Hydrochlorothiazide belongs to this class. Many people who have hypertension take this medication on its own or it is commonly combined with other high blood pressure medications in one pill. Indapamide is another medication found in this class. Thiazide diuretics also cause sodium and potassium loss, but not in the magnitude of loop diuretics.

The third main class of diuretics is potassium sparring diuretics. These diuretics do not cause sodium loss and therefore do not contribute in depleting sodium from the body. However, this does make them a weaker diuretic. Examples of a potassium sparring diuretic are spironolactone and amioloride.

When starting diuretics you may notice their effect are strong at the start and then they seem to weaken. This is normal. Whether you are using a diuretic to help decrease blood pressure or remove excess fluid from the body they all have the same effect; they make you pee. Therefore I recommend taking diuretics in the morning or at least during the early part of the day. No one wants to be up all night using the washroom.

We now have this and most other articles published in the Parkland Shopper on our Website.  Please visit us at www.dcp.ca

The information in this article is intended as a helpful guide only.  It is not intended to be used as a substitute for professional advice.  If you have any questions about your medications and what is right for you see your doctor, pharmacist or other health care professional.

Diuretics: Get Rid of the Water – Audio

By Barret Procyshyn.  Recorded by the nice people at 730 CKDM, The Parkland’s Best Music

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Hypertension – Audio

By Trevor Shewfelt.  Recorded by the nice people at 730 CKDM, The Parkland’s Best Music

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High Blood Pressure

By Trevor Shewfelt, Pharmacist at the Dauphin Clinic Pharmacy

We now have this and most other articles published in the Parkland Shopper on our Website.  Please visit us at www.dcp.ca

The information in this article is intended as a helpful guide only.  It is not intended to be used as a substitute for professional advice.  If you have any questions about your medications and what is right for you see your doctor, pharmacist or other health care professional.

I walked up to the house.  I rang the door bell.  I was there to pick up a girl for our second date.  A woman whom I had never seen before opened the door, and slapped me across the face.  I was shocked and didn’t know what to do.  To this day, my sister-in-law swears there was a mosquito on my face.  Perspective.  It is amazing how a point of view can change how we look at something.

My sister-in-law and I also have different perspectives on our professions.  My sister-in-law is an early childhood educator.  She likes to brag that during early childhood educator awareness week the board of her daycare in Winnipeg buys the workers gifts and spa packages to show the workers their appreciation for all their hard work.  Don’t get me wrong, I think looking after pre-school children would be very hard, and I don’t think I could do it.  But, I think if I told my customers they should start bringing me gifts for Pharmacy Awareness Week (PAW), I think they would go to another pharmacy.  So for Pharmacy Awareness Week, let me give you a gift.  Let’s get some new perspective on high blood pressure.

We all know that having high blood pressure is bad.  It increases your chance of having heart attacks, strokes, kidney disease and a variety of other conditions.  The World Health Organization estimates that 7.1 million deaths a year can be attributed to high blood pressure.  The WHO also says two thirds of strokes and half the cases of ischemic heart disease are caused by poorly controlled high blood pressure. 

The new perspective on high blood pressure lately was in a report released by Stats Canada.  In February 2010 they released a very ambitious survey.  They actually went out and measured the blood pressure of 5600 Canadians between the ages of 6 and 79 years old between March 2007 and February 2009.  This is impressive because most surveys of blood pressure just ask people if they have high blood pressure.  We call that kind of survey self reporting.  Self reporting surveys often underestimate high blood pressure rates.

So what did the Stats Can survey find?  About 1 in 5 of Canadians between 20 and 79 have high blood pressure.  That means their systolic blood pressure was above 140, their diastolic was above 90 or they reported to have used a blood pressure medication in the last month.  Of the people with high blood pressure, one third had blood pressure that wasn’t well controlled.  That means 6.6% of the adult population in Canada or about 1.6 million of us have poorly controlled high blood pressure.  Mothers Against Drinking and Driving ( MADD) Canada estimates that 1600 of us die and 400,000 of us are injured every year from drinking and driving.  That means 4 times as many Canadians are at risk of death and injury from poorly controlled blood pressure than from drinking and driving.  This is where your local pharmacist can help.

If you are over 40 and don’t know what your blood pressure is, run don’t walk to your local pharmacy and have it checked.  If you kinda stopped taking that blood pressure pill a couple of months ago, call your pharmacist.  Maybe we can help figure out a blood pressure pill that will agree with you better and send a recommendation to your doctor.  If you don’t think you need that blood pressure pill, come talk to me.  I can tell you how much fun you can have with half your body paralyzed due to a stroke.

For Pharmacy Awareness Week, come talk to me about your blood pressure.  Let me give you the gift of health information and show you how a new perspective on high blood pressure is better than a slap in the face.

As always if you have any questions or concerns about these or other products, ask your pharmacist.

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