The importance of maintaining a "normal" blood pressure

Sep 17, 2019

By Trevor Shewfelt, Pharmacist at the Dauphin Clinic Pharmacy

It seemed like a good idea at the time. I've been riding my bike all summer. I climbed hills for the MS Bike tour. Why not see what the new mountain bike trails around the Countryfest site were like? I got Kirk Nyquist to take me and his son Michael on a tour of the newly designed trails. Before I go any further, kudos to all the volunteers who cleared bush etc. to make the trails. They are very pretty. At the trail head, it was harder than I thought. Lots of tight turns around rocks and trees. Then some very steep but short descents. But I was being careful. However, about a quarter of the way through, we crossed a creek on a low plank bridge.

I bet you can predict where my trail riding tour is headed. In turn, I can predict where your blood pressure is headed. Over your life time, you have a 90% chance of developing high blood pressure before you die. High blood pressure is so common, this one disease has a significant impact on our national health spending. Weaver et. Al published a study in the July 2015 Hypertension showing Canada spends about 10% of its health care budget on high blood pressure and its consequences. In 2010 that was $13.9 billion dollars. By 2030 that could be $20 billion.

About 1 in 5 Canadians has high blood pressure right now. 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. You will notice the doctor always talks about two blood pressure numbers. They will say things like they want your blood pressure less than 140/90. 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 if you get high blood pressure? Well high blood pressure increases your chance of stroke, 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 should give it a chance, because although high blood pressure doesn't hurt a stroke or heart attack does.

How we can treat high blood pressure without medication? If you lose weight, exercise, and change your diet you can reduce your blood pressure. If you lose 10 kg or 22lbs, you can reduce your blood pressure by about the same amount as being on one blood pressure pill. Diet changes to reduce blood pressure include reducing the amount of salt, alcohol and saturated fats you consume. You should also increase the amount of fruit and vegetables you eat. If you reduce your salt intake to less than about 1 teaspoon per day, that can also reduce your blood pressure by about the same as adding one blood pressure pill. The tricky part is most of the salt in our diet isn't from what we add at the table with the salt shaker. Most of it is from eating processed food. There is a lot of salt added when a food is packaged for you. The only way to know for sure how much salt you eat is to prepare all or most of your own food at home. That can be a very tall order for many people.

What blood pressure pill should I be on? You and your doctor will talk about what other conditions you have first. If you have high blood pressure, but no other conditions, you might be put on a diuretic. A diuretic like hydrochlorothiazide makes you pee out some excess fluid and that decreases your blood pressure. If you have high blood pressure and diabetes your doctor might choose an ACE inhibitor because it has some extra protective qualities for the kidney and the heart. If you just had a heart attack your doctor might put you on a beta-blocker. The beta-blocker will slow down your heart a little. This will reduce your blood pressure and help your heart not to work as hard. This will help your heart heal better after the heart attack.

Around the world, high blood pressure causes an estimated 18% of deaths or about 9.4 million people annually. Treating high blood pressure is not difficult. Eat less salt. Eat more fruits and vegetables. Get more exercise. Take a pill every day.

My front tire went off the right side of the plank bridge. It dropped about a foot into the creek. My tire immediately dug into the sand and mud of the creek bank. I catapulted over the handle bars into the sand and mud. My glasses went flying. I landed on my right elbow and jammed my shoulder. I wasn't badly hurt and I did manage to walk/ride the rest of the trail. My bike didn't have enough grip to climb the steeper hills. I didn't have enough nerve to go down around the switch-backs. But I walked/rode to the end. That night, my shoulder hurt so much I couldn't sleep. My back tire is now a little warped and I think my front fork is bent. Over the next week my shoulder healed nicely. I can almost lift my right arm over my head without wincing. And kudos again to all the volunteers who created the trails. They look very nice. But I think I'll leave them at .... Riding them seemed like a good idea at the time.

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

Hypertension Canada www.hypertension.ca

University of Calgary's Cumming School of Medicine Study - http://hyper.ahajournals.org/content/early/2015/07/13/HYPERTENSIONAHA.115.05702.abstract

CBC Story on costs of Hypertension - http://www.cbc.ca/news/canada/calgary/high-blood-pressure-draining-canada-s-health-care-system-suggests-study-1.3188881

 


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