MISCONCEPTIONS ABOUT HYPERTENSION

 Dr Himanshu Gul Mirani

Emergency Physician and Centre Head

UCC, Kalkaji

1.       Hypertension can’t be asymptomatic

Hypertension is a silent killer. It’s very much possible to have high BP and yet be asymptomatic. Symptoms like headache/ nausea/ vomiting/ chest pain/ shortness of breath –may not be present at the very outset of disease.  

It’s not a rule that BP is high only when you can feel it!

Usually such patients present to ER upon decompensating into “Hypertensive Crisis”.

2.       Anti-hypertensive medicines need to be discontinued once normal values are recorded

Your normal values may well be because of the anti-hypertensive medicines itself. So don’t discontinue them without a proper physician consult.

Sudden discontinuation of these medicines without medical supervision can predispose the patient to “rebound hypertension” and precipitate “Hypertensive Crisis”.

3.       It’s OK to miss my doses of medicines – anyways I take them every day, so some drug holiday is allowed

Non drug compliance itself is thought to cause about 89000 pre mature deaths in USA per annum. These deaths are simply preventable by practicing drug regime adherence.

So don’t skip your doses. It would only undo the good.

4.       It’s been quite some time since I saw my doctor & I am continuing with my prescription which is ages old

It’s very much advisable to have a diligent follow up with your GP, although you may be having a good control of BP with your current medicines. Anti-hypertensive medicines have their own side-effects which need to be monitored, eg patients on ACE Inhibitors need Kidney Function Tests regularly at the commencement of therapy and continuation of therapy. Diuretics predispose a person to dyselctrolytemia. Maybe the cough for which you are gulping OTC cough syrups is a side effect of ACE inhibitor drug.

So do keep visiting your GP as advised by him/her.

Also maybe after implementing positive therapeutic lifestyle interventions you may need drug dose reduction!

5.       I left exercising as it increases BP

Exercising to the best of one’s capability and capacity is advisable to even heart failure patients. It has been established that regular permissible exercise and weight management can only have positive impact on one’s health.

In fact for every 10kg weight loss SBP may fall between 5-20 mmHg and if one does regular exercise for about 30-45 mins – on most days of a week, preferable 5 out of 7; this itself can bring a fall in SBP of 4-9 mmHg. Sedentary life style is one of the leading risk factor predisposing to hypertension.

6.       High BP affects only oldies

The disease has epidemically plagued the Gen Y and Gen Z and is no longer limited to the Baby Boomers. There is enough evidence to testify that the young are fast getting engulfed by hypertension.

High stress levels, lack of physical activity, tobacco and alcohol addiction, excess salts in packaged and processed foods, fast foods – all contribute immensely to increase the disease load.

7.       Medicines are ineffective in old patients and they can’t hit their “goal BP”

With the multiple drugs in the armamentarium of your physician – the drugs are very much capable to help you attain your target level of BP. These drugs act by varied mechanisms to help an individual attain the desired control of BP.

Target BP is determined based on one’s other co-morbid conditions - more the co-morbidities like diabetes and chronic kidney disease – the more stringent the control of BP.

8.       Medicines are the only way to control BP

Non pharmacologic methods to control BP have a very well established role in today’s BP management methodology. They have variable effects depending upon individuals. The following are the suggested measures:

·         Decrease sodium (salt) intake

·         Regular exercise on most days of a week

·         Weight reduction

·         Moderation of alcohol consumption

·         Quit smoking

·         Follow DASH diet

For any feedback/ suggestions/ query regarding this article; contact the author on himanshu.mirani@urgentcare.co.in

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