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Lying awake nights worrying if terrorists or bird flu will get you?
Consider, instead, a threat that’s far closer to home, and one that you can
control: high blood pressure.
One in three adults has high blood pressure, but only 61% are under
treatment and roughly two-thirds do not have it under control, according to the
American Heart Association (AHA) web site. In 2004, the disease killed more
than 50,000 people in the U.S., yet the AHA says high blood pressure is easily
detected and usually .
Complications of blood pressure medications are one reason people never seek
treatment (what if it makes me impotent?), abandon treatment (these swollen
ankles look terrible), or cut back on their medication dosage (I’m tired of
being tired).
WebMD talked with two cardiologists and a pharmacist about seven
you should be aware of. Most , they say that
complications shouldn’t be a reason to abandon treatment or cut back on
prescribed dosages. Instead, talk to your doctor or pharmacist. “We have
200 medications for treating high blood pressure,” says Thomas Giles, MD,
who is professor of medicine at Louisiana State University School of Medicine
in New Orleans. “We’ll keep on it till we find what will give you the best
result and be least intrusive in your life. It’s no good to make people feel
terrible, and we don’t have to do that.”
1. Fatigue and Dizziness
Dan Jones, MD, tells WebMD that when people begin taking blood pressure
medication, the most common problem is fatigue. Jones is dean of the School of
Medicine at the University of Mississippi in Jackson, and spokesman for the
American Heart Association (AHA). “It’s especially true for older patients.
If blood pressure has been elevated for a while, when the medication is taken
and the blood pressure begins to come down, for a period of time there’s less
circulation in some of the vessels, including those in the brain. It takes time
for those constricted vessels to relax. There may be a perception that there’s
less blood flow, which can produce fatigue or dizziness. If it’s mild, it can
be worked through simply by staying with the medication.”
A patient who feels fatigued when on the medication may decide instead of
taking it daily to take it every few days or so. “When they go off it, the
blood pressure rises and they feel better,” says Jones. “If they
continue this cycle, they never get past the fatigue, which typically will go
away after two to six weeks of therapy.”
2. Cough
ACE inhibitors are a class of medication that can cause a persistent cough
in 10% to 15% of patients. “Don’t continue the medication,” says Giles.
“I tell patients that if they get a cough, let me know.” If the ACE
inhibitor is stopped, it will need to be replaced with some other drug.
Examples of ACE inhibitors include: Lotensin, Monopril, Prinivil, Zestril,
Accupril, Altace, Vasotec, and Capoten.
3. Frequent Urination
No one wants to become famous for frequent bathroom breaks. Using diuretics
is a matter of timing. Try to take them in the beginning of your
day. “I tell patients not to take the diuretic and drink a lot of water
before they go to bed,” says Giles, who is president of the American
Society of Hypertension. “And don’t take your pill before a one-hour taxi
ride to my office. Wait till you get here to take it.” One of the most
common diuretics used for high blood pressure is hydrochlorothiazide. It may be
in its own pill on in combined formulations such as Hyzaar or Maxide.
4. Fluid Retention
Virtually any medication for hypertension that isn’t a diuretic can cause
edema or fluid retention. Swelling of the ankles and legs can be more than a
cosmetic problem. “Calcium channel blockers like amlodipine (also known as
Norvasc) and nifedipine (also known as Procardia) are famous for causing
swelling and pain in the legs,” says Sarah Ray, PharmD, BCPS. These drugs
can also worsen underlying heart failure or other heart problems or reveal an
unknown heart condition. “We’ve seen patients discover a heart problem only
after starting on a calcium channel blocker.”
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