Controlling the Silent Killer

May 17, 2016
While high blood pressures, or hypertension, is typically an asymptomatic condition, adherence to therapy is important to prevent a heart attack or stroke
  • High Blood Pressure/Heart Disease


Most people assume they only need to take their medication when they are sick, meaning when they experience symptoms. In the case of hypertension, this type of thinking could kill you.

Patients who have hypertension are often completely asymptomatic – that’s the reason hypertension is often called the silent killer. The belief that symptoms such as headaches, nose bleeds, nervousness, sweating, difficulty sleeping or facial flushing are signals to take blood pressure medication is a myth.

Nonadherence to hypertension medication is a huge challenge. Research shows that 1 in 3 American adults suffer from high blood pressure, but only 47% effectively treat their disease to keep blood pressure levels under control.

Higher Risk for Heart Attack, Stroke 

I recently spoke with a patient who was 40 days late to refill her blood pressure prescription. When I asked her about the delay, she said she only takes her medication when she feels stressed or has a headache. The problem with this is that patients with hypertension may feel perfectly fine before suffering a heart attack or stroke.

Normal blood pressure is less than 120/80, but consistent levels above 140/90 require medical attention. Simply keeping a patient’s blood pressure under control decreases the risk of heart attack by 25%, stroke by 33% and heart failure by 50%.

But the only way to have a precise measurement is through a blood pressure reading.

Become an Engaged Patient

I encourage patients to become engaged in their own health and keep track of their blood pressure readings, which can help prevent unnecessary hospitalizations or ER visits.

For patients with white-coat hypertension – those whose blood pressure rises from stress in the doctor’s office – a home blood pressure monitor is a good option.

Here are useful tips for patients monitoring their pressure at home:

  • Take blood pressure readings in a seated position with arm at the heart level
  • To regulate the monitor, discard the first reading
  • Keep a record of your blood pressure levels to bring to your doctor’s appointment

This additional data will help your physician better understand your condition and make better medical decisions to ensure healthier outcomes.

Lifestyle Changes Can Help 

In addition to staying adherent to blood pressure medication, regardless of symptoms, the following lifestyle modifications also can improve cardiovascular health:

  • Consume a heart-healthy diet rich in fresh fruits and vegetables, and low in salt, fat and cholesterol.
  • Engage in regular aerobic physical activity.
  • Manage your weight, limit alcohol consumption and do not smoke.

Value of Specialized Understanding

Even with lifestyle modifications, most patients need at least two medications to reach their blood pressure goal. Intervention and education from specialist pharmacists provide an important resource to improve medication adherence. When patients understand the value of their treatment and embrace good cardiovascular health, they bring a little more noise to this silent killer.

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