Doctors said mistake in hypertension treatment

The scientists followed more than 21,000 patients with hypertension for five to nine years. Half of the participants took the pills in the morning and the other half in the evening. The study showed that the hospitalization rates for hypertension in both groups were approximately the same. About the authors’ observation results reported At the 2022 meeting of the European Society of Cardiology.

“In this study, we considered the option for one person to take the drug once a day. I have to say that this is a pretty rare occurrence.

The effects of the drugs last less than 24 hours, and many people have to take them several times a day, although some unscrupulous manufacturers promise long-term action,” he said.

Hypertension is diagnosed when the systolic pressure is at least 140 mm Hg on two different days. Art. and/or diastolic pressure was above 90 mm Hg on both days. Art. Hypertension is not a death sentence, but it should still be treated with care because if left untreated it increases the risk of stroke and heart attack. Modern drugs can effectively reduce pressure, preventing consequences.

“Doctors have at their disposal different groups of drugs for lowering blood pressure. First of all, these are ACE inhibitors and calcium antagonists. If they are ineffective, diuretics can be considered. In any case, the drug is selected individually, so you should not prescribe them yourself, ”warned Savonina.

The main condition for the effectiveness of treatment is regularity and constancy.

“Patients with hypertension and other cardiovascular diseases in Russia very poorly follow the treatment regimen, stop taking medication on the advice of a taxi driver, neighbor, relative or someone else.

The figures are very sad: only 40% of Russians with hypertension are on medication, and only 18% of them reach the target blood pressure values. This is partly due to the fact that in early hypertension the patient has no complaints – there is no motivation to be treated.

“Since one tablet is easier to take than three tablets, combination preparations containing several active substances can improve adherence to treatment,” said cardiologist Tamaz Gagloshvili.

Savonina added that, as a rule, lifelong blood pressure medications are prescribed, except in cases of treatable secondary hypertension due to another disease, such as kidney disease. Gagloshvili noted that often secondary hypertension is caused by apnea, that is, snoring, accompanied by short-term respiratory arrest.

Savonina added that sometimes taking medication at a given time can be justified by the need to alleviate side effects.

For example, the calcium antagonist amlodipine can increase heart rate. For some patients, it makes sense to take it at night, since physiological bradycardia is observed during sleep, that is, the heart beats less.

Gagloshvili added that evening antihypertensive medications are also necessary for people with nocturnal hypertension, whose high blood pressure may be suspected soon after waking.

The effectiveness of treatment also depends on the moment it started, so it is important not to skip the initial stage of hypertension.

“Everyone should know about their normal blood pressure. This is necessary in order to detect hypertension in a timely manner. For teenagers, it is usually enough to undergo a medical examination once a year, but this must be done, because their high blood pressure often does not manifest itself in any way, ”savenina stressed.

He also noted that you shouldn’t buy generics without consulting a doctor (not a pharmacist at the pharmacy), as most are less effective than the original drugs. You need to drink the drug only with clean water. Especially in this regard, grapefruit juice, which can completely neutralize the active substance in the liver, is dangerous.

“From a nutritional standpoint, it’s worth limiting salt to 1 teaspoon per day. From semi-finished products and ready-made foods should “fit” and have hidden salt. At the same time, you do not need to give up salt completely. It is also necessary to sleep at least eight hours, and not forget about physical activity: walking for at least half an hour a day, ”saponina suggested.

Risk factors for the development of hypertension include obesity, smoking and physical inactivity in addition to excessive salt intake.

“Lifestyle plays a big role in the treatment of hypertension. The same drug will have different effects in 70 kilos of hypertensive patients and 150 kilos of hypertensive patients.

Fat is the source of many hormones that affect both the risk of hypertension and the effectiveness of treatment. It is not uncommon for a person to lose 30 pounds and the need for medication disappears completely. People think they’re going to take pills and everything will be fine. You need to drink pills, but still, the prognosis of the disease primarily depends on the lifestyle, ”summed Gagloshvili.