Cardiology

And your parents control blood pressure? How to target the older generation for the treatment of hypertension

Hypertension
Written by med

“The demographic situation in Russia is deteriorating” or “We are dying” are two different in form but identical in essence to the phrase. For 8 years the country lost more than 2 million people. Of the causes of the General mortality of the population in the first place has long been firmly established cardiovascular disease, which share in the structure of mortality accounts for 55.6 per cent. Among the elderly is the most common cause of death.

The root of all evil — arterial hypertension (AH). It underpins the two main reasons given in the death certificates of persons dying from cardiovascular diseases: ischemic heart disease (IHD) and cerebrovascular pathology.

According to official data the incidence of hypertension in the country is about 15%. It is only those who are on the dispensary account. Meanwhile, international experts have cited figures of between 35-50%, which is more like the true state of Affairs. Blood pressure (BP), heart pathology and mortality are inextricably linked. And the effective control of AD, the more likely people prone to hypertension to see our own grandchildren. What is meant by the effectiveness of blood pressure control? If the result of the correction of lifestyle (avoiding harmful habits, sufficient physical activity, balanced diet) and adequate pharmacological support of blood pressure throughout the greater part of the day does not exceed 140/90, then we can talk about the effectiveness of the control over HELL.

And here we come to one of the main problems, giving heart disease a truly demonic status: low adherence to therapeutic measures, but simply the lack of desire to be treated. It is our national characteristic, peculiar for the most part the older generation. Why is this happening? Below I will try to get to the bottom of this phenomenon. Before this, I would say, that article was written based both on medical professionals and those who have elderly relatives (read: the vast majority).

First and foremost, a lot, of course, depends on the doctor, his ability to find the proper level of understanding as with the patient and his relatives. His direct responsibilities included explaining to the patient the essence of the disease, how it manifests itself, which can be complications. It is very important to identify the purpose of treatment, clearly explain that the therapeutic interventions can improve quality of life and reduce the risk of fatal complications along the line of the cardiovascular system.

Important and the proposed treatment, its pharmacological component. Proven in practice that if the drug should be taken-2 times a day, it negatively affects adherence to treatment. Discourage to be treated may assign a large number of drugs, the high price of the drug, treatment failure, or, conversely, too rapid normalization of blood pressure (in this case lose motivation to treatment). Again, but for the patient it is important to feel respected, therefore the doctor should be informed of the drug name (and not “karabati” on a piece of paper), purpose, duration and frequency reception.

To reach the target blood pressure levels, unfortunately, one drug is often not enough: the hypotensive effect is negligible. However, if we assign a combination of drugs, then it must be rational. It is desirable that the hypotensive effect of the drugs was implemented in different ways. The best combinations are diuretic/beta-blocker diuretic/angiotensin-converting enzyme inhibitor (ACE), calcium antagonist/ACE inhibitor, calcium antagonist/beta-blocker.

Probably needless to say that the drug should have minimum side effects about which the doctor is obliged to inform the patient and to strictly control the process of treatment. Everything must be subordinated to improving the quality of life of the patient, so at the slightest manifestation of the “side effects” replacement of a drug — usually the drug of another group.

Another proven technique to increase the effectiveness of treatment — appointment prolonged preparations. Ideally, the medication should be taken 1 or 2 times a day. If more — it will take at best in time proven! But in the case of pass receiving medication for something called withdrawal syndrome with abrupt pressure rise, resulting in a hypertensive crisis. What is the way out of this situation? To prescribe drugs with a longer half-life, applicable over a wider interval between doses.

Another stumbling block to adequate treatment of hypertension, and any other — the price of the drug. Well, not accustomed to our parents and grandparents to pay for the drug a quarter of his pension! Agree, this is of course, difficult to blame. I refer to the statistics: more than 20% of patients associated their reluctance to be treated with the high price of drugs.

But not all, as you know, depend on third-party (doctor, method of treatment) reasons. Largely to blame the patient. Smoking, alcohol, table salt, lack of exercise — this is not an exhaustive list of “deadly sins”, a punishment for which could serve as a whole bunch of cardiovascular pathologies, starting with hypertension and coronary artery disease and ending heart attack or stroke. All of the above risk factors are disposable, so everything is in hands of the patient.

On the salt let us separately. If a person has a tendency to AG, its daily dose of salt should not exceed 5 grams. This is achieved by rejection of dozarivaniya, limiting salty foods.

And, most importantly in control of your HELL, this is actually a measurement of the pressure. If a person, particularly the elderly, pressure measurement has become a daily ritual, such as washing hands before eating, it is welcome. In order to facilitate this action, get your parents to try and explain fully how to use it. Ideally (I understand that it’s almost unreal) the patient must keep a diary of self-control in HELL.

As you can see, activities to improve adherence to treatment of arterial hypertension are characterized by their, shall we say, multi-vector. Subject to at least a few of them can be forced to be treated even the most stubborn of patients.

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