Yasmin Williams - HEALTH-WISEI THINK that many persons who are hypertensive and diabetic do not understand the real reason for treating hypertension and diabetes. This in many instances makes for non-compliance with continuous drug treatment (patient does not keep on taking medication) and leads to scenarios like the following:-
Patient with long-standing essential hypertension or primary hypertension says, "Doctor I took off all the medication which I got for the high blood pressure. It finished one month ago. How is my pressure now?"
I have had similar statements from patients in relation to their blood sugar but it does seem to occur more often with patients with hypertension.
When faced with a scenario like the above, I start by explaining that when a person is diagnosed as having essential hypertension or primary hypertension, it means that the person now has to commit to lifestyle changes which involve weight management, exercise and stress management and in many instances drug treatment for life.
Drug treatment for life means that medication has to be taken on a daily basis to keep the blood pressure and in the case of diabetes, the blood sugar, at a level (normal range) where the risk of damage to the blood vessels of the brain, heart and kidneys is minimised. High blood cholesterol the bad cholesterol (LDL cholesterol) will also damage the blood vessels.
Many persons do not seem to realise that elevated blood pressure, blood sugar and 'bad cholesterol' can remain undetected for long periods of time and unless one specifically investigates and intervenes, damage to the blood vessels of the brain, heart and kidney will continue unabated resulting in damage to the brain, heart and kidneys. One does not have to feel light-headed or giddy with elevated blood pressure. You may not feel ill, in fact you feel quite well and the damage can present for the first time as a 'stroke', 'heart attack' or kidney failure.
I often get the feeling that some persons think of treatment of hypertension in the same way that they think of treatment of a respiratory tract or lung infection you take a course of treatment and that clears up the problem. Perhaps it is just too difficult to conceive that one will have to take a particular kind of medication every day for the rest of one's life. But then again, I think all of us accept that every day we have to eat to live, so what's the difference!
I find that sometimes, less educated patients come for review without taking the morning's or the previous day's medication. One has to explain, the necessity of taking the medication as prescribed because the practitioner needs to see what kind of levels are obtained when one is taking the medication as prescribed, and that each drug has a particular life span in the body hence the need to take each drug as prescribed.
When medication is taken as requested, the practitioner is in a better position to ascertain what strength of the drugs is needed and whether drugs should be discontinued or added bearing in mind that each individual may respond differently to medication.
Hopefully, more and more persons are presenting for blood pressure, blood sugar and blood cholesterol checks especially if they have the risk factors which we discussed in earlier columns and hopefully my colleagues and I are getting better at helping patients to take responsibility for their health and the management of their medical conditions.
Dr. Yasmin Williams is a family doctor and public health specialist; email: yourhealth@gleanerjm.com.
