This article is from the WebMD Feature Archive
High Blood Pressure Aftermath
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. According to the CDC, high blood pressure was listed as a primary or contributing cause of death for 326,000 Americans in 2006, yet the AHA says high blood pressure is easily detected and usually controllable.
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 complications you should be aware of. Most importantly, 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 Accupril, Altace, Capoten, Lotensin, Monopril, Prinivil, Vasotec, and Zestril.
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