Hypertension, Medication, and Polypharmacy

NEED TO KNOW
SPECIAL ISSUE: HIGH BLOOD PRESSURE
WORDS - Aarti Patel
ILLUSTRATION - Stella Wei + Paloma Diaz-Dickson

Managing Hypertension with Medication:
Managing hypertension looks different for everyone. While some are able to manage high blood pressure with lifestyle changes, many people require medication. If you have a family history of high blood pressure or heart disease, or if you have high blood pressure despite making healthy changes, this may indicate that you should start on medications. 

Questions for your health care provider
Starting a new medication can be overwhelming, but the long term consequences of high blood pressure can cause irreversible damage to your body. Blood pressure medication can help prevent that damage.

Before you begin taking blood pressure medication, it’s important to talk to your provider about the specific medication and possible side effects that can occur. Here are some questions to ask your provider:

• What is the name of the medicine? 

• Is this a brand name or generic name?

• Are there less expensive medications for my blood pressure? 

• What are the risks of not taking this medication?

• How and when do I take this medication, and for how long?

• Should I take it with food or on an empty stomach?

• What foods, drinks, other medicines, or activities should I avoid while taking this medicine?

• What happens if I miss a dose?

• How will I know that my medication is working?

• What are common side effects? What should I do if I have any of these side effects?

• What is my blood pressure goal?

• What is a blood pressure cuff and can the cost be covered by my insurance?

There are several different blood pressure medications. Depending on your medical history, your provider may recommend one over another. Once you begin taking your medicine, you should measure and record your blood pressure levels at least once a day using a blood pressure cuff. If your insurance does not cover the cost of a cuff, or if you can’t afford one, many local pharmacies have cuffs that you can use. Bring your log of blood pressure readings to your next doctor's appointment. 

Polypharmacy (Taking multiple medications):
You may have multiple conditions, in addition to high blood pressure, that require medication. Taking multiple medications is called polypharmacy, and can include the use of over-the-counter pills, vitamins, and supplements.

Taking other medications may interfere with your blood pressure levels, so it’s important to inform your health care provider about all medications you are taking. Medications and substances that may affect your blood pressure and the effectiveness of your blood pressure medication include:

• Alcohol

• Caffeine and energy drinks

• Certain antidepressants

• Atypical antipsychotics (e.g. clozapine and olanzapine) 

• Decongestants (e.g. Sudafed)

• Herbal supplements (e.g. licorice root, ephedra, ginseng) 

• Hormonal birth control 

• Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) (e.g. ibuprofen and naproxen sodium)

• Recreational drugs (e.g. cocaine and ecstasy)

• Steroids (e.g. prednisone and dexamethasone) 

If you are taking multiple medications, it’s important to do a medication check up. This is when you gather all your prescriptions, vitamins, and over the counter drugs and bring them to discuss with your health care provider or pharmacist. Medication check ups can help identify dangerous medication combinations, reveal medications that you no longer need, or demonstrate if you're taking a medication incorrectly. If you’re confused or unsure about any medication, you should feel empowered to ask questions.