(BioMedCentral) — Despite the availability of a wide selection of effective antihypertensive treatments and the existence of clear treatment guidelines, many patients with hypertension do not have controlled blood pressure. We conducted a qualitative study to explore beliefs and perceptions regarding hypertension and gain an understanding of barriers to treatment among patients with and without diabetes.
Methods
Ten focus groups were held for patients with hypertension in three age ranges, with and without diabetes. The topic guides for the groups were: What will determine your future health status? What do you understand by “raised blood pressure”? How should one go about treating raised blood pressure?
Results
People with hypertension tend to see hypertension not as a disease but as a risk factor for myocardial infarction or stroke. They do not view it as a continuous, degenerative process of damage to the vascular system, but rather as a binary risk process, within which you can either be a winner (not become ill) or a loser. This makes non-adherence to treatment a gamble with a potential positive outcome.
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The findings of the study are accurate but do not address the physicians and their lack of knowledge of the many hundreds of drugs available for the treatment of hypertension most of which have serious side effects. Most physicians only know how to prescribe commonly used, well known meds. If those meds are not well tolerated or are not effective, the physician is at a loss and then has to begin experimenting by trying different drugs. This may take months or even years of going through what my physician said were “hundreds of different drugs”. There is no clear way to establish what the patient can or cannot tolerate. Couldn’t this be handled more efficiently and less painfully with genetic testing to determine what classes of drugs the patient can or cannot tolerate? Or can anyone think of another way to attack this problem? I believe the physician and our health care system are at the root of the patient’s behavior and attitude toward hypertension.
You are so right. There has to be a better way of finding out what effects these drugs may have on you. It is not really living with these side effects and DRs think the side effects dont matter as much HBP
Wow! Thankyou for stating so clearly what so many of us believe. You have actually got right to the heart (no pun intended) of the problem, and the mess that so many of us find ourselves in. In my case, my GP has just told me to double the Amlodipine I am taking! I think this is lazy prescribing, and I don’t want to do it as I dread more side-effects and I have no faith or belief that it will bring my BP down. Do out health care providers need to be completely re-educated on hypertension treatment for the benefit of all their patients stuck on unsuitable drugs? I wish we could be heard.
I have diabetes, HBP and now 3’d degree kidney failure GFR 51. I have learned to ignore those doctors who tell you to take your BP only once a day, or once a week. I use an Omron meter. I have learned to pull apart a 12,5 hydrochlorothiazide spill about a third of it in water put the capsule back together and take it with 1/2 metroprolol 50 er at night,( better than atenalol). I also take diovan 160. If my bp rises I take a little more diuretic, Still have side effects including fatigue but not as severe as when I was on clonidine. Do not be afraid to experiment a little as long as you monitor and know how to treat periodic bouts of low blood pressure by lying supine and raising your legs, or adding a boullion salt cube to water. Doctors simply do not understand how horrible bp med side effects can be.
BP meds are not easy for any doctor to monitor, you should not discontinue any without consulting your doctor though.
I agree wholeheartedly. I have been prescribed every type of anti-hypertension drug, with universally horrific effects. Of course I now refuse all hypertension treatments with the result that my doctors see me as a difficult patient and once tried to strike me off their patient list.
What on earth to do? I am not overweight, don’t smoke or drink, eat and exercise sensibly and still my bp is high.
Not fair!
I hear you, Wendy! I’m in the US and I’ve actually been “fired” by doctors for refusing antihypertensives. I’m so sick of them freaking out when they take my blood pressure. I’m finding it impossible to get medical care for anything, because none of them ever addresses my presenting complaint.
Reberta has made the key point. There should be a shortcut to drug choices without the subsisting and very dangerous trial and error system. Medical researchers please come to our aid!
BP is a much more complex condition than the system acknowledges. Trying to apply standard meds recipes that are “in vogue” with the phara sales efforts is a disaster (case in point the recent warning about certian combinations being deadly after years of preferred treatment).
Each person with BP problems is unique and requires very thorough monitoring and continual assessment to sufficiently understand whats going on. In the absence of this level of attention the treatment reaction will more likely be harmful than helpful.
I am 77 and have been treated for HBP since 49. In my younger years it was low! My mother had the same situation as menopause began. My body is VERY sensitive to all drugs and I have tried sooo many BP ones with horrible and scary results. It is such a guessing game on the medical field and pharma parts.
They should have to exoerience the miserable side effects.I am taking a combo now that drug papers say should not be used together but there is nothing left.I am on 3 drugs and it is still not well controlled. Recently used prescrption steroid cream for sumac poisoning and my pressure went thru the roof, I try NOT to think about it or take readings too often as it just makes you more concerned about something you really cannot control. I HAVE TRIED MANY MANY WAYS. Why doesn’t research spend more time trying to find the cause instead of more drugs for something they don’t really understand.
I put in a query previously about possible research into the relative benefits of cardio-vascular exercise compared with Resperate for countering hypertension, but there has been no response so far. The query could be extended to cover drugs (the “default” ..) as well but this would I fear then become very complicated.
How about recommending some different types of treatment for borderline High, rather than drugs? Diet? exercise?
I think most patients are fully aware what it means to be hypertensive and the risk involved remaining hypertensive without any drugs and getting worse. Patients become non-compliant when the side-effects become so bad that they affect quality of life. The accumulation of what are often described as ‘minor’ side-effects are often regarded as outweighing the benefits, which is understandable. If you suffer from chronic headaches and fatigue, dizziness, bloating, dry mouth, etc. day in day out, how can patients be blamed for discontinuing the treatment? Patients become non-compliant not because they are ignorant or uneducated, but because they feel so sick every day and just want their normal life back.
marmotte, I will see that and raise you. I have gone to the source and read the studies that have been done about the supposed risks of hypertension, and it is my firm belief that there are no risks. No ine can show a correlation between blood pressure and stroje or cardiac events. It simply does not exist. Moreover, blood pressure did not become such an issue until drug comapnies came up with these very expensive medications, most of which only make people feel very bad. I’m not a conspiracy theorist, but blood pressure and cholesterol are pseudo-issues which have been manufactured by drug companies. The information is out there for anyone who wants it.
I managed to bring my blood pressure down to normal by changing my diet and working out everyday. I eat oats for breakfast. I also use soya milk istead of dairy. I have plenty of salad e.g beetroot, cucumber, onions tomatoes. I eat chicken breast and mackerel. I have my own home monitor. My blood pressure came straight down just as it would have done with prescribed drugs. Also drink plenty of water. Also I noticed that my blood pressure is far higher when I have it taken at the doctors than when I take it at home. Cinamon bark also helps.