What’s Up Doc?: New year is a good time to control the silent killer
By Dr. Noorali Bharwani on December 24, 2019.
In the new year, you can wish for many things and make many resolutions. But don’t forget to take care of the silent killer – your blood pressure. The lifetime risk for developing hypertension (high blood pressure) among adults aged 55 to 65 years is 90%. Our New Year’s resolution should be to keep our blood pressure under control. More about that later. First, I have a question for you: When is the best time to take your blood pressure pill? Currently, there are no guidelines on when to take your blood pressure pills – is it better to take it in the morning or at bedtime? The answer is in an article recently published in the British Medical Journal (BMJ 23 October 2019) titled “Taking antihypertensives at bedtime nearly halves cardiovascular deaths when compared with morning dosing.” A study of nearly 20,000 hypertensive patients in primary care has shown taking pills for high blood pressure at bedtime is associated with improved blood pressure controls. Besides, the risk of dying from cardiovascular causes is reduced by half when compared with morning dosing. The Hygia Chronotherapy Trial randomly assigned 19,084 hypertensive patients (median age 60.5 years) to take their entire daily dose of one or more antihypertensives at bedtime or on waking in the morning. The patients were followed up with ambulatory blood pressure monitoring, for a median follow-up period of 6.3 years. The results show these patients have better controlled blood pressure and, most importantly, a significantly decreased risk of death or illness from heart and blood vessel problems. The researchers found there was enough evidence from this study to recommend patients consider taking their blood pressure medication at bedtime. It should be noted that this recommendation does not apply to medicines that need to be taken more than once a day or to blood pressure medicines that are prescribed for other problems, such as angina or heart failure. Do not change your medication schedule without consult your doctor. What is considered to be high blood pressure? Blood pressure that is consistently more than 140/90 mmHg is considered high, but if you have diabetes or chronic kidney disease, 130/80 mmHg is high, says Health Canada website. High blood pressure significantly increases risk for stroke, ischemic heart disease, peripheral vascular disease and heart failure. Some facts about high blood pressure (hypertension): 1. Hypertension affects more than one in five people. 2. Approximately 17 per cent of individuals with hypertension are not aware of their condition, the true prevalence of hypertension is likely higher. 3. Hypertension is the most common reason to visit a doctor. 4. Hypertension is the number one reason for taking medication. 5. The lifetime risk for developing hypertension among adults aged 55 to 65 years with normal blood pressure is 90%. 6. It is estimated that almost 30% of hypertension can be attributed to excess dietary sodium. Reduction in daily sodium intake to recommended levels could result in one million fewer Canadians with hypertension. 7. Smoking, being overweight or obese, lack of physical activity, too much salt, stress, genetics and family history can induce hypertension. That is it for this year. Let me wish you all Merry Christmas, Season’s Greetings, and a Happy, Healthy, Safe and Sober New Year! Remember what Earl Wilson (American Athlete) said, “One way to get high blood pressure is to go mountain climbing over molehills.” Talk to you next year. Dr. Bharwani is a general surgeon, freelance writer, photographer and author of A Doctor’s Journey and Doctor B’s Eight Steps to Wellness. His latest book is available at Shoppers Drug Mart and Coles Book Store (Medicine Hat Mall), and http://www.nbharwani.com. You can discuss this article and other articles on his website: nbharwani.com and sign up for RSS feed, Twitter or get on the email list. 25-24
