What is the role of patient education in managing Hypertension (High Blood Pressure)?

From the Guidelines

Patient education on blood pressure is crucial for maintaining cardiovascular health, and it should prioritize lifestyle modifications and medication adherence to reduce the risk of stroke and other complications, as recommended by the most recent guidelines 1. To manage blood pressure, it is essential to monitor it regularly using a home blood pressure monitor, taking readings at the same time daily while seated with your arm supported.

• Normal blood pressure is below 120/80 mmHg, with the top number (systolic) representing pressure when your heart beats and the bottom number (diastolic) showing pressure between beats.
• High blood pressure, or hypertension, is diagnosed when readings consistently exceed 130/80 mmHg. Lifestyle modifications are crucial and include:
• Reducing sodium intake to less than 2,300 mg daily
• Following the DASH diet rich in fruits, vegetables, and whole grains
• Exercising for 150 minutes weekly
• Limiting alcohol consumption
• Maintaining a healthy weight
• Avoiding tobacco If prescribed medications like ACE inhibitors (lisinopril), ARBs (losartan), calcium channel blockers (amlodipine), or diuretics (hydrochlorothiazide), take them exactly as directed, even when feeling well. These medications work by relaxing blood vessels, removing excess fluid, or reducing heart workload. Report side effects to your healthcare provider rather than stopping medication independently. Uncontrolled hypertension can lead to serious complications including heart attack, stroke, kidney damage, and vision problems, making consistent management essential for long-term health, as emphasized by the Asia-Pacific Consensus Conference on Stroke Prevention in Hypertensive Patients 1.

From the Research

Patient Education on Blood Pressure

• Patient education on blood pressure is crucial for managing hypertension and preventing cardiovascular complications 2, 3, 4, 5, 6
• Studies have shown that antihypertensive therapy can have beneficial effects on morbidity and mortality, but adequate blood pressure management remains suboptimal 2
• Different classes of antihypertensive agents, such as calcium channel blockers, ACE inhibitors, and angiotensin receptor blockers, have varying efficacy profiles 2, 3, 4

Antihypertensive Agents

• Amlodipine, a dihydropyridine calcium channel blocker, has been widely used for two decades and has good efficacy and safety, with strong evidence from large randomized controlled trials for cardiovascular event reduction 2
• Amlodipine has been shown to be effective in minimizing blood pressure variability (BPV) compared to other antihypertensive agents, such as atenolol and lisinopril 3
• ACE inhibitors, such as lisinopril, have been compared to angiotensin receptor blockers (ARBs) and have been found to have similar efficacy but more adverse events, such as cough and angioedema 4

Fixed Combinations of Antihypertensive Agents

• Fixed combinations of antihypertensive agents, such as lisinopril, amlodipine, and rosuvastatin, can be effective in controlling multiple cardiovascular risk factors, including hypercholesterolemia and arterial hypertension 5
• These combinations can increase adherence to therapy and reduce the risk of cardiovascular complications 5

Visit-to-Visit Variability of Blood Pressure

• Visit-to-visit variability (VVV) of systolic blood pressure (SBP) has been compared across different antihypertensive agents, including chlorthalidone, amlodipine, and lisinopril 6
• Results have shown that chlorthalidone and amlodipine are associated with lower VVV of SBP than lisinopril 6