Sixty-one-year-old Sandra Robertshaw first had high blood pressure when she was 27, right after giving birth to her daughter. She was on medication for a few months until her levels returned to normal. But when she turned 40, her blood pressure once again started to rise, kicking off two decades of trying to manage it.
Nearly one in four Canadians live with high blood pressure, commonly called hypertension. Known as a silent killer, hypertension often presents no symptoms until it’s too late.
“High blood pressure is an important preventable cause of premature death and disability, but the challenge is you could have high blood pressure for years and have no idea,” says Dr. Ross Tsuyuki, a pharmacist and president of Hypertension Canada. “It might turn out that the first time you realize you have high blood pressure is when you have a stroke. That’s not the kind of pathway we’d like people to take, but it’s easy to see how this happens with a condition that doesn’t have any symptoms.”
Hypertension happens when there is too much pressure in the blood vessels, which are responsible for pumping blood throughout the body. When pressure remains high, blood vessels become damaged over time which increases the risk for many health conditions including heart attack, stroke, kidney failure, and dementia.
Hypertension is high blood pressure
The only way to detect hypertension is to measure your blood pressure. This is measured as systolic pressure (when your heart contracts) over diastolic pressure (when your heart relaxes and fills with blood). In general, a blood pressure reading below 140/90 is considered healthy, but some countries, including the United States, have set a lower target of 130/80. And while hypertension is more common in people over the age of 50, it can affect younger people too.
“Every adult should get their blood pressure measured at least once,” says Dr. Raj Padwal, professor of medicine at the University of Alberta. “If you’re seeing your doctor, ask them to check it, or you can get a reading done at a pharmacy. If your reading is high, you should buy a monitor and check at home from time to time. If your blood pressure has sustained elevation, then you should go to your doctor and get assessed.”
Padwal says the treatment for hypertension typically includes a combination of lifestyle changes — predominately lowering salt intake and losing weight when necessary — as well as medication. For some, hypertension is genetic, which means they will likely be on medication for the rest of their lives.
For Sandra Robertshaw, finding a medication that doesn’t cause unbearable side effects has been difficult. Another unexpected challenge has been limiting the amount of salt she eats. Robertshaw says when she was first diagnosed and started tracking her salt intake, she was shocked at how much she was unknowingly consuming.
“When I first told to track my sodium, I figured it would be fine because I never add salt to anything,” she says. “But I was horrified when I started looking at my numbers. It turns out salt is in everything and it’s in everything in abundance.”
According to Tsuyuki, another challenge when it comes to treatment is that many people will stop taking their medication because they don’t feel any different. With a condition that is typically symptom-free, it’s common to not have any noticeable changes and physicians need to make sure patients understand this.
Pharmacists can play a role in managing hypertension
Tsuyuki also says pharmacists should be more involved in primary care of hypertension. In a 2015 study, his research team at the University of Alberta found patients with hypertension who were followed by a pharmacist for six months had greater blood pressure reduction than those who saw their family physician.
The research team was uniquely positioned to do this study — Alberta is one of few provinces in Canada where pharmacists have the authority to diagnose and prescribe treatment for certain conditions. Tsuyuki believes that if more provinces and territories followed suit, hypertension could be better managed in Canada.
“Hypertension tends to fly under the radar, whereas many other heart diseases get a lot of attention,” says Tsuyuki. “We put a lot of money into research and treatment of heart attacks for example, but the number one cause of heart attacks is actually high blood pressure.”
Vanessa Hrvatin is a Vancouver-based writer.