Hypertension and the Role of the Pharmacist

By Karen Riley BScPhm, Pharm D, BCPS, BCGP, BCACP, CDE 

One U.S. adult out of every three and one Canadian adult out of four has high blood pressure, which increases the risk of heart disease and stroke. What is not surprising is that the number of people with elevated blood pressure, not yet in the high range, is much higher.  As I was catching up on my journal reading, I came across two different articles of interest this month both related to hypertension.

The first article was published in the Journal of the American Medical Association (JAMA) . In this article, research showed that elevated systolic blood pressure (SBP) is not just a problem in North America but is a leading global heart risk. The study looks at SBP based on 844 studies published between 1980 to 2015 from 154 countries. The study found that that the number of people with elevated SBP has increased dramatically in the past 25 years, and so has the rate. Researchers found that 3.5 billion adults have SBP high enough to bring some risk and 870 million people around the world are hypertensive. Elevated SBP was found to be a leading contributor to preventable death in 2015 and was linked to more than 10 million deaths – 1.4 times the number in 1990.

The researchers were particularly interested in the systolic number which can escalate quickly in older adults. Elevated SBP of at least 110-115 mm Hg has been linked to heart disease, kidney, and cerebrovascular disease and stroke.  Even though hypertension medication isn’t typically used until a person’s SBP reaches 140 mm Hg, the researchers wanted to see the link between lower SBP levels and bad health outcome.

The authors of the article stated that not everyone needs to take a medication for elevated SBP. It’s possible to lower your blood pressure naturally through changes in diet, exercise and weight. The important thing is to start paying attention to blood pressure early.

The second article that I read was titled the “Cost-effectiveness of pharmacist care for managing hypertension in Canada” published in the Canadian Pharmacists Journal on March 21, 2017. The article says, “Pharmacists are ideally placed, highly accessible health care providers who have shown that they can effectively contribute to solving this care gap in hypertension management. Santschi et al. recently conducted a systematic review and meta-analysis of 39 randomized controlled trials assessing the effect of pharmacist interventions on blood pressure management. These interventions were largely patient education and counselling, feedback to physicians about management (including drug-related problems, recommendations for changing pharmacotherapy and development of care plan) and medication management (including monitoring with adjustment of change in medication).”  The study, led by Carlo Marra, showed that comprehensive long-term pharmacist care for Canadians with hypertension, including patient education and prescribing, improves health outcomes and could result in a projected cost savings of more than  $15.7 billion if full scope pharmacist care were administered to the full eligible population in Canada.

As pharmacists, we are uniquely positioned in the community to counsel and manage patients, supporting them in protecting their overall health-we make a big difference every day just by helping them manage their blood pressure.  Encouraging our patients to adopt a healthy lifestyle through weight loss, exercise, and medication management can certainly help keep those numbers in check- enabling them to live longer and healthier lives.

To join the ranks of healthcare providers fighting obesity, tweet @DrsFightObesity or use #DoctorsFightingObesity to keep the conversation going.

Karen Riley BScPhm, Pharm D, BCPS, BCGP, BCACP, CDE  is president of KD Riley Pharmacist Professional Corporation. She is a Medication Therapy Management Pharmacist providing pharmacy consulting services to a broad range of patients. She serves as a Clinical Assistant Professor with the University of Florida College of Pharmacy. Dr. Riley also sits on the Sarnia Lambton Alzheimer Board of Directors and the Lambton Mental Health Board of Directors.  She is a member of the Ideal Protein Medical Advisory Board and is an Ideal Protein Weight Loss Consultant in Sarnia, Ontario.