Blood pressure control with elevated blood pressure measurements while in a physician’s office but normal measurements at other times. For patients with suspected white coat syndrome, maintaining a log of routine home blood pressure monitoring can help to verify if the condition is present.

Poor adherence with medications can also lead to lack of blood pressure control. Studies have found that approximately 40 percent of patients with newly diagnosed hypertension will discontinue therapy during the first year. Hypertension is a condition without symptoms, so patients often have difficulty understanding its significance. Also, the medications may actually make the patients feel worse than they felt with high blood pressure, making them not want to take the medication. Pharmacy filling records can be utilized if the patient is filling the prescription at appropriate intervals. Without valuable information about adherence, which the pharmacist can provide, a physician might simply increase the dose or add another medication to the regimen.

TABLE 3

Measuring blood pressure

• Do not consume caffeine or alcohol for at least 30 minutes before taking a blood pressure reading, as this may increase blood pressure levels.

• Do not use tobacco products for at least 30 minutes before taking a blood pressure reading, as this may increase blood pressure levels.

• Go to the bathroom first, a full bladder may increase blood pressure levels.

• Rest for at least 15 minutes before taking your blood pressure.

• Find a quiet place in which to take your blood pressure.

• Sit in a chair that provides back support and place your feet flat on the floor.

• Rest your arm on a table so that the wrist or arm cuff is at the same level as your heart.

• Remain still and do not talk while taking your blood pressure.

• It is best to take two or three readings, separated by a few minutes each.

• Be sure to record your blood pressure, including the time of day.

• Be sure to read the directions for your specific monitor.

CONCLUSION

Hypertension remains a significant problem in the United States. With nearly half of patients not achieving blood pressure goals, all members of the healthcare team need to assist patients in improving blood

pressure. The pharmacy technician is in an ideal position to notice problems with refill history or to hear comments and concerns expressed by the patient. Pharmacy techni-

cians should not hesitate to involve the pharmacists to get the patient the counseling he or she needs to improve blood pressure outcomes.

Learning Assessment

Successful completion of “Promoting adequate blood pressure control” (lesson 401-000-08-203- H01) is worth one contact hour of credit. Mail completed answer sheet to DrSN/Pharmacy Practice, P.O. Box 31180, Tampa, FL 33631-3180. For faster service, fax to (813) 626-7203. For fastest service, visit our Web site at www.cedrugstorenews.com.

1. Nearly 1-out-of-every- 4 individuals with hypertension is unaware of his/her condition. a. True b. False

 

2. The higher the blood pressure: a. the greater the risk. b. the lower the risk. c. has no influence on risk.

 

3. Risk factors for hypertension include: a. age. b. smoking. c. obesity. d. all of the above.

 

4. Normal blood pressure is defined as: a. >160 />100.

b. 145/95. c. 125/85. d. <120/<80.

 

5. Studies have found that among people under 75 years old with hypertension, approximately how many have their blood pressure under control?

a. Most (more than 90 percent). b. The majority (at least 60 percent). c. About half (approximately 40

percent to 60 percent). d. Almost none (less than 20 percent).

6. People with high blood pressure usually know there is something wrong because they get headaches and other symptoms. a. True b. False

 

7. Studies have shown that patients who monitor their blood pressure at home are more likely to improve their blood pressure control. a. True b. False

8. White coat hypertension is: a. when a physician has hypertension.

b. when a person’s blood pressure is over 150/95.

c. when a person has high blood pressure readings in the doctor’s office but normal readings at home.

d. when a person has one high blood pressure reading on a home blood pressure monitor.

 

9. When measuring blood pressure, patients should:

a. sit in a chair with feet flat on the floor.
b. take two or three readings separated
by a few minutes.
c. have the blood pressure cuff at the
same level as the heart.
d. all of the above.

 

10. Although we do our best for them, we don’t really expect that people with hypertension will be able to lower their blood pressure. a. True b. False

May/June 2008

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