Physicians generally assume their patients take their medicines, but in reality, this is often not the case. This is particularly true for medicines used to treat high blood pressure. It turns out that over 25% of the 18.5 million Medicare beneficiaries prescribed a blood pressure medicine do not adhere to the instructions on how to take it. That amounts to 4.9 million seniors not taking their medicine as directed.
This lack of adherence to the prescribed regimen is important because those who follow the instructions are 45% more likely to achieve blood pressure control, which is associated with a 38% reduction in risk for heart disease and stroke when compared to people who are nonadherent.
Barriers to treatment
There are many reasons for nonadherence, starting with the fact that hypertension is typically a silent disease without symptoms. In other words, people with high blood pressure generally feel the same whether or not they take their medicine, so it is easy to forget and hard to be motivated to adhere to treatment. Additional common reasons for not taking blood pressure medication include high cost and difficulty sticking to a schedule. Blood pressure medicine can also be associated with a wide range of side effects depending on what class of drug you are taking. It is not uncommon for individuals to report they feel better when they don’t take their meds.
If you are one of the 25% who isn’t taking your medication as prescribed, please start by having an open and honest discussion with your doctor. If cost is a problem, generics might be an option, and some pharmaceutical companies have discount programs or will pay for medication entirely. Drug costs can also vary significantly among pharmacies. If side effects are bothersome, your doctor may be able to adjust the dose or prescribe something different that is more tolerable; perhaps you can focus on lifestyle changes and achieve control even without medicine at all. Most importantly, don’t be silent and suffer with a side effect when there may very well be a suitable alternative.
Finally, if motivation is a problem, monitoring your blood pressure at home can help. That way you can see the beneficial results of taking your medicine every day. It is also important to understand the risks of high blood pressure and the resultant effects uncontrolled disease can have on your independence and daily functioning.
This is not easy. Only 50% of seniors with high blood pressure have achieved adequate control. Take the time to learn about your options, partner with your doctor, and together you can formulate a plan to reduce your risks and feel well. It can be done.
Matt Narrett, M.D., is chief medical officer for Erickson Living and leads the medical team at all Erickson Living communities. He received his medical degree from Harvard Medical School and has been providing care for seniors for over three decades.