Has your doctor recommended a medication to help control your blood pressure or to help control heart disease risk factors? The many medications available can be confusing.
Mathue Baker, MD, Bryan Heart cardiologist, discusses common medications and how they can help lower your blood pressure and control risk factors for heart disease.
Your Blood Pressure, Cholesterol & Heart Medications Explained
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Learn more about Dr. Mathue Baker
Mathue Baker, MD, Bryan Heart
Dr. Mathue Baker is a cardiologist with Bryan Heart.Learn more about Dr. Mathue Baker
Transcription:
Your Blood Pressure, Cholesterol & Heart Medications Explained
Melanie Cole (Host): Has your doctor recommended a medication to help control your blood pressure or to help control coronary artery disease risk factors? The many medications available, can be quite confusing. My guest today is Dr. Mathue Baker. He is a Bryan Heart cardiologist. Welcome to the show Dr. Baker. So, what are some of these medications? Let’s discuss them because they can be confusing. If somebody comes to your office and you determine that they have high blood pressure or certain risk factors for coronary artery disease, high cholesterol; what is the first line of defense? What do you tell them about the many medications available?
Dr. Mathue Baker, MD (Guest): Well there are many medications available depending on exactly what problems the patient’s presenting with. But finding the right medication for the right patient at the right time is sort of our mantra. For patients who come in with hypertension; we have a long list of medications available and depending on what other medications the patient is on, what other problems they have; we can usually find a medication tailored just for their needs.
Melanie: So, sometimes it’s you trying to determine and the first medication you try might not always work, correct, because sometimes people want to know why you switch them around or change the dose?
Dr. Baker: Exactly. Yeah, that’s one of very common questions we get and see as patients who were referred for hypertension who have been on several medicines and they start one and it doesn’t work and, so they start something else and it doesn’t work, and it turns out, all those medicines were working, they just require more than one medication. So, frequently, for hypertension; you end up on a combination of medications and generally you can get medications working together and get patient’s blood pressures down where we like them to be.
Melanie: So, what are some of these medications? Discuss for us Dr. Baker, beta blockers, calcium channel blockers, diuretics, some of these kinds of medications that you might recommend first line.
Dr. Baker: You bet. In our practice, beta blockers are one of the very most common medications that we use. Beta blockers work by relaxing your heart, slowing things down, thereby reducing your blood pressure. The term beta in medicine refers to essentially the effects of adrenaline and so beta blockers work by blocking that effect and if you can imagine what happens to your body when you get a surge of adrenaline, the beta blockers, they basically reverse that process. We find that to be helpful in a whole host of patients. Beta blockers are not only used just for blood pressure; we also use them for arrhythmias, congestive heart failure, sometimes we even use them for high blood pressure and even tremors from time to time benefit from beta blockers.
Melanie: Sometimes a beta blocker has to be combined with other medications, such as a diuretic. Explain what that one does.
Dr. Baker: Absolutely. Diuretics are medications that essentially get rid of fluid and salt from your body and if you think about your cardiovascular system as somewhat of a hydraulics system, the more fluid you jam into it, the higher the pressures get and if you can reverse that process, get rid of the salt and the fluid; those pressures come down nicely.
Melanie: So, that’s interesting because people are always wondering about sodium and salt intake if they do have hypertension or high blood pressure so, it really does make a difference whether they take in salt.
Dr. Baker: Oh yes. Salt can have big effects on blood pressure. Certain patients tend to be more salt sensitive than other patients. Some people can get away with it and some people can’t. But yeah, salt will cause your blood pressure to go up rather acutely and you will see an effect of salt for at least 24 hours.
Melanie: What about things like Lipitor? We hear a lot about these cholesterol lowering statins in the media. What are they? What are they intended to do?
Dr. Baker: So statins are one of our more important medications as well. When people think about statins, they think about them as cholesterol medications. It turns out the effects of statins go way beyond cholesterol numbers in your blood stream. The net clinical benefit of statin medications is that they have a profound effect on reducing your risk of strokes and heart attacks. The underlying process of vascular disease is the development of plaques and on top of that, unstable plaques that rupture result in clinical events that range from strokes to heart attacks and statin medications in addition to the effects that they have on the measured cholesterol also stabilize those plaques and that’s probably where we get the most benefit from statins.
Melanie: So, people also hear Dr. Baker, about simple aspirin therapy and when might that be used and who would you use that for?
Dr. Baker: That’s a great question. It seems like such a simple thing but the research and recommendations on aspirin therapy has been back and forth many times over the years. That’s a good conversation to have with your own physician. Aspirin is not right for everybody, but for those folks who have a history of heart disease or stroke; the net clinical benefit of aspirin almost always outweighs the risk and essentially the risk of aspirin therapy is bleeding and the benefit is clinical reduction in heart attacks and strokes.
Melanie: Another one that you might use along those same lines are blood thinners and maybe if somebody has stroke risk, you might put them on a blood thinner. What is that intended to do and how does that reduce their risk for stroke?
Dr. Baker: Most commonly the true blood thinners that we use are intended to reduce stroke risk in a very common arrhythmia called atrial fibrillation. And their job is to thin the blood out so that as it flows through your heart, the little bit of stagnation that comes with atrial fibrillation doesn’t result in blood pooling and clotting and then essentially jarring loose and causing strokes.
Melanie: So, are there any we haven’t mentioned that you would like the listeners to know about or what questions would you like them to ask their doctor if they are getting put on some combination of any of these medications?
Dr. Baker: Well this is a timely talk. The guidelines were just recently changed for more strict blood pressure control, so it’s a great time for patients to have a conversation with their doctor about their blood pressure, what numbers they have been getting at home and whether or not they need to be more aggressive about blood pressure control. The current recommendations just reduced the goal blood pressure down – all the way down to below 130/85 for most folks.
Melanie: So, what questions would you like them to ask their doctor about these medications because people get worried mostly about the side effects, Dr. Baker, that’s what they hear, they hear side effects may include and some long list. What do you tell them when they say I don’t want to go on a cholesterol medication because I hear these side effects or any of these others? What’s your best advice?
Dr. Baker: Well, I tell people that nothing is permanent and if they start a medication and it makes them feel bad or they are having a side effect that is something they just don’t want to deal with; then there are a million other hypertension medicines out there and we can always stop that medicine and start over, try something different. The important thing is that they just continue to communicate with their physician, whoever is managing their blood pressure and make sure that between the two of them they are able to get on a medication that reaches the goal of reducing their blood pressure and also minimizes side effect profile.
Melanie: Thank you so much for being with us today. It certainly is a timely topic and what great information. If you are concerned about your heart health, take our free quick and confidential heart aware online screening at www.bryanhealth.org/heartaware , that’s www.bryanhealth.org/heartaware . This is Bryan Health podcast. I’m Melanie Cole. Thanks for listening.
Your Blood Pressure, Cholesterol & Heart Medications Explained
Melanie Cole (Host): Has your doctor recommended a medication to help control your blood pressure or to help control coronary artery disease risk factors? The many medications available, can be quite confusing. My guest today is Dr. Mathue Baker. He is a Bryan Heart cardiologist. Welcome to the show Dr. Baker. So, what are some of these medications? Let’s discuss them because they can be confusing. If somebody comes to your office and you determine that they have high blood pressure or certain risk factors for coronary artery disease, high cholesterol; what is the first line of defense? What do you tell them about the many medications available?
Dr. Mathue Baker, MD (Guest): Well there are many medications available depending on exactly what problems the patient’s presenting with. But finding the right medication for the right patient at the right time is sort of our mantra. For patients who come in with hypertension; we have a long list of medications available and depending on what other medications the patient is on, what other problems they have; we can usually find a medication tailored just for their needs.
Melanie: So, sometimes it’s you trying to determine and the first medication you try might not always work, correct, because sometimes people want to know why you switch them around or change the dose?
Dr. Baker: Exactly. Yeah, that’s one of very common questions we get and see as patients who were referred for hypertension who have been on several medicines and they start one and it doesn’t work and, so they start something else and it doesn’t work, and it turns out, all those medicines were working, they just require more than one medication. So, frequently, for hypertension; you end up on a combination of medications and generally you can get medications working together and get patient’s blood pressures down where we like them to be.
Melanie: So, what are some of these medications? Discuss for us Dr. Baker, beta blockers, calcium channel blockers, diuretics, some of these kinds of medications that you might recommend first line.
Dr. Baker: You bet. In our practice, beta blockers are one of the very most common medications that we use. Beta blockers work by relaxing your heart, slowing things down, thereby reducing your blood pressure. The term beta in medicine refers to essentially the effects of adrenaline and so beta blockers work by blocking that effect and if you can imagine what happens to your body when you get a surge of adrenaline, the beta blockers, they basically reverse that process. We find that to be helpful in a whole host of patients. Beta blockers are not only used just for blood pressure; we also use them for arrhythmias, congestive heart failure, sometimes we even use them for high blood pressure and even tremors from time to time benefit from beta blockers.
Melanie: Sometimes a beta blocker has to be combined with other medications, such as a diuretic. Explain what that one does.
Dr. Baker: Absolutely. Diuretics are medications that essentially get rid of fluid and salt from your body and if you think about your cardiovascular system as somewhat of a hydraulics system, the more fluid you jam into it, the higher the pressures get and if you can reverse that process, get rid of the salt and the fluid; those pressures come down nicely.
Melanie: So, that’s interesting because people are always wondering about sodium and salt intake if they do have hypertension or high blood pressure so, it really does make a difference whether they take in salt.
Dr. Baker: Oh yes. Salt can have big effects on blood pressure. Certain patients tend to be more salt sensitive than other patients. Some people can get away with it and some people can’t. But yeah, salt will cause your blood pressure to go up rather acutely and you will see an effect of salt for at least 24 hours.
Melanie: What about things like Lipitor? We hear a lot about these cholesterol lowering statins in the media. What are they? What are they intended to do?
Dr. Baker: So statins are one of our more important medications as well. When people think about statins, they think about them as cholesterol medications. It turns out the effects of statins go way beyond cholesterol numbers in your blood stream. The net clinical benefit of statin medications is that they have a profound effect on reducing your risk of strokes and heart attacks. The underlying process of vascular disease is the development of plaques and on top of that, unstable plaques that rupture result in clinical events that range from strokes to heart attacks and statin medications in addition to the effects that they have on the measured cholesterol also stabilize those plaques and that’s probably where we get the most benefit from statins.
Melanie: So, people also hear Dr. Baker, about simple aspirin therapy and when might that be used and who would you use that for?
Dr. Baker: That’s a great question. It seems like such a simple thing but the research and recommendations on aspirin therapy has been back and forth many times over the years. That’s a good conversation to have with your own physician. Aspirin is not right for everybody, but for those folks who have a history of heart disease or stroke; the net clinical benefit of aspirin almost always outweighs the risk and essentially the risk of aspirin therapy is bleeding and the benefit is clinical reduction in heart attacks and strokes.
Melanie: Another one that you might use along those same lines are blood thinners and maybe if somebody has stroke risk, you might put them on a blood thinner. What is that intended to do and how does that reduce their risk for stroke?
Dr. Baker: Most commonly the true blood thinners that we use are intended to reduce stroke risk in a very common arrhythmia called atrial fibrillation. And their job is to thin the blood out so that as it flows through your heart, the little bit of stagnation that comes with atrial fibrillation doesn’t result in blood pooling and clotting and then essentially jarring loose and causing strokes.
Melanie: So, are there any we haven’t mentioned that you would like the listeners to know about or what questions would you like them to ask their doctor if they are getting put on some combination of any of these medications?
Dr. Baker: Well this is a timely talk. The guidelines were just recently changed for more strict blood pressure control, so it’s a great time for patients to have a conversation with their doctor about their blood pressure, what numbers they have been getting at home and whether or not they need to be more aggressive about blood pressure control. The current recommendations just reduced the goal blood pressure down – all the way down to below 130/85 for most folks.
Melanie: So, what questions would you like them to ask their doctor about these medications because people get worried mostly about the side effects, Dr. Baker, that’s what they hear, they hear side effects may include and some long list. What do you tell them when they say I don’t want to go on a cholesterol medication because I hear these side effects or any of these others? What’s your best advice?
Dr. Baker: Well, I tell people that nothing is permanent and if they start a medication and it makes them feel bad or they are having a side effect that is something they just don’t want to deal with; then there are a million other hypertension medicines out there and we can always stop that medicine and start over, try something different. The important thing is that they just continue to communicate with their physician, whoever is managing their blood pressure and make sure that between the two of them they are able to get on a medication that reaches the goal of reducing their blood pressure and also minimizes side effect profile.
Melanie: Thank you so much for being with us today. It certainly is a timely topic and what great information. If you are concerned about your heart health, take our free quick and confidential heart aware online screening at www.bryanhealth.org/heartaware , that’s www.bryanhealth.org/heartaware . This is Bryan Health podcast. I’m Melanie Cole. Thanks for listening.