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The Silent Killers: High Blood Pressure and High Cholesterol

Dr. Rachel Hartline discusses the seriousness of leaving high blood pressure and high cholesterol issues untreated, as well as offers medical and dietary tips to decrease your risk. 

Learn more about Rachel Hartline, MD
The Silent Killers: High Blood Pressure and High Cholesterol
Featured Speaker:
Rachel Hartline, MD
Rachel Hartline, MD is a Family Medicine Physician with Obstetrics at Upland Hills Health in Dodgeville. 

Learn more about Rachel Hartline, MD
Transcription:
The Silent Killers: High Blood Pressure and High Cholesterol

Caitlin Whyte: Now we're all busy, but during this pandemic, it seems like there's a lot more to worry about than our more quiet chronic health conditions. Today, we're talking to Dr. Rachel Hartline, a family physician at Upland Hills Health, about the seriousness of leaving high blood pressure and high cholesterol issues untreated.

This is the Inspire Health podcast from Upland Hills Health. I'm Caitlin Whyte. So Dr. Hartline, why should I care about high blood pressure and high cholesterol?

Dr. Rachel Hartline: Yeah, that's a really good question. It's not something that necessarily you'll feel many symptoms of until it's kind of caused too much damage. High blood pressure and high cholesterol both affect your blood vessels and they cause them to narrow and kind of not function as optimally as we'd like them to. And that overtime puts you at risk for big things that you do care about like heart attacks and stroke and vision loss and poor kidney function.

Caitlin Whyte: Now I hear about statins and medicines that my grandparents are on for high blood pressure. Can you break down some of these different options for medicines?

Dr. Rachel Hartline: Yeah. You know, there's a lot of different options for medicine. Um, for high cholesterol, you know, statins are one that get a lot of buzz because they're ones that, again, like most of the medicines for, uh, for these type of problems, you know, you don't ever really feel the good effects because the effect is preventing a stroke or a heart attack you didn't have, but they may have side effects that you do notice. You know, statins get a lot of buzz because they're one of the ones actually that has the best evidence of preventing problems down the line.

So, you know, when we think about cholesterol, you probably think about the numbers and the numbers are important, but what's really important is preventing those heart attacks and strokes. And statins are that the category of cholesterol medicine that we have really good evidence that shows it prevents those heart attacks and strokes rather than just makes the numbers look better. There's a few other things that can be helpful, especially in people who, you know, try their hardest, but really just can't tolerate a statin very well. But statins are kind of the mainstay as far as cholesterol medicines go.

For blood pressure medicine, there's a lot of really like dozens of choices in a few different categories, but a lot of them sometimes can do double duty for other conditions that you may have, so they can do things like protect your kidneys if you have diabetes, um, you know, make your heart pump better if there's a reason that your heart's not functioning optimally. They can treat things like tremor or anxiety. And in men, sometimes you can get a blood pressure medicine that helps with your prostate. So there's really a lot of choices out there. And it's a good idea to talk with your doctor about other concerns that you might have that we can address maybe with a blood pressure medicine as well.

Caitlin Whyte: Now you mentioned that, you know, you don't feel the good effects because they're preventative and then some of the side effects that medicine has. Can you tell us more about those?

Dr. Rachel Hartline: Yeah. So the side effects, it really depends a lot on the medicine that you're taking. And honestly, most people will take the medicine and really not notice any significant side effects, but there's always, you know, a sizable minority of folks who take something and notice it. It depends on which medicine you're taking, which side affects you may notice. But for example, with statins, a common side effect is muscle aches, um, or cramping. And sometimes we can help people with that by having them take it at night or, um, to take a supplement called CoQ10 that can sometimes decrease the chance of that happening or switching to a different medicine in the same category. Sometimes you have more side effects with one than with another. So there's lots of ways to sort of work around that problem if it comes up, but at the same time, you know, knowing that it's a medicine that you're only going to prevent things. Um, you won't necessarily, you know, feel better having taken your statin.

Caitlin Whyte: So if I have high blood pressure, high cholesterol, and I don't know it yet, I mean, are there symptoms that I'm probably feeling or is it completely kind of an invisible condition?

Dr. Rachel Hartline: Okay. Yeah, a lot of times, um, it's completely unbeknownst to you. You know, that's part of why we think of them as kind of the silent killers. If your blood pressure gets really high, sometimes people will have a headache or they notice chest pain or blurry vision. Um, but that is a lot less common than the kind of low-level high blood pressure that your doctor's office picks up on. But you say, "Oh, I feel fine. I don't know if that's really anything. I'm just nervous to be here." Um, you know, a lot of times we have that discussion. "No, I really, you know-- this has been happening over time." And that poses a risk over time. You know, that's part of why your doctor's probably, um, more concerned about it than you might be, is that low-level over time can also cause changes to your blood vessels. Um, even though it's not an emergency, it's something that we should, um, help reduce your risk with.

Caitlin Whyte: Is there anything for people who maybe don't want to go on a daily medication or something I could pick up at the drug store?

Dr. Rachel Hartline: Yeah. So there's lots of ways to kind of lower your blood pressure and cholesterol risk. And so it starts with what you're putting into your body. So, um, your diet is the biggest thing that can impact changes for most people. So the less processed food you're eating and the more kind of stuff you were eating that was recently alive, either it was like growing from the ground, came from a tree, you know, was on four hooves, you know, those types of things. When they've been, you know, not had a bunch of things added to them at, you know, the potato chip plant or whatever. If it doesn't come necessarily from a bag, but, you know, from a farmer's market or even with the grocery store, but, you know, someplace, um, that sells things that were recently grown. That's like a good rule of thumb for kind of how to eat to lower your blood pressure, because most food that gets kind of processed is going to have a lot of hidden salt in it and food that you prepare yourself, you know how much salt is going to be in something. But if you get it at a restaurant or get takeout or something, um, a lot of times those things, you know, make things taste better. So there's a lot added behind the scenes that you don't necessarily know about, but salt is one of the biggest things that can affect in terms of blood pressure. And then in terms of cholesterol, the more you can focus on those kinds of foods that were recently growing, that is a really good way to approach things, more fruits and veggies.

Caitlin Whyte: So with this being such a silent killer, like you say, I mean, how-- it makes me think that people might not take it as seriously as other diseases because they're not feeling it. I mean, what happens if people kind of throw it to the side or don't really take it that seriously?

Dr. Rachel Hartline: Yeah. I mean over time it just increases their risk of problems. So, you know, uncontrolled high blood pressure for a long time can cause damage to the kidneys. It can cause damage to your vision. And the biggest, like sort of, you know, event that can happen is heart attacks and strokes. Strokes are kind of where the blood flow to your brain gets disrupted and that can happen because those blood vessels aren't behaving the way that they're supposed to.

Caitlin Whyte: Great, doctor. Anything else you want to add to this conversation about high blood pressure and cholesterol?

Dr. Rachel Hartline: I think the other thing I would add is that there's a lot of times that-- well, A, I think there's a lot of times that your doctor thinks you're taking your medicine and you're not necessarily, and we can't help you out unless you being honest with us. Um, and so we, you know, try and ask questions in an approachable way, but if we're not getting to the hardest things or, you know, if we don't have that accurate knowledge, we can't help you very much or help you as much as we'd like to anyway.

And the other thing I would say is that there's a lot of barriers in terms of costs sometimes. And it's not easy for us to know how much things are going to cost when we send them because there's so many different insurance plans. So if you get to the pharmacy and discover this is more expensive than what you can afford, um, or what you want to afford, definitely call us back and we can work around. There's a lot of, especially blood pressure medicines that are on, um, the generic $4 list at most pharmacies.

Caitlin Whyte: Well, thank you so much for your information and your time Dr. Hartline. To learn more, you can call (608) 930-8000. That's (608) 930-8000. Or visit us online at uplandhillshealth.org. Thanks so much for hanging out with us. This has been the Inspire Health podcast. I'm your host, Caitlin Whyte. Stay well.