Thursday, November 21, 2019
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Micardis for blood pressure

The top 3 infamous health conditions among Malaysians are diabetes mellitus, hypertension, and heart disease, with heart disease as the leading cause of death. Hypertension is diagnosed when blood pressure is more than 140/90 mmHg on two or more properly measured and seated BP readings on each two or more clinic visits. Therefore, repeated measurements are taken to confirm the diagnosis and exclude underlying triggers such after emotional stress, caffeine intake or physical activities.

The public is urged to take precautionary steps starting from adopting a healthy lifestyle by making smarter food choices and staying active whereas for individuals diagnosed with hypertension and/or history of coronary arterial disease, peripheral arterial disease, stroke, transient ischemic attack or diabetes mellitus with end-organ damage, medical treatment is required. Prescriptions are given, for instance, Micardis for blood pressure is mainly to control as well as preventing further complications such as stroke or another deadly heart attack.

Complications of high blood pressure if left unattended?

  • Heart: Coronary heart disease, heart failure
  • Brain: Stroke or transient ischemic attack
  • Peripheral arterial disease
  • Kidney: Chronic kidney disease
  • Eyes: Hypertensive retinopathy
  • Hypertensive crisis defined as persistent elevated BP more than 180/110 with symptoms like headache, dizziness and lethargy. This is a common complication among undiagnosed hypertensive patients.

The risk of developing hypertension and its complication is multiple times greater if the patient also has a family background of hypertension and is a chronic smoker.

Secondary cause of hypertension?

Hypertension can be broadly divided into primary and secondary hypertension. Primary hypertension arises without a known secondary cause. Secondary hypertension can be due to:

  • Parenchymal kidney disease
  • Sleep apnoea
  • Drug-related: Oral contraceptives, steroids, non-steroidal anti-inflammatory drugs, erythropoietin
  • Cushing syndrome
  • Thyroid disease
  • Coarctation of the aorta

Hence, aside from physical examination, further lab investigation will be arranged to exclude the above causes. Factors above will require additional treatment including surgery for example in selected cases of hyperthyroidism. In such a case, removal of the thyroid will resolve the hypertension issue.

What is Micardis?

Micardis belongs to the class of angiotensin receptor blockers (ARBs) drugs with Telmisartan as its content. Unlike ACEi, it has an added benefit of not causing coughing episodes and a long duration of action, thus ensuring blood pressure control throughout the once-daily dosing interval. It exerts its functions by blocking the vasoconstrictor and aldosterone-secreting effects of angiotensin II in many tissues, such as vascular smooth muscle and the adrenal gland.

Where is Micardis being used?

  • Primary hypertension
  • Reducing the risk of getting myocardial infarction (MI), stroke or death in patients more than 55 years old and are unable to tolerate ACE inhibitors.
  • Patients with evidence of coronary arterial disease, peripheral arterial disease, stroke, transient ischemic attack or diabetes mellitus with end-organ damage.
  • As an adjunct to antihypertensive, antiplatelet or lipid-lowering therapy.

How can I get my hands on Micardis?

Micardis is not an over-the-counter medication. It requires a prescription letter by a medical doctor. The patient is then advised to measure and record their blood pressure daily.  After a given duration of being put on one of the medications, follow up will be conducted. During the follow-up session, the responsible doctor will want to observe daily blood pressure control and inquire for any possible side effects in addition to possible organ damage. Alteration of dose, change of medication type or additional treatment will be considered if blood pressure control is not satisfying or the patient is intolerable to the side effects.