European Stars And Stripes (Newspaper) - August 25, 1987, Darmstadt, Hesse                                Better use of drugs in Battle against High blood pressure by Daniel q. Haney associated press High blood pressure is probably the sneak ies cd the world s big time killers. But its perils Are yielding to an armory of drugs along with doctors newfound prowess in using Triem. People with High blood pressure often feel just Fine. But lha drugs Means to keep them wait can leave them depressed lived even impotent. From the patient s Point no View the treatment often seems worse than the disease. As 9 result people May refuse to take their blood pressure drugs even though they know the Huray can save their lives. This dilemma has provided an incentive to create Beller drugs and find better ways to administer them. Or. Edward Rocella of the National institutes of health says the Effort is making life better for people with High blood pressure. Physicians Are now tailoring their drug therapy to the extent that the Side elects should virtually disappear he says. The first step in conquering High blood pressure what doctors Call hypertension is learning who has it. And this is one area where americans have made lots of Progress. In 1984, when the last figures were Pul together 65 percent of americans with High blood pressure knew they had it. In the Early 1970s, Only half were aware of their disease. People have also become far More Likely to do something Aboul it. In 1934, three quarters of americans with High blood pressure were taking medicines to control their condition compared with just a third in the Early 1970s. Yet Rocella who coordinates the National High blood pressure education program readily concedes that there is plenty of work to be done. Uncontrolled hypertension continues to kill people he says ii is the major cause of stroke which is the third leading cause o death " this year he says about 150,000 americans will suffer strokes and Many will die from them. Much of this death and disability could be prevented if people had their blood pressure under control hypertension is also a major underlying cause of heart attacks and kidney disease. Thu Good news is that there Are a variety of ways to control hypertension he says. Diuretics and Beta blockers have been mainstays of hypertension control Lor several years. But two new varieties of Medicine have been introduced that work Well with fewer Side effects. They Are Calcium Channel blockers and angiotensin convening enzyme or Ace inhibitors. Those Are very exciting new directions says or. Dorothea period of the University of California san Francisco medical Center but Hoo older experts she believes those potent medicines must be meted out carefully. With More than 50 hypertension drugs on the Market prescribing the right one can be confusing. The federally appointed joint National committee on detection evaluation and treatment of High blood pressure issued ils most recent guidelines just three years ago. But the Field is evolving so quickly thai these recommendation Are already out of Date. One of the most significant things that has happened in the last two years says or. Harriet p. Dunstan of the University of Alabama has been the growing realization and acceptance that there Are certain characteristics that determine responsiveness to Anil hypertensive drugs so you can get Beller  Fqy example doctors arc learning that diuretics work Beller in Black people than they do in whiles while Beta blockers Are frequently info Lclive in Blacks bul us Lul for whiles. Diuretics Are often better than Beta blockers for the elderly but Bela blockers work nicely Tor younger people the Issue for us is learning to use a drug correctly says Focella. Doctors arc tinkering with varying doses and combinations of medicines to Malch patient with therapy. In the past he says drugs were Given at fairly High doses because we were concerned about lowering blood pressure. We be recognized that such a High dose in t needed. And As a Teush some of the drugs Are being used at loss than a full dose and therefore the Side of Leclare  another strategy he says is to Combine Low Levels of two different drugs rather than giving a big dose of one. Often this too will minimize Side effects drugs Aren t always needed either any folks with mildly elevated blood pressure can bring it Down by losing weight and cutting Down on Salt and alcohol. Even the definition o hype Ilenson is evolving. Most exports now agree that anyone with blood pressure of 140 Over 90 has it. But those with Dias lost pressure the second and lower number of the iwo that s Between 85 and 89 should try to change their eating habits to Stop lha pressure from rising one area that s still uns called is what to do Tor people with diastolic pressure Between 90 and 94. Should Thoy get drugs there Are Hawks and doves says Perwolf. Those of us who Are Hawks think that we should treat even the ones Wilh mild disease before they become severe disease and the doves say let s Wail a while but All at us agree that one should  this is Likely to mean thai a Man who smokes is overweight and has High blood cholesterol Levels will be Given Medicine even if his blood pressure is Only mildly elevated while an otherwise healthy woman with the same blood pressure but no family history of strokes will not be. How blood pressure is measured blood pressure is usually measured by observing How Many Millimetres i column of Mercury n sea a a result of a pressure applied when an artery is squeezed a la an inflatable cull. Trie  . B the Reading is Given in two figure separated by a slash. The higher pressure called systolic is taken when blood rushes through the arteries impelled by heart muscle contraction. A systolic pressure of 210 would be dangerously High a Normal Man or woman of Middle or Lale 50s would legs Sliff roughly 139. C Dia Aidlic blood pressure ii measure Din me Lull when the heart is relaxing alter a beat Trio healthy Middle aged person would probably have a diastolic pressure of Aboul 84, tuesday August 25. 1987 the stars and stripes Page 17