One-third of people abandon treatment for high blood pressure

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“I had very high blood pressure for over 20 years – usually 120 to over 200. It was unrecognizable. I usually lift several tons with dumbbells in an evening. I smoked a pack a day, but I didn’t get suffocated,” recounts 51-year-old Jiri Danko in the hallway of the Brno University Hospital.

Several years ago doctors put him on various blood pressure medications and advised him to lose a few pounds. “I have nothing left,” he says, showing a photo of his toned muscles as a four-year-old. The pressure didn’t ease, and Jiri later admitted that she had given up treatment.

“Mr. Danko reminds me how I wish it didn’t end for most patients. So most of them start treatment on time,” says his doctor, Petra Vysoganova, in the office a few minutes from the internal cardiology clinic.

We’re in one of the offices of the Hypertension Treatment Center, and Jiri Danko is joking with the doctor: “If you get caught by the doctors, you’ll never get out.”

Photo: Tomáš Svoboda, Seznam Správy

The Center for Hypertension Treatment is located in the front building of FN Brno.

Two years ago, high blood pressure brought him to the brink of death – the inner wall of his aorta, or heart tube, ruptured. “After exercising in the morning, I took a bath and packed cigarettes. First, pain in the lower jaw, as if someone is pulling your forehead with one hand and tearing your jaw from your head with the other. I wiped the sweat from my forehead and the second, better phase began,” he recalls of the difficult moments.

He could not breathe, move or make a sound. “It is said to be a pain worse than childbirth. At that moment I really wanted to die.’

Nevertheless, he managed to call an ambulance and woke up in two days. He says doctors gave him only a few percent chance of survival during the operation. He did just that as he battled colon cancer last year.

Photo: Tomáš Svoboda, Seznam Správy

Doctor Petra Vysokhanova with patient Jiri Danek.

Now he is one of the regular visitors to the Bohunice Center in Pavilion X. He treats dozens of patients every day — mostly those who aren’t helped by the practitioner’s usual high blood pressure treatment.

“Mostly we’ve already put out the fire.”

Doctors consider hypertension a condition in which a patient’s blood pressure is repeatedly measured between 140 and 90 mm Hg or higher.

“We often deal with difficult cases of so-called resistant hypertension, where the patient is taking four drugs for hypertension and still does not have satisfactory values ​​or has serious organ problems such as heart failure or damaged blood vessels. We are already trying to put out the fire and keep the damage to a minimum,” he said. Vysokhanova explains.

Zora Lukasová and ninety-year-old Věra Zajíčkova are also sitting in the waiting room before the examination room. “I think mom started medicated with high blood pressure and then the meds leveled it out. Now the pressure is on her. She’s been treated for chronic heart arrhythmia and has a pacemaker,” he narrates.

Her main mother still lives alone and continues to work in the garden. “I can’t read, my vision is bad after eye surgery. There’s nothing on TV, what should I do?” laughs Veera Zajikova.

Photo: Tomáš Svoboda, Seznam Správy

Zora Lukasova and her ninety-year-old mother, Vira Zajikova, also regularly visit the center.

Genetic predisposition and lots of salt

Czechs have the highest blood pressure in the world. “According to statistics, two million hypertensive patients are now treated in our country and many more remain undiagnosed. We can say that half of the adults will develop high blood pressure in our lifetime,” explains the doctor, adding a famous note from the textbooks, “High blood pressure doesn’t hurt, it kills.” .

High blood pressure can have many causes – smoking, being overweight, lack of exercise, polluted air or lack of sleep. Vysoganova also notes the strong genetic predisposition of people from Central and Eastern Europe.

“Scientists explain this by genetic stress over the last thousand years, such as famine or various infectious diseases. They worked out that people could maintain high blood pressure even in negative personal circumstances,” explains the doctor.

According to him, when the average life expectancy at that time was about 40 years, high blood pressure may have been genetically favored, but now we double the age when the damage to the organism from high blood pressure becomes evident over time.

“A high proportion of patients with salt-sensitive hypertension is common in this part of the world. If they eat too much salt, it increases the pressure,” he explains.

One of the most common causes of high blood pressure is salt. Czechs are among the world leaders in high salt consumption. “The average here is 13.5 grams per person per day, the European average is 10 grams and the World Health Organization recommends a daily intake of five grams. We are almost three times higher,” emphasizes Jan Waklavik, head of the Department of Internal Medicine and Cardiology at Ostrava University Hospital and head of the Faculty of Medicine, University of Ostrava. .

According to him, checks are only partially responsible for the problem. “We take three-quarters of the food we buy as salt. For example, baked goods in the Czech Republic contain more salt than anywhere else in Europe. Sausages, which we consume more than other Europeans, also contribute to this,” he adds. He mentions sauces, ketchup, mustard or potato chips.

Last week, he lectured among hundreds of experts at a conference of practitioners in Brno. At the same time, he presented the National Salt Income Reduction Scheme there. “The goal in the Czech Republic is to reduce salt intake by 30 percent by 2030. We will reach the European average of around ten grams of salt per day,” calculates Vaclavić. According to experts, cardiovascular events can decrease by up to 30 percent.

Computer scientist Jiri Danko reflects on what was behind Bohunis’ hospital collapse two years ago. He did not restrict himself in any way in food or cigarettes. “But only the one at the top knows the exact reasons,” he explains.

In an examination room for routine testing, the new device measures his blood pressure repeatedly for several minutes. The cuffs around the arm are raised by the wind, and a general growl is heard. “The patient has to sit still. The device then averages the measured values,” explains nurse Victoria Kristen.

After some time, the screen shows a pressure of 124/72. He manages to de-stress.

Photo: Tomáš Svoboda, Seznam Správy

Jiri Danko in the exam room.

The center’s doctors use four basic drug groups to try to find the right combination of drugs for each patient. It is different for elderly or pregnant women.

According to a survey commissioned by Seznam Správy in the project How to live in the Czech Republic from Ipsos, Czechs often take medication for high blood pressure. About a third of people take them regularly.

Patient failure

Ninety-year-old Věra Zajíčkova admits that in the waiting room, she took 12 drugs in addition to blood pressure, for example, cholesterol or thyroid gland. “I have a dispenser all week. I remember it for years. He hates certain medications, so I have to take it apart,” she says.

Dr. Vysokhanova emphasizes that modern medicine is trying to reduce the number of pills. “We have clear data. The more the patient takes them, the more dramatically the probability of him missing one of the medications increases. From six a day it becomes almost certainly the limit.

They also take blood pressure pills. “We have standard combinations that require two or three blood pressure medications in one pill. We try to have the patient take it once a day,” Vaclavic says.

Doctors also appeal to young people whose high blood pressure problems are just starting and have not yet damaged organs in the body. “It is a big problem for us to explain to the patient that in the best case scenario I am treating a disease that would not cause any problems. It is estimated that a third of patients stop blood pressure treatment in the first year. The patient failure in this case is huge,” says Vysokhanova.

He calls for prevention. The above national plan against excess use of salt prepares a two-stage campaign. Its creators intend to create an expert panel with representatives from ministries. “We want to tackle the food industry so that manufacturers reduce the amount of salt in food, and create an education campaign for the public so that people are aware of the consequences of consuming too much salt,” says Waklavik.

They talk, for example, about the most popular food labeling or places on TV, radio or social networks. “For example, we have inspiration from Great Britain or Finland, where the campaign started. Our goal is realistic,” Vaclavić says confidently.

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