BOOK REVIEW
Hypertension and You: Old Drugs, New Drugs and the Right Drugs for Your High Blood Pressure
Hypertension and You: Old Drugs, New Drugs and the Right Drugs for Your High Blood Pressure’
By Samuel J. Mann, M.D.
Published by Rowman & Littlefield Publishers, Inc. Lanham, Maryland, 2012: 196 pp.
By Merri Rosenberg
With more than 70 million Americans diagnosed with hypertension (or high blood pressure) and about 50 million of them taking some form of medication to manage their condition, this book does a useful service.
The author, Samuel J. Mann, M.D., is a professor of clinical medicine at New York Presbyterian Hospital/Weill-Cornell Medical College and an expert in hypertension. Clearly frustrated by the misinformation, and mismatch of medications that plague patients, this targeted volume is intended to deliver concise information to medical consumers about what these medications do, what the side effects might be and how to work with your doctor to achieve the best results.
Untreated hypertension puts patients at risk for strokes, chronic kidney disease, aortic aneurysms, heart attacks and heart failure. Patients with hypertension (like any patient) aren’t identical, which means that the medications they take shouldn’t be, either. As Dr. Mann acknowledges, one of his goals in writing this book is trying to address the reality that “Millions of people who are taking their medication regularly aren’t getting the results they should be getting.” For patients, he urges, “If you are going to be taking blood pressure medication for the rest of your life, it is imperative to get it right.”
Not only are many side effects unpleasant, but patients may be so uncomfortable from them that they’re not as compliant as they should be about following a treatment plan. For example, depending on the dosage and type, diuretics may cause muscle cramps, gout, or erectile dysfunction. Calcium blockers can lead to constipation or edema. Beta- blockers can cause weight gain, mental fogginess, fatigue, asthma and depression. And patients on alpha-blockers may experience fainting, dizziness or edema.
But Dr. Mann’s take-away message is not avoiding medication. This is not the place to go if your concern is managing your hypertension through lifestyle adjustments, like diet and exercise. Dr. Mann doesn’t discount the benefit of lifestyle changes, but his focus remains fixed on the 50 million Americans who “can be doing better than they are doing.”
His goal is helping readers find “the drug or drug combination that is right for you,” which “is the one whose mechanism(s) of action matches the mechanism(s) underlying your hypertension.”
One of the biggest problems, Dr. Mann suggests, is that non-specialists often don’t have enough knowledge about hypertension medications, and the various side effects or combinations of these drugs with other medications. When patients are seen by hypertension specialists, the odds are distinctly better that they’ll receive a more customized and effective treatment plan.
Ultimately, says Dr. Mann, simplifying the choices for patients and their doctors will lead to better outcomes. He writes, “the drug treatment of hypertension has become too complicated … It needs to be simplified, so that it is teachable and understandable yet takes into account that different people need different medications.”
Dr. Mann has done just that. #
