Is chronic medication making you chronically ill?

If your chronic medication ‘does its thing’, but simultaneously results in intolerable side effects, you are in a predicament. But you are not alone.

For the purpose of this article, blood pressure medications are under review, seeing that recent statistics from the World Health Organisation suggest that hypertension affects one in three adults worldwide.

Is bringing down your blood pressure worth the symptoms that your hypertensive medication could bring on board? According to the American Heart Association that would be a ‘Yes,’ as uncontrolled blood pressure can lead to an array of dangerous cardiovascular outcomes including heart failure, heart attack, angina, atherosclerosis and stroke. HBP can also cause damage to the arteries around your kidneys and vision loss due to strained and damaged blood vessels in your eyes.

Another factor to consider in this Catch-22 is that despite the possible side effects of individual drugs, some medications will react unfavourably when prescribed in combination.

This means that an effective chronic prescription regimen cannot be achieved in isolation, but requires a  balancing act between indicated drugs, their potential side effects and their interactions with other drugs.

However, the good news follows in abundance:

1. There are lots of medication options.

There are nine different classes of drugs prescribed to manage hypertension, and they all have potential side effects:

• Diuretics may cause dizziness and electrolyte imbalances but may also interfere with the action of Non-Steroidal Anti-Inflammatory Drugs, lithium, and some anti-depressants.
• Beta-blockers may cause fatigue and a dry mouth and their mechanisms of action may be reduced by antihistamines, insulin, caffeine, and alcohol.
• ACE inhibitors may cause a dry cough and they may interact with medications or supplements that contain potassium.
• Angiotensin II receptor blockers may cause headaches, and their efficacy may be increased or decreased by over-the-counter medications for colds and flu.
• Calcium channel blockers may cause flushing and swollen feet or ankles. These side effects may be aggravated by consuming grapefruit juice.
• Alpha-blockers may cause a rapid heart rate, nausea and erectile dysfunction and may exacerbate other medical conditions such as narcolepsy and angina.
• Alpha-2 receptor antagonists may cause fatigue and orthostatic hypotension (dizziness when standing up.)
• Central antagonists may cause fever, anaemia, and nasal congestion and may result in dangerously low blood pressure if taken in conjunction with sleeping pills, anti-anxiety medication or alcohol.
• Vasodilators may cause heart palpitations, joint pain, and weight gain and their action may be enhanced by other drugs. This is not a good thing because blood pressure control is preferable to a dramatic drop.

2. The side effects are not set in stone.

Put simply, due to genetic variations in drug metabolism, medication will affect different people differently. More specifically, each administered pill could present four possible outcomes:

• The desired effect: The medication works efficiently at the administered dosage and there are no side effects.
• The undesirable effect: The medication works efficiently at the administered dosage but results in side effects. A dose reduction or an alternate medication may be required.
• The non-event: The medication does not work at the administered dosage, and it does not cause side effects. A dose increase or an alternate medication may be required.
• The worst-case scenario: The medication does not work at the administered dosage, but it still results in side effects. An alternate medication will be required.

3. DNA testing can predict which medications are the most suitable.

Luckily, due to advancements in the scientific study of genetics, we can now predict the likely effect certain medications will have on an individual according to their DNA. Click here to learn more about PharmaGene.

Finding the correct medication to control your blood pressure takes time, care and the utmost consideration of others (other medications that is). However, effective communication with your prescribing healthcare provider and a thorough understanding of the genetic influences  can ensure that your chronic medication is prescribed at the lowest possible dose, for maximum therapeutic benefit and with minimum potential for side effects.

The future of pharmacological management lies in the personalisation of prescriptions according to your unique genetic code.

Similarly, your genetic blueprint will dictate the dietary and lifestyle adjustments required to prevent the manifestation of illness and to optimise well-being. Click here to learn more about 3X4 and your personal genetic guidebook.