According to a study published in 2012, stroke is one of the top five leading causes of death and one of the top 10 causes for hospitalization in Malaysia. The top 5 risk factors are hypertension, diabetes, hyperlipidemia, smoking, and ischaemic heart disease whereas the main culprit for cardiovascular disease is a silent killer, high cholesterol level. This is due to the fact that lipids or fat molecules accumulation in the blood vessel causes narrowing of the passage and gradually but greatly reduces oxygen flow to the organs, precipitating the onset heart attack and stroke. Stroke is usually a consequence of heart diseases. However, both diseases are easily preventable through lifestyle modification and preventative medications such as Micardis. Until a sudden attack occurs, patients usually choose to turn a deaf ear to a doctor’s health advice.
Prevention is better than cure and it’s better late than never. Lifestyle changes start with making better food choices even though it is understandably the hardest first step to make as Malaysians are blessed with a variety of food available 24/7. Health advocates use the concept quarter and a half to ease the public’s understanding of meal planning. Basically, your plate must consist of a quarter of carbohydrates, a quarter of protein and half a plate of vegetables and/or fruits.
The next step is to enjoy the outdoors. You are advised to allocate 150 minutes per week for working out. Exercises can be as easy as slow walking in the park, yoga, meditation, pilates to hiking, jogging or even building on your physical strength in the gym. Exercising is beneficial because a heightened level of adrenaline helps break down sugar and fat into energy production in addition to increased oxygen supply to vital organs, thus preventing heart attack or even body aches. Do you know, sweat production and increased respiratory rate aids in removing toxins and other metabolic by-products in our body?
Medical professionals will also include prescriptions such as Micardis to reduce the risk of stroke in those who are unable to take ACE inhibitors (ACEi). Micardis belongs to the class of angiotensin receptor blockers (ARBs) drugs with Telmisartan as its content, one of the antihypertensive medication types. Unlike ACEi, it has an added benefit of not causing coughing episodes. 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.
Other groups of medications for consideration of being prescribed by doctors includes:
- ACEi: Captopril, Enalapril
- Beta blockers : Propranolol, Metoprolol
- Calcium channel blockers: Verapamil, Diltiazem
- Diuretics: Furosemide, Thiazides
- Vasodilators: Hydralazine, Nitroprusside
- Central alpha-2 agonist: Clonidine, Methyldopa
Pharmacology treatment is prescribed accordingly based on the patient’s response to their medications. After a given duration of being put on one of the medications, follow up will involve inquiring about blood pressure control and for probable side effects. Alteration of dose, change of medication type or additional treatment will be considered if blood pressure control is not satisfying.
One of the most common misconceptions of patients is stopping medication after blood pressure is under control. With a definite diagnosis of hypertension or heart diseases, strict adherence to medication is needed to prevent a life-threatening complication, for instance, cardiac arrest. Thus, patients are advised to attend constant follow-up as both heart attacks and hypertension can precipitate the insidious onset of illness in other organs such as kidney disease.