Who's Who for Treating High Blood Pressure

How well is your health care professional doing at helping you manage your high blood pressure? According to the studies, not too well. Physicians tend to significantly overestimate how well their patients manage their high blood pressure; wait too long to recommend medication (and even then often don't prescribe it according to national guidelines); and suggest lifestyle changes to fewer than half their patients with high blood pressure. Doctors are also slow to switch their patients' medications when blood pressure levels remain high.

However, physicians aren't the only reason so many people have uncontrolled hypertension. Patients also play an important role. They may not make the recommended lifestyle changes or may not take their medication as directed. In fact, studies find that 30 percent or more of those with hypertension don't take their medication as they should. One reason is that it's hard to take medicine when you don't feel sick—and remember, high blood pressure usually causes no symptoms! Another is that the medication may have side effects so people stop taking it, often without speaking to their health care team. Unfortunately, many patients don't talk to their doctor about medication concerns—whatever they may be.

What's important here is not only that you make the lifestyle changes you and your health care professional discuss and take your medicine as directed, but also that you keep the lines of communication open between you and your health care professional. In fact, studies find that partnering with your health care professional and sharing in decision making about your disease can improve how well you stick to your treatment plan and how successful it will be for you.

Your primary care provider—whether a family physician, internist or nurse practitioner—will most likely treat your high blood pressure. Other medical professionals involved in your high blood pressure treatment team may include:

• A nephrologist if you have kidney disease
• An endocrinologist if you have diabetes
• A cardiologist if you have cardiovascular disease
• A neurologist if you have had a stroke or have other neurological diseases