Prof. Edyta Zbroch: "After a year, many patients simply stop taking their medications – even those who have had a heart attack"

Prof. dr hab. Edyta Zbroch: All of this is regulated – I personally can have my preferences, but first and foremost we have guidelines for the treatment of hypertension. Recently, our Society's joint recommendations, developed in cooperation with the Polish Cardiac Society, were published. They specify when – depending on the level of blood pressure – pharmacological treatment should be started.

However, drug treatment must always be supported by non-pharmacological treatment. And in the case of mild hypertension, we can – at least initially – limit ourselves to non-pharmacological methods alone. Neither the patient nor the doctor should underestimate the importance of lifestyle modification. This is a very broad concept, encompassing many different elements that can actually lead to a reduction in blood pressure.

That is why it is worth using these methods and reminding patients that there are effective ways to change their lifestyle. Often, at various health promotion events, we emphasize how important prevention and daily habits that support health are.

EZ: Absolutely. Today, we are increasingly dealing with young, so-called young adults. As a hypertension specialist, I am seeing patients at an increasingly younger age, often referred by pediatricians – which means that their hypertension was diagnosed in childhood or adolescence.

This is directly related to obesity, which, unfortunately, is on the rise in our country. We often have the so-called constellation: obesity, diabetes, hypertension - and it is this that makes us struggle with the problem of blood pressure much earlier than before.

In addition, there is an unhealthy lifestyle and stress, although the latter has always accompanied people. The difference is that awareness is also growing now - patients are more likely to report to the doctor because of high blood pressure, and the educational activities we conduct are starting to bring real results.

Thanks to this, elevated blood pressure values ​​can be detected earlier. More and more young people have hypertension and in general it is diagnosed more often.

EZ: This is indeed a big problem, which is increasingly being discussed at conferences and conventions. Because we already know how to treat hypertension, we know how to do it effectively – but the biggest challenge is to keep the patient on treatment. Large epidemiological studies show that after a year, many patients simply stop taking their medication – even those who have had a heart attack. They feel fine, so they stop taking the treatment.

I always tell my patients: hypertension, as the editor rightly pointed out, is a chronic disease. It is not angina, which we get rid of after one course of antibiotics. The treatment must be constant. The fact that the patient has good blood pressure today is the result of systematically taking medications over the past few days - it does not mean that the disease has disappeared. It is only well controlled. In order to maintain this condition, the therapy must be continued.

Fortunately, solutions are emerging that make it easier for patients to follow recommendations. Both doctors and pharmaceutical companies are now promoting the use of multi-ingredient drugs – so-called SPC tablets, which combine several substances in one dose. There is also a campaign called “Less Medicines” aimed at doctors. Thanks to the website małolekow.pl , you can enter the names of the drugs you are taking to check if they can be combined into one tablet.

In the treatment of hypertension, this is a huge convenience – we have available preparations combining up to three antihypertensive drugs in one tablet, available in different doses. For many patients, this means the possibility of effective and simple treatment – ​​one tablet in the morning is enough to control the pressure throughout the day. And this is really not a big burden.

When it comes to costs – there are of course different products, both reimbursed and non-reimbursed, but generally speaking, antihypertensive drugs are not expensive today. For people over 65, reimbursed drugs are completely free. Despite this, I observe that even patients who could receive drugs for free do not always take them. I have the impression that sometimes they simply do not respect them – because if something is free, then "I will take it or I will not take it", "I will buy it or I will not", "I will put it aside and then it will expire".

But someone pays for these drugs. Just because they are free for the patient does not mean they are free. The state pays for them. And the state is us – the citizens. That is why it is important for us all to be aware of this responsibility.

EZ: Access to medicines in Poland is really good. Of course, new products – especially the newest combinations – are not always reimbursed immediately, but their prices are not prohibitive anyway. Sometimes I see people in pharmacies spending money on supplements, vitamins, “off-label” products, which are not really medicines. They don’t waste their money on that. And when they go to the doctor, they want the “cheapest and best” medicines – and unfortunately, that doesn’t always go hand in hand.

In the meantime, you can really ask your doctor to choose a therapy that will be financially adapted to the patient's capabilities. Even if it is not a multi-ingredient drug, you can use cheaper substitutes - effective and affordable. You just have to ask.