Looking after the heart should be a top priority, but despite heart disease being largely preventable, it’s Australia’s leading cause of death. With blood pressure an important indicator of heart health, pharmacies play a significant role in encouraging customers to have their blood pressure monitored and their heart health checked regularly.
Cardiovascular disease (CVD) is an umbrella term encompassing heart, stroke and blood vessel diseases. According to the Australian Institute of Health and Welfare, CVD was responsible for more than 600,000 hospitalisations in the 2020/21 financial year, and In 2019/20, 107 million PBS prescriptions supplied to the Australian community were for cardiovascular medicines. Along with this, high blood pressure or hypertension were the most common chronic conditions recorded in patients.1
High blood pressure is the most important risk factor for CVD, which is why encouraging patients to be aware of their blood pressure can mitigate the risk of the disease.2 With many pharmacies offering blood pressure screening, pharmacy assistants can help patients to remain informed about their health and advise that they arrange a blood pressure test.
Heart Foundation National Clinical Evidence Manager Dr Amanda Buttery says everyone should be aware of their blood pressure, to keep track of their heart health.
“It’s important to know what your blood pressure numbers are and what they should be,” she said. “See your doctor for a regular heart health check, especially if you’ve been diagnosed with high blood pressure.
“Your doctor will tell you what your ideal blood pressure should be, based on your medical history.
“You can have your blood pressure measured by a doctor, a nurse, a pharmacist, or at home with an approved machine. Your doctor will usually be the one to ask you to measure your blood pressure at home – if needed.”
Tanya Hall, CEO and founder of health promotion charity hearts4heart, agrees that retail pharmacy assistants can help their communities to prioritise heart health by encouraging blood pressure monitoring.
“Many pharmacies offer screenings for blood pressure, cholesterol, and other risk factors for heart disease,” she said. “Retail pharmacy assistants can encourage their customers to participate in these screenings and provide information on the importance of early detection and management of heart disease.”
What is blood pressure?
“Blood pressure is the pressure of your blood on the walls of your arteries as your heart pumps it around your body,” Dr Buttery said.
“Blood pressure is recorded as two numbers. The systolic blood pressure, the higher number, indicates the pressure in the blood vessels when the heart is contracting or pumping. The lower number is called the diastolic blood pressure, and this is the pressure when the heart is relaxing before the next beat.
“A ‘normal’ blood pressure reading would be a systolic blood pressure under 120mmHg and diastolic blood pressure under 80mmHg.”
Some variation in blood pressure throughout the day is normal and can be influenced by the activities you do throughout the day, Dr Buttery says.
“Your blood pressure will go up and down naturally throughout the day [and] can go up temporarily due to stress, your emotional state, recent physical activity, caffeine consumption or even talking,” she said.
Hypertension
High blood pressure is also called hypertension, and represents a significant risk for CVD as it increases pressure on the heart and arteries, Dr Buttery says.3
“There are no obvious signs or symptoms of high blood pressure, so you may not know you have it,” she said. “That’s why it’s important to have regular check-ups to measure your blood pressure levels, and learn how to manage it. Over time, high blood pressure can increase your risk of having a heart attack or stroke.”
Dr Buttery says high blood pressure has no single specific cause, but several factors can increase the chances of developing it, including:
- Family history.
- Eating patterns (including salty foods).
- Alcohol intake.
- Smoking
- Weight.
- Physical activity and exercise levels.
Reducing the risk
Ways to help reduce the risk of CVD include maintaining a healthy lifestyle and staying informed about general health.
“The Heart Foundation recommends that you’re at least physically active for 30 minutes each day, follow a heart-healthy eating pattern, achieve and maintain a healthy body weight, limit your salt and alcohol intake and quit smoking,” Dr Buttery said.
Natalie Raffoul, Healthcare Programs Manager at Heart Foundation, added: “If you’re 45 or over – 30 for Aboriginal and Torres Strait Islander people – you should visit your GP for a heart health check, which includes measuring your blood pressure. This will help determine your risk of having a heart attack or stroke in the following five years.”
“During a heart health check, the GP will also check your blood pressure, cholesterol and blood sugar (glucose) levels, and have a discussion with you about your family history and lifestyle.”
Dr Buttery says that while medicines can be prescribed to help control blood pressure, many lifestyle changes can be implemented to help ensure blood pressure is at a normal level.
“You may be prescribed medicines to help manage your blood pressure, but there are other things that you can do to help,” she said.
Promoting good heart health as a PA
Dr Buttery says pharmacy assistants should remind communities that the best way to look after [their] heart is with a healthy lifestyle, and that they should refer to the Heart Foundation website for “trusted information”.
She offers these tips for PAs to suggest in promoting good heart health within their communities:
Follow a heart-healthy eating pattern
- Develop a ‘heart-healthy’ way of eating by enjoying a variety of nutritious foods regularly.
- Eat plenty of vegetables, fruit and wholegrains to help with your weight, blood pressure and cholesterol.
- Use herbs and spices to flavour foods, instead of salt (a diet high in salt can lead to higher blood pressure). Most of the salt people consume is found in processed and packaged foods such as canned goods, deli meats such as ham and salami, and baked goods.
- Choose healthy fats and oils. Foods with high amounts of healthy fats include avocados, olives, nuts, and seeds. Healthy oils for cooking include olive, canola, sunflower, peanut and soybean oil.
Manage cholesterol
- Cholesterol is a fatty substance carried in your blood.
- Your body needs some good cholesterol (HDL) to be healthy, but too much bad cholesterol (LDL) in your blood can increase your risk of a heart attack or stroke.
Manage diabetes
- If you have diabetes, it’s important to manage the disease effectively to help prevent a heart attack or stroke.
- A GP can refer you to a credentialled diabetes educator if you need more support.
Be physically active
- Regular physical activity is important for your heart health.
- You should get 30 minutes of physical activity on most days of the week.
- The Heart Foundation offers free personal walking plans and arranges walking groups. Sign up here: heartfoundation.org.au
- All patients who have had a heart attack or heart procedure, or have been diagnosed with a heart condition should be referred for cardiac rehabilitation.
Be smoke free
Quitting or never smoking cigarettes is one of the best ways to protect your heart. All health professionals should provide smoking cessation advice using the ‘Ask, Advise, Help’ brief advice model. The steps of the model are:
- Ask all people if they smoke.
- Advise all people who smoke to quit and how to make a quit attempt.
- Help all people who smoke to quit (by making a referral to behavioural intervention through Quitline 137 848 and prescribing stop-smoking medicines, if clinically appropriate).
Look after mental health
- People who have depression, are socially isolated or lack good social support can have a higher risk of heart disease.
- Encourage people to talk with their doctor about their mental health and their heart disease risk factors. Staying socially connected and talking with family and friends can help well-being.
Limit alcohol intake
- Drinking alcohol can raise blood pressure.
- If you’ve been diagnosed with a heart condition, the latest research suggests that cutting back on alcohol provides many benefits. For some people, not drinking at all is the safest option.
Medicines
- People may need to take heart medicines to manage their blood pressure and cholesterol if a heart health check shows they have a moderate or high risk of a heart attack or stroke.
- Taking heart medicines can reduce the risk of future heart problems, manage symptoms, and help keep you out of hospital.
- It’s important to keep taking heart medicines if prescribed them, even for those who are feeling well. Check with your doctor or pharmacist before stopping any of your heart medicines, or changing the dose.
To learn more, visit: heartfoundation.org.au
References:
- Australian Institute of Health and Welfare. ‘Heart, stroke and vascular disease: Australian facts’, 2023. gov.au/reports/heart-stroke-vascular-diseases/hsvd-facts/contents/data-visualisations.
- Wu CY et al. ‘High blood pressure and all-cause and cardiovascular disease mortalities in community-dwelling older adults’, 2015. nlm.nih.gov/pmc/articles/PMC5059018/.
- Better Health. ‘Heart disease: know your risk’, 2022. vic.gov.au/health/conditionsandtreatments/heart-disease-risk-factors#where-to-get-help.
This feature was originally published in the April issue of Retail Pharmacy Assistants e-magazine.
