Fruitport family doctor explains treatment for high blood pressure
Dr. Diane Parrett, a family practitioner in Fruitport, Michigan believes it’s important to treat her patients with high blood pressure as individuals. “In medicine, we always want to standardize protocols,” she says. “But it’s important to look at patients as individuals and take into account other health issues they may have.”
“When I choose medications for their blood pressure, for example, I consider what will work for them and which side effects might be beneficial for that patient,” she explains.
If a patient has a family history of diabetes, Dr. Parrett might prescribe an ACE inhibitor because they can delay the onset of diabetes, she says. Or she can prescribe beta blockers, which can decrease the risk of a heart attack for those with a family history of heart disease.
In that same vein, her protocols for follow-up with patients depend on individual circumstances, namely how well the patient’s blood pressure is controlled. “I follow up with patients every three months if their blood pressure is under control,” says Dr. Parrett. “Otherwise, I follow up every month.”
The office makes sure patients schedule their follow-up appointments when they leave the office to increase the chances the doctor will see them according to schedule. At follow-up visits, Dr. Parrett checks blood pressure readings and adjusts medications if necessary.
Dr. Parrett also believes it’s important to discuss lifestyle changes with patients, such as exercise and diet, including reducing sodium.
“We talk about what happens when you let blood pressure get too high,” she says. “We discuss the risk factors for heart attacks and strokes. When it comes to smoking, I tell my patients they’ll either quit or find a new doctor because they’ll get tired of me nagging them.”
You can’t emphasize lifestyle enough, in Dr. Parrett’s view. She doesn’t shy away from difficult discussions. “We talk honestly about what happens if you have a heart attack or stroke,” she says. She warns patients of quality of life issues if they do have a stroke and lose the use of their hands or are left unable to walk.
One challenge to treating patients with high blood pressure is medication compliance. “No one wants to take medicine. But it’s more important to decrease the risks of heart attacks and stroke. I had a patient who didn’t come in for a while and stopped taking her medications,” relates Dr. Parrett. “When she finally came in for a follow-up visit, she couldn’t lift her arm and she said to me, ‘I think I had a stroke.’” She has since recovered and now takes her medication regularly.
Dr. Parrett keeps patients in control of managing their own health by emphasizing medication compliance and lifestyle. “We talk about medication compliance, and how much better patients can feel with a good diet and exercise.”
Making lifestyle changes can sometimes be a turning point for patients. “It happens all the time,” said Dr. Parrett. “I saw a young lady this week and I discontinued her blood pressure medications because she lost 60 pounds and runs three miles every day. I’ve taken her from three blood pressure medications down to none. She is doing great.”