There is an irony in the heart of the treatment of hypertension. The disease often has no symptoms, but drugs that treat it – and to prevent stroke or myocardial infarction later – may make people feel lame.
"You do not want to take it because you know It will help you, but it gets used to it," says Sharon Fulson, a customer service representative from Nashville, Tenn., Who tries to monitor and control her high blood pressure.
The daily pills Fulson began to make her last year feel fussy and nervous. Other people on the drugs report that dizziness, nausea and diarrhea, and men in particular may have a problem of excitement.
"All of these side effects are worse than high blood pressure," says Fulson.
Research shows that about half of patients do not take high blood pressure medicine as they should, although heart disease is the leading cause of death in America . For many unfortunate people, their first symptom of high blood pressure is a catastrophic heart failure. That's why high blood pressure is called the "silent killer."
A drug test is now available that can flag if a patient actually takes his prescribed medication. The screening, which requires a urine test, is intended to rub a more truthful conversation between patient and physician.
Fulson's blood pressure is a moving goal and when she shows me how she usually checks at home, it's a bit high.
"Being on the radio can affect me" she kisses. Even if you are in a doctor's office, you can add enough stress to increase the results.
This is why patient pressure – the familiar cuff test – does not confirm for cardiologists if patients consistently take their high blood pressure drugs. The new drug tested, dubbed KardiAssure, uses computers to analyze urine to search for 80 types of blood pressure and cholesterol medication, and reports the results in just three minutes.
The test can only determine if a patient has taken pills in the last day or two. But Aegis Sciences Corporation's CEO Frank Basile says it's a starting point.
"What we provide doctors is a tool that allows them to have a highly focused conversation with their patients," he says. Only after the problem is open in the open, he says, doctor can get to it.
The conversation starter has been effective for cardiologist Bryan Doherty in Dickson, Tenn., Who has worked with Aegis to test the test. In one case, when the results showed that a patient did not regularly take his medicine, even though he claimed he was, he quickly acknowledged.
"He immediately turned and said the cost was a problem" Doherty says. "I think there was a degree of embarrassment there, potentially or a feeling that I let go of me somehow – something that had not come up in a 25-minute first meeting when we had previously spoken."
Of course, the test also has a cost – about $ 100 – but Doherty finds that insurance, including Medicare, has covered it.
The conversation is important, says Doherty, because he can try cheaper recipes if the cost is the problem or experiment with different types of drugs if side effects are the problem. It's worth the potentially unpleasant encounter with the patient, he says, because medicine can make the difference between life and death.
Screening can also help a patient avoid other unnecessary tests or additional recipes, says Dr. Tom Johnston. He runs the hypertension clinic at Centennial Medical Center in Nashville and is the chairman of the local heart supply of American Heart Supply.
In addition to calling the pharmacy to make sure people replicate, he says that he usually takes his word for it.
"I think there are many times where you are questioning whether you have taken the medicine or not," he says. "I think it would also be good for the patient that the doctor should know that they do not take medicine so that we can not go wrong."
Johnston, who is not affiliated with Aegis, says that his only concern about using a drug test would run the risk of establishing a contradiction with a patient. But there's also a way around it, he says, by getting them to understand how important it is to take the drug properly.
Sarah Avery, Nashville, says she is fully aware of the consequences.
"My dad died because he did not take his medicine," she says.
Hypertonia goes into his family. Her mother and grandmother also hit high blood pressure. Still, the drug is such a move, she is sometimes determined to stop without the advice of her doctor.
"I lied. Actually, I lied," she admits. "He said," Do you take your medicine? "I said," Mmhmmm. Yes, my mom is sure I'll do it. "I'm just lying," she says.
It was until she had a stroke too. Now she has three blood pressure medicine and says she takes them without fail.
This story is part of NPR's reporting partnership with WPLN and Kaiser Health News .