The Pharmaceutical Journal Vol 267 No 7165 p342
15 September 2001

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Pharmacists’ place in stroke prevention

Among the different initiatives currently taking place in England and Wales, community pharmacists are getting involved in monitoring blood pressure as part of Stroke Awareness week (30 September to 6 October). The first National Blood Pressure Testing week is taking place next week (17 to 23 September). Zoë Gross reports

Sources of information

Stroke is the third most common cause of death in England and Wales with over 100,000 people suffering a first stroke each year. Stroke can affect anyone of any age but some people, for example those with hypertension or diabetes and those who smoke or are physically inactive, are at a higher risk than others. The Stroke Association says that about 40 per cent of strokes could, however, be prevented by having regular blood pressure checks, treating hypertension and by taking steps to improve overall health.

In Wales, for example, all community pharmacists in the Pembrokeshire Pharmacy Forum are getting involved in Stroke Awareness week at a local level. All community pharmacies within the area, including independents and multiples, will be providing a blood pressure monitoring service in conjunction with the Stroke Association in Pembrokeshire. Chris Martin, chairman of the Pembrokeshire Pharmacy Forum, told The Journal: “This is very much a health promotion role for pharmacists and a first for getting the whole area together.”

Monitoring blood pressure

Although blood pressure is usually monitored on three separate occasions before referring a patient, Mr Martin said that during Stroke Awareness week, pharmacists will be taking one reading. If it is found to be high then the patient will be referred to their GP and given a referral form. However, he suggests that pharmacists should write to GPs in advance and develop a local protocol as to when they want their patients to be referred. Pharmacists should also keep a record of the name and address of any patients they refer. Mr Martin is contacting general practitioners in the area, through the local health group, to inform them that community pharmacists will be providing a blood pressure monitoring service and that they may get referrals as a result.

The service is using the British Hypertension Society’s guidelines, which recommends an optimal target blood pressure range of <140/85mmHg. Pharmacists will be working within strict protocols for monitoring blood pressure and a training session is being provided for pharmacists before Stroke Awareness week. Mr Martin recommends that pharmacists should reassure patients that a high reading does not necessarily mean that they have hypertension. Their blood pressure may be high for various reasons, such as having run for a bus before the reading was taken or because they are stressed, he said.

During Stroke Awareness week, Healthbrands is providing pharmacies in Pembrokeshire with Seinex upper arm digital blood pressure monitors, free of charge. Pharmacists in the area have been sent a resource pack by the Stroke Association. Mr Martin comments that Stroke Awareness week will also provide pharmacists with the opportunity to talk to patients who are taking regular antihypertensive medicines and to discuss issues such as compliance with them. Pharmacists should make sure that these patients take their anti-hypertensive therapy continuously, he said.

Another member of the Pembrokeshire Pharmacy Forum told The Journal that the blood pressure monitoring service would allow the public to see all community pharmacists working together to provide a unified service.

Exercise to reduce stroke risk

The Stroke Association’s theme for this year’s awareness week is “Let’s get physical”. The Stroke Association says that regular exercise can help reduce the risk of a first or subsequent stroke. Its campaign is focusing on encouraging people of all ages and abilities to take more physical activity in their day-to-day lives, for example, walking to shops rather than driving and walking part of a journey. They suggest that 30 minutes of physical activity a day, five days a week, should reduce the risk of stroke, even if it is broken up into three brisk 10-minute walks in a day.

In the light of Stroke Awareness week focusing on exercise to reduce the risk of stroke, pharmacists in Pembrokeshire will be talking to patients about the need to make sure that they have a healthy lifestyle. Pharmacists will be discussing issues such as taking regular exercise, giving up smoking, reducing alcohol intake and having a balanced diet. Mr Martin commented that community pharmacists are ideally placed to help patients achieve these targets by being able to offer them, for example, smoking cessation aids.

The first National Blood Pressure Testing week is taking place two weeks before Stroke Awareness week. The campaign, entitled “Know your numbers! Check it or check out”, is being run by the Blood Pressure Association with the aim of raising awareness of the dangers to health of having high blood pressure and to heighten the public’s knowledge about their own blood pressure reading.

During National Blood Pressure Testing week over 340 blood pressure testing stations will be in operation across the United Kingdom to enable members of the public to have their blood pressure measured free of charge. The Blood Pressure Association said that a number of these testing stations are going to be set up in pharmacies across England, Wales and Scotland and, as of 11 September, 52 Moss pharmacies, seven Numark pharmacies and 50 Vantage pharmacies have offered to provide the service. All places providing the service are being provided with a set of blood pressure guidelines to adhere to. Digital upper arm blood pressure monitors are being supplied free of charge by Omron.

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Zoë Gross is on the staff of The Pharmaceutical Journal