Most Australians would probably ask: what is there to be aware of? We’re all aware of salt. But maybe we’re not all aware of just how much more salt we consume than is good for our health.

The ideal intake of salt is 1-2 grams per day, but many Australians consumer five or ten times that amount.

Salt is a leading cause of high blood pressure; and high blood pressure is a major risk factor for heart attack and stroke.

The Australian Division of World Action on Salt and Health (AWASH) has developed some simple ways we can pinch salt from our diet: we should limit takeaways and fast foods, avoid salty snacks or limit them to occasional treats, look for low fat or no fat options when shopping, use lemon juice, garlic, vinegar or herbs and spices when cooking (we should also avoid rock salt and sea salt). The AWASH website: www.awash.org.au provides other good suggestions on how we can “drop the salt”.

The first week in February was also designated National Naturopathy Awareness Week; and while so-called natural medicines have appeal (it is estimated more than 50% of Australians regularly use some form of complementary or alternative medicines) much of the advice offered by natural medicine practitioners really does need to be taken with a grain of salt.

One form of alternative “medicine”, namely homeopathy, is not really medicine at all. Homeopathic products contain no active ingredients. There is no evidence of benefit except for a placebo effect.

There can be a distinction between complementary and alternative treatments, where the former are used together with the “conventional” therapy and the latter instead of. In either case, with complementary and alternative medicines (CAMs), there is the potential for problems to occur.

Clearly, natural is not always necessarily safe. But if CAMS are your cup of herbal tea, then there are ways of managing the risk.

The Pharmaceutical Society of Australia has produced a fact card titled Complementary Medicines. The card – which is available from all pharmacies across Australia providing the Self Care health information – identifies the problems and pitfall of CAMs, and also indicates which of the claims made for various CAMs can be supported by evidence.

Recent studies have shown the herb saw palmetto, previously thought to be effective in treating non-cancerous prostate enlargement, may not be any better than placebo; while echinacea may not be of any benefit in preventing or treating colds.

Of even greater concern is the fact that some commonly used CAMs can cause serious side effects. Following a safety review, the Therapeutic Goods Administration (TGA) in Australia has concluded that medicines containing black cohosh should include the warning statement that, “Black cohosh may harm the liver in some individuals”.

St John’s wort – considered useful to treat mild depression – can interact with a number of prescription products causing toxicity or a reduction in effectiveness.

On the positive side, many people have gained some pain relief from osteoarthritis symptoms with glucosamine; and long-term use of cranberry juice or extract helps prevent the occurrence of urinary tract infection.

The undeniable fact is that complementary and alternative medicines are made up of chemicals, just like any medicine. If they are taken in a dose sufficient to have some benefit, they can also do harm.

Before self selecting any CAM, especially if you are taking a prescription medicine, check first with your pharmacist. And ask for the Complementary Medicines fact card at one of the Self Care pharmacies – call 1 300 369 772 or check out the Pharmaceutical Society’s website at www.psa.org.au and click on Self Care Pharmacy Finder.

©2010 Pharmaceutical Society of Australia

But too much blood pressure can result in a catastrophic outcome – just like a pressure cooker on high heat without an escape valve.

Hypertension (the medical term for abnormally high blood pressure) is considered by the World Health Organization (WHO) as one of the most serious risk factors for death worldwide. It is estimated that about 30% of Australian adults have hypertension; and most of these people are receiving no treatment.

What makes hypertension so serious is that, well before the explosive heart attack or stroke occurs, there is underlying, sometimes irreparable damage done to the cardiovascular system, the kidneys and the brain. Also, hypertension, especially when combined with diabetes, significantly increases the risk of blindness.

In most cases the actual cause of high blood pressure can’t be identified, but we do know what groups of people are most at risk of developing hypertension; and we do know ways whereby we can reduce the risk.

There are usually no symptoms of hypertension; at least generally not until the blood pressure reaches a sustained dangerous level. So, if there is a history in the family of heart disease, kidney disease or diabetes, a regular – at least yearly – check up with your GP is essential.

For most of us, lifestyle behaviour changes will help prevent high blood pressure problems occurring and certainly help control high blood pressure if it does occur. This involves effective weight management strategies (being over weight or obese is a major risk factor), adequate exercise, moderation in alcohol consumption and becoming (if not already) a non-smoker.

If we do have hypertension, regular and long term treatment with medication will most likely be a necessity. Understanding how these blood pressure medicines work is helpful; and your pharmacist can provide you with so-called Consumer Medicines Information (CMI) which explains the benefits and the occasional problems you may encounter. Uncomfortable side effects with anti-hypertensive therapy can sometimes be experienced, especially in the early stages of treatment, so it’s nice to know what to expect.

For more information about hypertension ask for the Blood Pressure fact card at one of the 2,000 pharmacies around Australia providing the Pharmaceutical Society’s Self Care health information. There are also cards on Weight and Health, Exercise and the Heart, and Staying a Non-Smoker.

Taking ownership of a medical condition will often help improve outcomes. With hypertension this can sometimes be achieved by the use of home blood pressure measuring devices. The modern machines are simple and easy to use. Check with your doctor whether one of these could be an advantage. And if you have trouble remembering to take your blood pressure tablets, a ‘dose administration aid’ or medication blister pack could help.

It’s as well to remember that there are some medicines – both prescription and non-prescription medicines – which can cause or worsen hypertension. This includes some pain relievers, anti-depressants oral contraceptives, cough and cold products and various herbal preparations. If you have high blood pressure, always check first with your pharmacist before self selecting another medicine.

Meanwhile, for the location of the nearest pharmacy where you can pick up those Self Care fact cards, phone the Pharmaceutical Society on 1 300 369 772 or log on to the website at www.psa.org.au and click on Self Care Pharmacy Finder.

©2009 Pharmaceutical Society of Australia

Uncontrolled diabetes poses a serious risk to our health. Complications can include blindness, kidney failure and increased risk of heart disease and stroke.

Diabetes is the name given to the condition where our body is unable to use glucose properly – and glucose is our major energy source; the fuel which keeps our body functioning effectively.

There are two major forms of diabetes – type 1 and type 2. Type 1 diabetes usually occurs in childhood or young adulthood – possibly because the body’s immune system runs a bit wild and attacks and destroys the insulin-producing cells in the pancreas gland. Because the body stops making insulin, people with this form of diabetes need daily doses of insulin.

However, type 2 diabetes is the form of diabetes likely to affect most Australians (in type 2, insulin is produced, but we just can’t use it effectively). It accounts for 85-90% of the more than a million Australians with the condition – a number that could double over the next 10 years or so, if control strategies are not put in place.

Type 2 diabetes usually occurs in older adults – it used to be called maturity onset diabetes – but increasingly the condition is affecting younger people. Family history is one reason.

Of course our parents are not totally to blame. Family history is just one risk factor. Lifestyle issues are also highly significant. Overweight and obese adults are two to four times more likely to suffer from diabetes.

We now know that high blood pressure is another major risk factor for diabetes; a factor which is apparently not widely understood. According to Dr Neville Howard, President of Diabetes Australia – NSW, “there is a staggering lack of awareness about the link between high blood pressure and developing diabetes and its serious complications.” “While most people are aware that family history and being overweight can put them at risk,” he said, “a Diabetes Australia Study conducted last year has shown that 90% of people surveyed did not know that high blood pressure was a risk factor.”

When blood pressure is measured, two reading are taken; and it is usually expressed as one larger number over another. The top reading (so-called systolic blood pressure) is a measure of the force of the heartbeat. The lower reading (diastolic) is a measure of the blood pressure when the heart is at rest between beats.

There is no “ideal” blood pressure – it will vary from person to person; but as a guide the target blood pressure is less than or equal to 130/80.

Lifestyle changes are the key to reducing the risks of and treating high blood pressure, said Dr Howard. This should involve healthy eating, regular exercise, drinking lots of water, reduced salt intake, alcohol in moderation (no more than two standard drinks per day) and no smoking. Most of us will also need to lose some weight around our waist line. The aim should be a waist circumference of less than 80cm for women and 94cm for men.

And every time we visit the doctor we should get our blood pressure checked. If we seem otherwise healthy, we should make sure we have at least a yearly check up, especially if we’re over 40.

You can get more information about diabetes from the Diabetes Australia website or pick up a Fact Card from one of the 1,650 pharmacies around Australia providing the Pharmaceutical Society’s Self Care health information. Phone 1300 369 772 for the nearest location or go to the Pharmaceutical Society’s website at www.psa.org.au and click on “Self Care Pharmacy Finder”.

©2009 Pharmaceutical Society of Australia