Let’s talk about hypertension, the ‘Silent Killer’
By Dr Brighton Chireka
“In life we procrastinate to the tipping point and we allow the blame culture to creep in. Diseases like high blood pressure need our urgent attention otherwise they will kill us silently” , says Dr Chireka
May I invite you take this health journey with me and you will be glad that you did join in. We need to take ownership of our health and this is our journey together. I have a few questions that I need to ask you about your blood pressure (BP). Do you know your BP and also do you understand what those two figures mean? When was your BP last checked? What are you doing to prevent high BP and do you know what you can do to reduce your BP? I hope after reading this article you will feel empowered to do something about your BP.
High BP is known medically as hypertension. Blood pressure measures how strongly blood presses against the walls of your arteries (large blood vessels) as it is pumped around your body by your heart. It is measured in millimetres of mercury (mmHg) and it is recorded as two figures. One is called Systolic pressure which is the pressure of the blood when your heart beats to pump blood out. The other one is called Diastolic pressure which is the pressure of the blood when your heart rests in between beats. Let us look at the cut-of-point and discuss what it means. You may be told that your blood pressure is “140 over 90”, or 140/90mmHg. This means you have a systolic pressure of 140mmHg and a diastolic pressure of 90mmHg. You have high BP if readings on separate occasions consistently show your blood pressure to be 140/90mmHg or higher. A one-off reading that is high will need to be repeated or you may be given a BP machine that records your blood pressure for a period of 24 hours and gets your average blood pressure
The numbers of people with high BP throughout the whole world is worrying. The World Health Organization (WHO) estimates that more than one in three adults, or about one billion people, is affected by high BP. High BP contributes to nearly 9.4 million deaths due to heart disease and stroke every year and, together, these two diseases are the number one cause of death worldwide. The sad thing is that worldwide, more than half of all patients with high BP are unaware they have the condition. To make matters worse the majority of those who are aware of their diagnosis and are receiving drug treatment for high BP, only about a third of them have their BP under control. High BP related diseases are the second leading overall cause of death in Africa, after HIV/AIDS, and are the leading cause of death among individuals over the age of thirty. The WHO projects that over the next ten years Africa will experience the largest increase in death rates from high BP.
In Zimbabwe data analysed by J Mufunda and his team, found that the prevalence rate of high BP quadrupled from 1990 to 1997. A study of Bulawayo City Council employees in 2010 by Amon Marwiro found that there was a high prevalence of both diagnosed and undiagnosed high BP. Despite high percentage of treatment among hypertensive participants, majority were at risk of developing complications because of poor control. Some studies have shown that there are low levels of awareness and treatment of high BP. In addition to the low level of awareness, there is a challenge to convince the new patients to regularly take medications for life for a disease, which does not have any presenting symptoms. A large number of people tend to see their doctors when it’s too late. I hope that after reading this article you will go and have your blood pressure checked.
There is often no clear cause of high blood pressure but you are at an increased risk of getting high blood pressure if you eat a lot of salt. Are you one of those who puts salt in their food before they taste it? Are you one of those who like to “BBQ” meat (gochi gochi) and put lots and lots of salt in the meat? Other risk factors are: being overweight, having a relative with high blood pressure, lack of exercise, being african, drinking a lot of alcohol or caffeine based drinks and not eating enough vegetables and fruits.
There are two main types of hypertension. Some people experience essential hypertension, which has no identifiable cause. If you are diagnosed with this its origins may be genetic, or due to your lifestyle including diet, weight and physical inactivity. Secondary hypertension is caused by another condition such as problems with your kidneys, certain medicines and some other medical problems.
Preeclampsia is a condition that can develop during pregnancy characterized by high blood pressure (hypertension) and protein in the urine (proteinuria). If not properly recognized and managed, preeclampsia can progress to eclampsia, which involves the development of seizures in a woman with preeclampsia. Eclampsia can be serious for both mother and baby and can even be fatal (killing the mum or baby or both). If you are pregnant, it’s important to have your blood pressure checked on a regular basis, even if it isn’t high.
High blood pressure (hypertension) usually has no obvious symptoms and many people have it without knowing hence the name “Silent Killer”. The only way to know if you have high BP is to have your blood pressure measured. In some rare cases, where a person has very high BP, they can experience symptoms including a persistent headache, blurred or double vision, nosebleeds or shortness of breath.
If we do nothing about high BP, it can cause strokes, heart attacks as well as heart and kidney failure. The good news is that blood pressure is easily measurable without any discomfort. The next good news is, once you know you have an elevated blood pressure you can do something to prevent and control rising blood pressure and thus avoid potential risk. The World Hypertension League (WHL) recommends that everyone should get their blood pressure checked at least once every year. Electronic BP machines are now easily available and are affordable such that people can check their blood pressure in the comfort of their homes.
Many people with high blood pressure often wonder if there is anything they can do to reduce their blood pressure other than by taking medications. A number of persons with high blood pressure believe there are quick fixes, crash diets, special herbs or remedies that can lower their blood pressure. Some of these quick fixes can be dangerous, many are expensive and most are poorly tested both for ability to lower blood pressure and safety. However there are several proven changes a person can make which can effectively reduce blood pressure. We need to accept that life style changes are difficult. If you try and do not succeed, do not be overly discouraged. Most persons require several attempts before achieving long lasting success. In fact, your chance of success increases with each attempt you make.
Being overweight is one of the most frequent causes of having high BP and reducing weight is one of the best methods of reducing BP without drug therapy. Excessive intake of alcohol both increases blood pressure and causes hypertension. A reduction in alcohol consumption will reduce BP and can also assist with weight reduction. Those who are unable to reduce their drinking on their own should consult a health care professional.
Inactive individuals can lower their blood pressure by increasing their physical activity. Physical activity is especially important for those who are overweight as an aid to weight loss. Vigorous physical activity is not necessary to lower blood pressure. Optimum reductions in blood pressure are achieved by as little as one hour of low intensity activity (e.g. walking) performed three or four times a week. Simple measures such as walking rather than driving to close locations, using stairs instead of elevators and avoiding the use of electronic conveniences can be effective in reducing your BP.
Reducing sodium intake will usually reduce blood pressure in persons who have hypertension. This can be achieved. However, it is difficult to sustain a reduced salt diet because much of the salt is added in the processing of foods. It is recommended to avoid salty foods and not to add salt to food at the table. Also reduce or do not add salt in cooking. New analysis published in BMJ Open this year shows that the UK salt reduction programme has led to a fall in population blood pressure and thereby stroke and heart disease events and deaths. From the fall in blood pressure that was due to the salt reduction there has been a saving of approximately 18,000 stroke and heart attack events a year, 9,000 of which would have been fatal. So let us all pledge ourselves right here, right now to cut down on our intake of salt and secure ourselves a heart/kidney-healthy future.
Smoking does not cause high blood pressure but markedly increases the risk of heart disease in persons with high blood pressure and can reduce the effectiveness of blood pressure lowering medication. Stopping smoking is an important step for persons with high blood pressure.
I hope having read this article, you now feel empowered to do something about your BP. Since you rarely get symptoms of high blood pressure and may be feeling fine, I suggest that every adult should have his/her blood pressure checked by a nurse or doctor today. Please do not procrastinate as untreated blood pressure can damage your body. Be involved in the management of your blood pressure because what you eat and do after that does affect your BP. Your doctor will usually suggest changes to your lifestyle and, sometimes, medication to control your high blood.
This article was compiled by Dr Brighton Chireka who is a GP and a Health Commissioner in South Kent Coast in the United Kingdom. You can contact him at: email@example.com and can read more of his work on his blog at DR CHIREKA’S BLOG
Disclaimer: This article is for information only and should not be used for the diagnosis or treatment of medical conditions. Dr Chireka has used all reasonable care in compiling the information but make no warranty as to its accuracy. Consult a doctor or other health care professional for diagnosis and treatment of medical conditions. Views expressed here are personal and do not in any way , shape or form represent the views of organisations that Dr Chireka work for or is associated with.