High Blood Pressure…………the silent killer

The World Health day was recently celebrated globally on 7^th of April to commemorate the origin of the World Health Organization, founded 65years ago as a specialized agency for the United Nations to champion health related issues. This year’s celebration focuses on creating awareness on HIGH BLOOD PRESSURE as a public health concern globally and the promotion of healthy living, early and improved detection and management of high blood pressure. The objective was to raise awareness on the causes, consequences and prevention of high BP to then reduce the incidence of heart attacks, strokes and such cardiovascular events. The prevalence of high blood pressure is increasing globally with highest incident rates found in low-income developing countries.

High blood pressure medically referred to as Hypertension is popularly called the silent killer because people who have the disease remain unaware until their blood pressure is measured. The Blood pressure is recorded as two numbers: the systolic (pressure in the arteries when heart contracts) and the diastolic (when the heart relaxes) e.g. 120/80mmHg (measured in millimeters of mercury). Uncontrolled high blood pressure is indirectly responsible for many deaths and disability resulting for heart attack or stroke. It is particularly dangerous because it is asymptomatic (no warning signs or symptoms) and can affect anyone regardless of race, gender or age. Once high blood pressure develops, it usually lasts for a lifetime (it is a chronic disease), you can only control or manage it.

Chronic hypertension most often leads to organ damage such as kidney failure, liver damage, stroke, eye damage that could lead to loss of vision, blocking of blood vessels or heart attack and often death.

Types and Causative factors:

There are two basic types of High BP: Primary and Secondary hypertension but other forms of high BP exist.

Primary hypertension occurs in majority of cases and is caused by risk factors such as age, family history, gender, being overweight, sodium sensitivity (high salt content from fast food, processed food or some over the counter drugs), socio economic status, alcohol use, smoking, injudicious use of birth control pills, lack of exercise and use of certain drugs (such as stimulants, allergy and cold drugs) to mention a few.

Secondary hypertension is caused by an underlining disease such as pregnancy, thyroid dysfunction or alcohol addiction.

Malignant hypertension is a severe condition where the diastolic blood pressure (lower number) often exceeds 140mm Hg. This high blood pressure requires emergency hospitalization in order to lower the blood pressure to prevent stoke or brain hemorrhage.

Diagnosis: High blood pressure   can be measured with a blood pressure cuff or sphygmomanometer. Blood pressure (BP) is classified as follows:

Category	Systolic (top number)		Diastolic (bottom number)
Normal	Less than 120	And	Less than 80
HBP
Stage 1(mild)	140–159	Or	90–99
Stage 2(mod - severe)	160 or higher	Or	100 or higher

The ranges in the table apply to most adults (aged 18 and older) who do not have short-term serious illnesses.

Management: There is no definitive treatment for high blood pressure, it can only be managed therefore the means of control is by lifestyle modification and the use of medication. It is important to have your blood pressure checked regularly by a trained medical professional with a machine that is known to be accurate to ensure efficiency of treatment and monitor your progress.

Lifestyle modifications: includes maintaining a healthy diet, regular exercise and increase of your physical activity; quitting smoking; moderating alcohol consumption; achieving healthy stress control and maintaining a healthy weight / Body Mass Index (BMI); reduce intake of salt and oral contraceptives to mention a few. You can incorporate physical exercise into your daily routine: use of stairs instead of the elevator, getting off the bus /car one or two stops early and walking the rest of the way, park farther away from destination, ride a bike, practice brisk walking or go dancing.

Medical Treatment: Medication can be used to manage high BP and most often will be taken for a lifetime. It is advisable to take these medications at all times as prescribed by the health care provider. The medications have been proven to reduce the risk of stroke, heart disease, and kidney problems.

Therapy: Alternative therapies may be helpful to people trying to control their blood pressure e.g. acupuncture. Techniques that induce relaxation and reduce stress are recommended. These include mediation, yoga, relaxation training or use of dietary supplements such as garlic, vitamins, fish oil or herbs. These techniques alone will not keep the blood pressure in the healthy range for many people, discuss with your Doctor to get a better picture.

High blood pressure can go unrecognized for years due to the asymptomatic nature but could ultimately cause damage to vital organs and eventually lead to death or a reduced quality of life. Promoting a healthy lifestyle is key in preventing hypertension. Ensuring regular blood pressure check, taking of medication and follow-up doctor’s visit to monitor organs is vital in management of high BP.

The role of government, individuals, civil society, health care providers and private sector in promoting lifestyle modifications is vital in promoting the objectives of the 2013 celebration therefore all should play their role in creating awareness on the causes and prevention of high BP so that the incident of strokes and heart attacks can be eradicated drastically.

Written by O’ Reese of En-pact Solutions Limited, 2013

Twitter: @O Reese2

         @EnpactHSE