What do we know about this significant global health threat?
What is hypertension (high blood pressure)?
Hypertension is a long-term condition where blood pressure is increased. It is the leading cause of death worldwide, affecting more than 1.4 billion people and accounting for more than 28,000 deaths each day.
Initially, it does not cause any symptoms but if left untreated it can lead to stroke, heart attack, kidney disease, vision loss, and dementia. Control of high blood pressure can help protect against these conditions and there are many steps that can be taken to help lower blood pressure.
Hypertension is a complex condition with many causes including lifestyle factors, such as physical inactivity, a salt-rich diet with high processed and fatty foods, and alcohol and tobacco use. Unfortunately, the incidence of hypertension is increasing at an alarming rate from developed countries to emerging economies, such as India, China and African countries.
Adequate treatment of high blood pressure lowers this cardiovascular (heart and vessel disease) risk towards normal levels. However, the biggest problem for controlling hypertension is compliance with treatment. Despite very effective and cost-effective treatments, target blood pressure levels are not always reached, even in countries where cost of medication is not an issue.
The members of the International Society of Hypertension (ISH), founded some 50 years ago, are working to raise awareness of this significant global health threat and to improve management of hypertension and related cardiovascular disease.
Key fact: Hypertension, or elevated blood pressure, is a serious medical condition that significantly increases the risks of heart, brain, kidney and other diseases.
An estimated 1.28 billion adults aged 30-79 years worldwide have hypertension, most (two-thirds) living in low- and middle-income countries
An estimated 46% of adults with hypertension are unaware that they have the condition.
Less than half of adults (42%) with hypertension are diagnosed and treated.
Approximately 1 in 5 adults (21%) with hypertension have it under control.
Hypertension is a major cause of premature death worldwide.
One of the global targets for non-communicable diseases is to reduce the prevalence of hypertension by 33% between 2010 and 2030.
What are the warning signs of hypertension?
If the blood pressure is extremely high, there may be certain symptoms to look out for, including:
o Severe headaches, nosebleeds, fatigue, confusion, or vision problems.
o Chest pain, difficulty in breathing, irregular heartbeat, or blood in the urine.
The four stages of hypertension include:
Normal: The systolic pressure is less than 120 mmHg, and the diastolic pressure is less than 80 mmHg. This range is considered normal. There is no need for drugs, but you must follow a healthy lifestyle and may regularly monitor your blood pressure.
Elevated blood pressure: If your systolic blood pressure is between 120 and 129 mmHg and diastolic blood pressure is not above 80 mmHg, you have elevated blood pressure.
It identifies people who are at risk of developing stage I or stage II hypertension in the future. This condition does not require medication, but lifestyle changes must be considered.
Stage I hypertension: If your systolic blood pressure is between 130 and 139 mmHg and diastolic blood pressure is between 80 and 89 mmHg, you have stage I hypertension. Your doctor may prescribe antihypertensive medications, such as beta-blockers, calcium channel blockers, and diuretics, and suggest lifestyle changes.
Stage II hypertension: If your systolic pressure exceeds 140 mmHg and the diastolic pressure exceeds 90 mmHg, it is taken very seriously.
To prevent complications, such as cardiac and stroke issues, the doctor may recommend more than one drug, lifestyle change, diet, and regular exercise.
According to the new guidelines by the American College of Cardiology and American Heart Association, about 46 percent of adults in the United States are now classified to have high blood pressure.
Hypertensive crisis is a systolic pressure greater than 180 mmHg or a diastolic pressure greater than 120 mmHg. If you notice these blood pressure readings, contact your doctor right away.
Things that can increase your risk of getting high blood pressure
It’s not always clear what causes high blood pressure, but there are things that can increase your risk.
You might be more at risk if you are: overweight, eat too much salt and do not eat enough fruits and vegetables, do not exercise enough, drink too much alcohol or coffee (or other caffeine-based drinks), smoke, do not get much sleep or have disturbed sleep, are over 65, have a relative with high blood pressure, are of black African or black Caribbean descent, live in a deprived area.
Making healthy lifestyle changes can sometimes help reduce your chances of getting high blood pressure and help lower your blood pressure if it’s already high.
Prevention-High blood pressure
Prevention: High blood pressure can often be prevented or reduced by eating healthily, maintaining a healthy weight, taking regular exercise, drinking alcohol in moderation and not smoking.
Healthy diet: Cut down on the amount of salt in your food and eat plenty of fruit and vegetables. Salt raises your blood pressure. The more salt you eat, the higher your blood pressure. Aim to eat less than 6g (0.2oz) of salt a day, which is about a teaspoonful. Find out how to cut down on salt.
Eating a low-fat diet that includes lots of fibre, such as wholegrain rice, bread and pasta, and plenty of fruit and vegetables also helps lower blood pressure. Aim to eat 5 portions of fruit and vegetables every day. Find out how to get your 5-A-Day.
Limit your alcohol intake: Regularly drinking too much alcohol can raise your blood pressure over time. Staying within the recommended levels is the best way to reduce your risk of developing high blood pressure. Men and women are advised not to regularly drink more than 14 units a week. Spread your drinking over 3 days or more if you drink as much as 14 units a week. Find out how many units are in your favourite drink and get tips on cutting them down. Alcohol is also high in calories, which will make you gain weight and can further increase your blood pressure. Find out how many calories are in popular drinks.
Lose weight: Being overweight forces your heart to work harder to pump blood around your body, which can raise your blood pressure.
Find out if you need to lose weight with the BMI healthy weight calculator. If you do need to lose some weight, it’s worth remembering that just losing a few pounds will make a big difference to your blood pressure and overall health. Get advice on losing weight safely.
Get active: Being active and taking regular exercise lowers blood pressure by keeping your heart and blood vessels in good condition. Regular exercise can also help you lose weight, which will also help lower your blood pressure. Adults should do at least 150 minutes (2 hours and 30 minutes) of moderate-intensity aerobic activity, such as cycling or fast walking, every week. Physical activity can include anything from sport to walking and gardening.
Cut down on caffeine: Drinking more than 4 cups of coffee a day may increase your blood pressure. If you are a big fan of coffee, tea or other caffeine-rich drinks, such as cola and some energy drinks, consider cutting down.
It’s fine to drink tea and coffee as part of a balanced diet, but it’s important that these drinks are not your main or only source of fluid.
Stop smoking: Smoking does not directly cause high blood pressure, but it puts you at much higher risk of a heart attack and stroke. Smoking, like high blood pressure, will cause your arteries to narrow. If you smoke and have high blood pressure, your arteries will narrow much more quickly, and your risk of heart or lung disease in the future is dramatically increased.
How is high blood pressure diagnosed?
High blood pressure is diagnosed with a blood pressure monitor. This is a common test for all doctor visits. A nurse will place a band (cuff) around your arm. The band is attached to a small pump and a metre. He or she will squeeze the pump. It will feel tight around your arm. Then he or she will stop and watch the metre. This provides the nurse with 2 numbers that make up your blood pressure.
The top number is your systolic reading (the peak blood pressure when your heart is squeezing blood out). The bottom number is your diastolic reading (the pressure when your heart is filling with blood). You may also hear the doctor or nurse say a blood pressure is “120 over 80.”
Normal blood pressure is less than 120 on top and less than 80 on the bottom. Prehypertension levels are 120-139 on top and 80-89 on the bottom.
High blood pressure stage 1 is 140-159 on top and 90-99 on the bottom. High blood pressure stage 2 is 160 or higher on top and 100 and over on the boot, the higher your blood pressure is, the more often you need to have it checked. After age 18, have your blood pressure checked at least once every two years. Do it more often if you have had high blood pressure in the past.
High blood pressure during pregnancy
Some women have high blood pressure during pregnancy. This can put the mother and her baby at risk for problems during the pregnancy. High blood pressure can also cause problems during and after delivery. The good news is that high blood pressure is preventable and treatable.
For further information, email [email protected]. Send messages to Dr Azadeh WhatsApp only on 002207774469.
The author is an MD, senior lecturer at the University of The Gambia and clinical director at Medicare Health Services.
