By Garth A. Rattray
Each year, since 2005, World Hypertension Day is observed on May 17. The theme for this year is 'Healthy Lifestyle - Healthy Blood Pressure'. High blood pressure (hypertension) is described as a modern epidemic. It is characterised as a 'silent killer' because it usually causes absolutely no symptoms.
According to a 2002 study carried out by Professor Wilks, Younger et al, Control of Hypertension in Jamaica, almost one in every four (23.8 per cent) people studied is hypertensive. His findings tally well with other figures that I found. The extrapolation is that about one billion people, 25 per cent of the world's adult population, is hypertensive. This translates into about 7.1 million deaths every year and an untold number of cardiovascular events (strokes, heart attacks, heart failure, aneurysms, and so on).
Hypertension is usually 'essential' (not caused by another condition). It runs in families, but is somewhat controllable by lifestyle adjustments/changes. In the Jamaican study, of that 23.8 per cent people who are hypertensive, 58 per cent are on no medication, and 26 per cent are not controlled - and, therefore, at high risk for cardiovascular events.
Many patients fear anti-hypertensive medications. The most popular reasons are fear of side effects and of becoming addicted to or dependent on tablets. However, side effects from anti-hypertensive medications are very rare and usually not serious. But, uncontrolled hypertension will always cause serious end-organ damage (with attendant infirmity, debilitation and premature death to the tune of about five million worldwide annually).
And, no anti-hypertensive is addictive or habit-forming. Most people need to stay on medication to lower their risk of stroke, heart attack, kidney failure, heart failure, and so on.
Many men are afraid of anti-hypertensive drugs because they fret about getting erectile dysfunction (ED) as a side effect. However, uncontrolled hypertension is a good way to ensure ED.
Many people only take their medication when they feel unwell or have a headache. The fact is that hypertension rarely causes any symptoms at all (including headaches) and, if it does, the blood pressure is dangerously high (life-threatening) by then.
Jamaicans often shun manufactured medications and opt for natural attempts at reducing their blood pressure. However, we don't have any evidence that garlic, soursop, lime juice or coconut water works. People who stop their tablets and take these substances return with high readings.
The really sad part is that, after their untreated hypertension causes serious end-organ damage and sometimes incapacitation, patients then take their medicine religiously - albeit too late to stave off disaster.
We know that diet and exercise can lower blood pressure to some extent. Succinctly put, the Dietary Approach to Stopping Hypertension (DASH) diet advocates reducing salt and fatty foods/drinks while increasing fruits and vegetables.
Aerobic exercises for 30-40 minutes most days each week (some say, 20 minutes each day) is best for lowering the blood pressure. Weightlifting/resistance training builds lean body mass but raises the blood pressure temporarily and, therefore, should not be done in isolation.
Stress raises blood pressure temporarily, but the other effects of long-term stress - disturbed sleep, overeating, eating salty and fatty foods, weight gain, alcohol/cigarette/drug intake and inactivity -
A blood-pressure reading of 120/80mm/Hg was once considered perfect, but now less than 120/80 is optimal and 120/80 is now considered 'pre-hypertension'. Readings of 120-139/80-89 are high-normal, 140/90 is high, and 160/100 is very high. This also applies to the elderly. Diabetics require tighter blood pressure control for cardiovascular risk reduction, so a systolic of 130 is considered high for them.
Fight this deadly epidemic; check your blood pressure because some observers believe that for every person treated for hypertension, one is undiagnosed. If it is high/normal or high, institute reduction measures: lifestyle changes and medications for life.
Garth A. Rattray is a medical doctor with a family practice. Email feedback to firstname.lastname@example.org and email@example.com.