We hear our grandparents often narrating a simpler, peaceful past. They never understand how important it is for us all to stay connected to the rest of the world whether for leisure or for work via cell phones, laptops, notepads etc. They don’t know how exciting it is to let the world know how very happy we are or what fun we are having or how engaged we are in our work. For them the world is this calm ball of trees and stars where family time is about delicious meals, laughter and time to talk about our daily activities amongst ourselves, for us it is a minor break to be rushed quickly so that we can fall back into our routines i.e. that pending report to mail, that birthday album to share, a test to prepare, that call to be made, the bill amount to be submitted. We always have one thing or other on our minds. This load of activities, duties and responsibilities often leads us to stress causing hypertension. No matter what age one is in, he/she will be a victim of hypertension more than several times in his life. This phenomenon increases when one reaches his early teens and steps into the pile of expectations, responsibilities and a head full of ego of one own, when one starts exploring new snacks available outside or develops a certain taste for fried, salty, spicy food. Our grandparents had simpler lifestyles, simpler food choices and few countable past time activities, they used to be engaged physically in their lives but mentally they had space and time at their expense where as we are busy mentally but physically not that active. This mental stress, love of junk food, unhealthy life style and a lazy physical day to day demeanor makes us a victim of hypertension.
Hypertension is defined as having a blood pressure higher than 140 over 90 mmHg, with a consensus across medical guidelines. Hypertension (HTN or HT), also known as high blood pressure (HBP), is a medical condition in which the blood pressure in the arteries is persistently elevated. High blood pressure usually does not cause symptoms. Long term high blood pressure, however, is a major risk factor for coronary artery disease, stroke, heart failure, peripheral vascular disease, vision loss, and chronic kidney disease.
High blood pressure is classified as either primary (essential) high blood pressure or secondary high blood pressure. About 90–95% of cases are primary, defined as high blood pressure due to nonspecific lifestyle and genetic factors. Lifestyle factors that increase the risk include excess salt, excess body weight, smoking, and alcohol. The remaining 5–10% of cases are categorized as secondary high blood pressure, defined as high blood pressure due to an identifiable cause, such as chronic kidney disease, narrowing of the kidney arteries, an endocrine disorder, or the use of birth control pills.
Blood pressure is expressed by two measurements, the systolic and diastolic pressures, which are the maximum and minimum pressures, respectively. Normal blood pressure at rest is within the range of 100–140 millimeters mercury (mmHg) systolic and 60–90 mmHg diastolic. High blood pressure is present if the resting blood pressure is persistently at or above 140/90 mmHg for most adults. Different numbers apply to children. Ambulatory blood pressure monitoring over a 24-hour period appears more accurate than office best blood pressure measurement.
Hypertension in Pakistan
The National Health Survey of Pakistan estimated that hypertension affects 18% of adults and 33% of adults above 45 years old. In another report, it was shown that 18% of people in Pakistan suffer from hypertension with every third person over the age of 40 becoming increasingly vulnerable to a wide range of diseases. It was also mentioned that only 50% of the people with hypertension were diagnosed and that only half of those diagnosed were ever treated. Thus, only 12.5% of hypertension cases were adequately controlled. Some remote areas like Baluchistan, there is a paucity of data but the control rate is likely to get even worse.
Symptoms of hypertension
High blood pressure itself is usually asymptomatic, meaning that patients do not experience any direct symptoms of the condition. This is why hypertension is often referred to as “the silent killer,” as it can quietly cause damage to the cardiovascular system. Hypertension can also lead to problems in the organs affected by high blood pressure. Long-term hypertension can cause complications through arteriosclerosis, where the formation of plaques results in narrowing of blood vessels.
The complications associated with hypertension-related arteriosclerosis can include:
• An enlarged or weakened heart, to a point where it may fail to pump enough blood (heart failure)
• Aneurysm – an abnormal bulge in the wall of an artery (which can burst, causing severe bleeding and, in some cases, death)
• Blood vessel narrowing – in the kidneys this can lead to possible kidney failure; in the heart, brain and legs, this can lead to heart attack, stroke or the need for amputation, respectively
• Blood vessels in the eyes my rupture or bleed, leading to vision problems or blindness (hypertensive – retinopathies classified by worsening grades one through four)
Diagnosis and tests for hypertension
Diagnosis of hypertension is made by measuring blood pressure over a number of clinic visits, using a sphygmomanometer – the familiar upper-arm cuff device. An isolated high reading is not taken as proof of hypertension. Rather, diagnosis can be made after elevated readings are taken on at least three separate days.
Measurements may be taken at the doctor’s office while a patient is seated and after standing; this helps the doctor to look for orthostatic or postural hypotension.
Blood pressure is measured by sphygmomanometer. The reliability of blood pressure readings may be improved by having a patient or someone else take a series of measurements outside the doctor’s office using standardized devices.
Treatments for hypertension
Lifestyle changes are important for both treatment and prevention of high blood pressure, and they can be as effective as a drug treatment. These lifestyle changes can also have wider benefits for heart health and overall health.
The lifestyle measures shown to reduce blood pressure and recommended by experts include:
• Salt restriction – typical salt intake is between 9 and 12 g a day and modest blood pressure reductions can be achieved even in people with normal levels by lowering salt to around 5 g a day – the greatest effects are seen in people with hypertension
• Moderation of alcohol consumption – expert guidelines say moving from moderate to excessive drinking is “associated both with raised blood pressure and with an increased risk of stroke”
• High consumption of vegetables and fruits and low-fat – people with, or at risk of, high blood pressure are advised to minimize intake of saturated fat and total fat and to eat whole-grain, high-fibre foods,at east 300 g of fruit and vegetables a day, beans, pulses, and nuts, and omega-3-rich fish twice a week
• Reducing weight and maintaining it – hypertension is closely correlated with excess body weight, and weight reduction is followed by a fall in blood pressure
• Regular physical exercise – guidelines say “hypertensive patients should participate in at least 30 min of moderate-intensity dynamic aerobic exercise (walking, jogging, cycling or swimming) on 5 to 7 days a week”
• Stress reduction – avoiding sources of stress, where possible, and developing healthy coping strategies for managing unavoidable stress can help with blood pressure control, especially as many people turn to alcohol, drugs, smoking and unhealthy foods or overeating to cope with stress
• Smoking can also raise blood pressure, and because of its wider effects on heart health and the rest of the body, giving up smoking is highly recommended for people with high blood pressure
Yesterday 5/17/2017 was world hypertension day. The article is shared in hopes that everyone who reads benefits from it whether they are able to help themselves or those around. Stay Safe and blessed!
Sources: Information adopted from an article at: http://www.medicalnewstoday.com/articles/150109.php?page=3, www.who.org, http://www.healthline.com/