Dr Botlalo Thibedi, Specialist Physician at Busamed Harrismith Private Hospital provides insight into High Blood pressure and the prevention and control of hypertension.
High blood pressure is a ‘silent killer’ because people who have high blood pressure may not have symptoms until something significant occurs. The only time most people realize that they are not well is when they have shortness of breath when walking faster, they have shortness of breath when going up a steep slope or when their legs are swollen. It is therefore important to go to your GP for a yearly check-up.
Blood Pressure BP 120/80mmHg, the top one i.e. 120 is the Systolic and 80 is the Diastolic
Blood pressure is expressed as the ratio of Systolic B/P that is; the pressure that is exerted on the walls of the arteries when the heart contracts to pump blood to the body and to the lungs. And the Diastolic B/P that is; the pressure when the heart relaxes to allow blood to flow in from parts of the body.
The stages of B/P are;
Types causes of high blood pressure/ Hypertension.
- Primary Hypertension; Primary hypertension is attributed to life style. The following are cause of high B/P; smoking, family history, alcohol, sedentary life style, overweight, unhealthy diet and inability to manage stress;
I) Smoking; cigarette smoking causes inflammation of inner lining of the arteries thereby causing hardening of the arterial wall and stiffness,
II) Alteration if prothrombic and antithrombic factors in the blood, thus predisposing to clot formation, leading to strokes and heart attacks.
III) Overweight; Fat that is inside your body, around your body organs is more dangerous than the subcutaneous fat. This inner fat is called central obesity or abdominal obesity. This fat is measured by your waist circumference.
The measurements of this fat according to the South African Hypertension Guidelines 2011 by YK Seedat and BL Rayner is as follows; men<90cm and women <80 cm.
IV) Unhealthy diet, high salt content in food leads to fluid retention, increase blood volume, thus high blood pressure. World Health Organization (WHO) defines excessive salt as >2g per day.
V) Physical inactivity; A sedentary life style contributes arteries hardening, and plague build up in the artery walls. Plagues are substances such cholesterol and inflammatory deposits in the blood system. These plagues can cause the artery walls to become narrowed thus increasing resistance in the artery walls.
VI) Advanced age; with aging the artery walls stiffen causing resistance and increase in blood pressure.
- Secondary Hypertension; This is high blood pressure caused by other medical conditions. It can be caused by conditions that affect the kidneys, arteries, the heart and the endocrines.
Symptoms of hypertension;
- Chest pain, sometimes associated with shortness of breath.
- Weakness on one side of your body,
- Nose bleeding,
- There may be blood in urine,
- Vision changes
Prevention of hypertension
Lifestyle changes include:
- Cutting back on sodium. World Health Organisation (WHO) recements 2g per day.
- Getting more exercise. Studies show benefits with 3-4 sessions per week, each lasting 40 minutes of ⦁ aerobic exercise (the kind that makes your heart beat faster).
- Losing weight, if you’re overweight. You can expect to shave about 1 point off your blood pressure numbers for each pound lost.
- Eating a healthy diet. The DASH diet is designed to improve blood pressure. DASH stands for Dietary Approaches to Stop Hypertension. It favours vegetables, fruits, whole grains, low-fat dairy, poultry, fish, and chicken.
- Limiting alcohol to no more than one drink a day for women or two for men.
- Avoiding tobacco smoking
- Cutting on foods high in saturated fat. Get dietician
Points to remember
- High blood pressure often has no signs or symptoms and is a silent disease. Adults after the age of 40 years should get their blood pressure checked at least once a year.
- High blood pressure can weaken your heart. When the pressure is high the heart exerts more force to pump the same quantity of blood within the same time. When this continues to happen over time it hardens the arteries and this increases the pressures even more further weakening the heart.
- Main reasons for high blood pressure are stress or mental tension, heredity, excess salt intake, overweight, sedentary lifestyle, smoking and excess alcohol.
- High blood pressure is responsible for 8.5 million deaths worldwide due to stroke, ischaemic heart disease, other vascular diseases, and renal disease.
- Isolated systolic hypertension (ISH) is a condition where only the systolic blood pressure remains high, while the diastolic blood pressure remains within normal limits.
- High blood pressure when uncontrolled leads to stroke, heart attack, congestive heart failure, kidney damage, blindness, or other conditions.
- As people become older, the diastolic pressure begins to decrease and the systolic blood pressure begins to rise.
- To keep blood pressure under control, limit the salt or sodium intake to 2.4 grams/day.
Control of hypertension.
- Yearly check-up,
- Regular taking of your medications,
- Never stop your medication without your doctor’s awareness,
- Manage your stress level,