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Hypertension: Uprooting the silent killer

By CHIOMA OBINNA

The sudden death of 27 year old Ikechi Jonas has remains a puzzle in his family. Jonas’s death did not only send cold chills down the spine of all who knew him while he was alive but prods the question: who will be the next victim?

Jonas was hale and hearty on that fateful Friday evening. Jonas and his friends whom he earlier cracked jokes with never had any inclination of what fate had in store for him that night.

Jonas was said to have returned home, had his bath and prepare for his dinner when he suddenly slumped.

His mother was the only one at home. She was helpless and confused. Immediately, she concluded that it was a spiritual attack. She started praying and rubbing anointing oil all over him but Jonas was gone. After some minutes of prayers, she let out a loud scream which attracted neighbours who rushed Jonas to the hospital. Getting to the hospital, Jonas was wheeled into the emergency ward of the hospital where series of tests were ran on him. The result of the tests indicated that Jonas had a heart attack. Further medical examinations revealed that the heart attack was as a result of an untreated Hypertension (High Blood Pressure) he has had for years without knowing.

Unfortunately, in spite of the battle to save his life, Jonas never woke up to tell his story. When Jonas was wheeled into the hospital, his Blood Pressure was 300. But experts say blood pressure is normal if it is below 120/80 mm.

According to the doctors, Jonas was already a walking corpse days before he finally collapsed.

For Janet Ade 60, receiving the news of her HBP status was also like hanging a death sentence on her neck.

Even for many weeks after she had commenced the treatment, she repeatedly asked her doctor if she would be totally cured of the disease.

On each occasion, she was given the assurance, while her doctor also kept reminding her that she shouldn’t miss her daily dose.

Few months into the treatment, Patient started feeling better and she did another HBP reading which showed her HBP numbers have improved.

“But still, I was told to continue with the required doses, on daily basis.” she recalled.

Janet like every other HPB patient also felt that she was out of danger few weeks into her treatment. The thought of having to take these drugs for life gave her sleepless night, hence, she decided to try the other one, herbal mixture.

Unfortunately, Janet never knew that he was only digging her grave. “I couldn’t still understand the message very well until I abandoned my drugs. Few months later I woke up on a hospital bed. The doctors said I was rushed to the hospital unconscious”

Janet was lucky to survive but Jonas is one of the many Nigerians that die as a result of undiagnosed hypertension.

Today, the magnitude of deaths as a result of High Blood Pressure (HBP) in Nigeria has become such that needs very urgent attention to avoid an imminent epidemic of cardiovascular diseases in the country. Cardiovascular diseases are classes of diseases that involve the heart or blood vessels, such as heart attack, heart failure, sudden death, stroke and cardiac rhythm problems amongst others.

Hypertension also called HBP is a common condition in which the force of the blood against the artery walls is high enough that it may eventually cause health problems, such as heart disease. According to medical experts, HBP typically develops over many years, and it affects nearly everyone eventually. Fortunately, it can be easily detected. And once you know you have high blood pressure, you can work with your doctor to control it.

Hypertension is the most common cardiovascular condition in the world, unfortunately, the problem of defining a strategy for control confronts all societies. Worst still, Hypertension has been implicated as the highest cause of cardiovascular disease in Nigeria. Although, it is treatable, social conditions in Nigeria and Africa in general make the implementation of blood pressure control programmes difficult.

Blood pressure is determined by the amount of blood the heart pumps and the amount of resistance to blood flow in the arteries. The more blood the heart pumps and the narrower the arteries, the higher the blood pressure. You can have high blood pressure for years without any symptoms. Uncontrolled high blood pressure increases your risk of serious health problems, including heart attack and stroke.

However, blood pressure is said to be normal if it is below 120/80 mm Hg. But some doctors recommend 115/75 mm Hg as a better goal. Once blood pressure rises above 115/75 mm Hg, the risk of cardiovascular disease begins to increase.

The disease which ranks third as a cause of disability in adjusted life years increases the risk of ischaemic heart disease to four-folds and of overall cardiovascular risk by three -folds in Nigeria. It also estimated that 40 per cent of cases of acute myocardial infarction or stroke are attributable to hypertension.

Despite the availability of effective treatments, studies have shown that in many countries, less than 25 per cent of patients have access to treatments.

A national survey of the occurrence of hypertension and other non-communicable diseases, found that 10 per cent of the Nigerian population have regular high blood pressure.

In the views of Emeritus Professor of Medicine, Olujimi Akinkugbe, HBP occurred essentially in 10 per cent of the population of adults aged between 15 and 70. “Prevalence rate was about the same in males and females; so if we are talking of a population of 140 million, that means about 10million people have hypertension”.

Of that 10 per cent, perhaps between seven and eight million will fall into the category of mild hypertension, no symptoms at all unless a check is conducted.

There are also pointers that indicate that hypertension is more common in the urban group in the cities than in the rural areas, because in the city you are exposed to more kinds of stress, violence, salt intake, overweight, little exercise, and other risk factors in the genesis; today the scenario has not changed rather it has worsen.

Following the silent nature of hypertension, experts advised on prevention rather than treatment, pointing out, “things that sustain hypertension are obesity, lack of exercise, high salt intake, stress of various types, and there are many of these in the slums across Nigeria where the violence index is high, where there is so much stress, congestion and so on; all these promote hypertension.

In a study titled, “Prevalence, awareness, treatment and control of hypertension in a Nigerian population” by Dr Obinna Ikechukwu and colleagues, it was documented that there is poor detection, treatment and control of hypertension in Nigeria.

The bottom line is that hypertension is a silent killer because it is deadly and has no early significant symptoms. To escape the dangers of Hypertension you must always get your blood pressure checked to rule out hypertension.

Overview of Hypertension

High blood pressure is a common condition in which the force of the blood against your artery walls is high enough that it may eventually cause health problems, such as heart disease.

Blood pressure is determined by the amount of blood your heart pumps and the amount of resistance to blood flow in your arteries. The more blood your heart pumps and the narrower your arteries, the higher your blood pressure. You can have high blood pressure (hypertension) for years without any symptoms. Uncontrolled high blood pressure increases your risk of serious health problems, including heart attack and stroke.

Symptoms

Most people with high blood pressure have no signs or symptoms, even if blood pressure readings reach dangerously high levels. Although a few people with early-stage high blood pressure may have dull headaches, dizzy spells or a few more nosebleeds than normal, these signs and symptoms typically don’t occur until high blood pressure has reached a severe even life-threatening stage.

When to see a doctor

You will likely have your blood pressure taken as part of a routine doctor’s appointment.

Ask your doctor for a blood pressure reading at least every two years starting at age 20. He or she will likely recommend more frequent readings if you have already been diagnosed with high blood pressure or other risk factors for cardiovascular disease. Children age 3 and older will usually have their blood pressure measured as part of their yearly checkups.

Causes

There are two types of high blood pressure. Primary (essential) hypertension. For most adults, there’s no identifiable cause of high blood pressure. This type of high blood pressure, called essential hypertension or primary hypertension, tends to develop gradually over many years.

Secondary hypertension: Some people have high blood pressure caused by an underlying condition. This type of high blood pressure tends to appear suddenly and cause higher blood pressure than the primary hypertension. Various conditions and medications can lead to secondary hypertension, including: Kidney problems, Adrenal gland tumors, certain defects in blood vessels, certain medications, such as birth control pills, cold remedies, decongestants, over-the-counter pain relievers and some prescription drugs and illegal drugs, such as cocaine and amphetamines

Risk factors

High blood pressure has many risk factors, including: Age, race, family history. High blood pressure tends to run in families, being overweight or obese, not being physically active, using tobacco. Others are too much salt (sodium) in your diet, too little potassium in your diet, too little vitamin D in your diet, drinking too much alcohol, stress, certain chronic conditions and sometimes pregnancy contributes to high blood pressure, as well.

Complications

The excessive pressure on your artery walls caused by high blood pressure can damage your blood vessels, as well as organs in your body. The higher your blood pressure and the longer it goes uncontrolled, the greater the damage. Uncontrolled high blood pressure can lead to Heart attack or stroke.

Increased blood pressure can cause your blood vessels to weaken and bulge, forming an aneurysm.

To pump blood against the higher pressure in your vessels, your heart muscle thickens. Eventually, the thickened muscle may have a hard time pumping enough blood to meet your body’s needs, which can lead to heart failure.

Weakened and narrowed blood vessels in your kidneys can prevent these organs from functioning normally.

Thickened, narrowed or torn blood vessels in the eyes can result in vision loss.

Metabolic syndrome is a cluster of disorders of your body’s metabolism — including increased waist circumference, high triglycerides, low high-density lipoprotein (HDL), or “good,” cholesterol, high blood pressure, and high insulin levels. If you have high blood pressure, you are more likely to have other components of metabolic syndrome.

Uncontrolled high blood pressure also may affect your ability to think, remember and learn. Trouble with memory or understanding concepts is more common in people who have high blood pressure.

Tests and diagnosis

Blood pressure is measured with an inflatable arm cuff and a pressure-measuring gauge. A blood pressure reading, given in millimeters of mercury (mm Hg), has two numbers. The first, or upper number measures the pressure in your arteries when your heart beats (systolic pressure). The second, or lower, number measures the pressure in your arteries between beats (diastolic pressure).

Blood pressure measurements fall into four general categories: Normal blood pressure. Your blood pressure is normal if it’s below 120/80 mm Hg. However, some doctors recommend 115/75 mm Hg as a better goal. Once blood pressure rises above 115/75 mm Hg, the risk of cardiovascular disease begins to increase.

*Prehypertension is a systolic pressure ranging from 120 to 139 mm Hg or a diastolic pressure ranging from 80 to 89 mm Hg. Prehypertension tends to get worse over time.

*Stage 1 hypertension is a systolic pressure ranging from 140 to 159 mm Hg or a diastolic pressure ranging from 90 to 99 mm Hg.

*More severe hypertension, stage 2 hypertension is a systolic pressure of 160 mm Hg or higher or a diastolic pressure of 100 mm Hg or higher.

Both numbers in a blood pressure reading are important. But after age 50, the systolic reading is even more significant. Isolated systolic hypertension (ISH) — when diastolic pressure is normal but systolic pressure is high — is the most common type of high blood pressure among people older than 50.

Your doctor may recommend routine tests, such as a urine test (urinalysis), blood tests and an electrocardiogram (ECG)

Lifestyle and home remedies

Lifestyle changes can help you control and prevent high blood pressure — even if you are taking blood pressure medication. Eat healthy foods by applying the Dietary Approaches to Stop Hypertension (DASH) diet, which emphasises fruits, vegetables, whole grains and low-fat dairy foods. Get plenty of potassium, which can help prevent and control high blood pressure. Eat less saturated fat and total fat.

* Decrease the salt in your diet. Although 2,400 milligrams (mg) of sodium a day is the limit for otherwise healthy adults, limiting sodium intake to 1,500 mg a day will have a more dramatic effect on your blood pressure.

* Maintain a healthy weight.

* Regular and Increased physical activity can help lower your blood pressure and keep your weight under control. Strive for at least 30 minutes of physical activity a day.

* Limit alcohol. Even if you’re healthy, alcohol can raise your blood pressure. If you choose to drink alcohol, do so in moderation — up to one drink a day for women and everyone over age 65, and two drinks a day for men.

* Don’t smoke. Tobacco injures blood vessel walls and speeds up the process of hardening of the arteries. If you smoke, ask your doctor to help you quit.

* Manage stress. Reduce stress as much as possible. Practice healthy coping techniques, such as muscle relaxation and deep breathing. Getting plenty of sleep can help, too.

* Monitor your blood pressure at home. Home blood pressure monitoring can help you keep closer tabs on your blood pressure, show if medication is working, and even alert you and your doctor to potential complications. If your blood pressure is under control, you may be able to make fewer visits to your doctor if you monitor your blood pressure at home.

* Practice relaxation or slow, deep breathing. Practice taking deep, slow breaths to help relax. There are some devices available that can help guide your breathing for relaxation; however, it’s questionable whether these devices have a significant effect on lowering your blood pressure

Hypertension at a glance

•High blood pressure (hypertension) is designated as either essential (primary) hypertension or secondary hypertension and is defined as a consistently elevated blood pressure exceeding 140/90 mm Hg.

•High salt intake, obesity, lack of regular exercise, excessive alcohol or coffee intake, and smoking may all adversely affect the outlook for the health of an individual with hypertension.

•Poorly controlled hypertension ultimately can cause damage to blood vessels in the eye, thickening of the heart muscle and heart attacks, hardening of the arteries (arteriosclerosis), kidney failure, and strokes.

•Heightened public awareness and screening of the population are necessary to detect hypertension early enough so it can be treated before critical organs are damaged.

•Lifestyle adjustments in diet and exercise and compliance with medication regimes are important factors in determining the outcome for people with hypertension.

•The goal of therapy for hypertension is to bring the blood pressure down to 140/85 in the general population and to even lower levels in diabetics, African Americans, and people with certain chronic kidney diseases.

•Screening, diagnosing, treating, and controlling hypertension early in its course can significantly reduce the risk of developing strokes, heart attacks, or kidney failure.


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Comments expressed here do not reflect the opinions of vanguard newspapers or any employee thereof.