Doctor: Does your father have hypertension?
Man: No, he takes medicines daily for high blood pressure (BP).
Doctor: I think the answer is yes, because hypertension is the medical term for high blood pressure.
Man: Okay! Thanks. I didn’t know that.
However common the term hypertension is among healthcare professionals in Nigeria, it is still not widely known amongst those who do not provide health services. Hypertension and high blood pressure can be used interchangeably. It is a very common disease of the heart and blood vessels. Many times healthcare professionals hear people say, “He’s got BP (blood pressure),” but the fact is that everyone has blood pressure.
Blood pressure is the force of blood pushing against artery wall. Blood flows through the blood vessels to and from the heart at a given pressure. Hypertension means sustained increased blood pressure, that is, higher than normal or expected. A blood pressure level of 140/90mmHg or higher is considered high.
Hypertension is one of the leading causes of morbidity and mortality in Nigeria. Commonly considered as one of the “silent killers”, hypertension may show no symptoms and consequently lead to heart attack, stroke, kidney disease, amongst others, and eventual death. The cause of hypertension is unknown, but it has been linked to certain risk factors (conditions that increase chances of developing a disease) that could be modifiable or non-modifiable. Some of the risk factors include excessive salt intake, obesity, high cholesterol level, excessive alcohol consumption, increasing age (especially the elderly), family history, tobacco consumption, sedentary lifestyle, diabetes and pregnancy. Other causes include mental stress, hence the saying the popular saying by Earl Wilson: “One way to get high blood pressure is to go mountain climbing over molehills.”
Most people with high blood pressure will not experience any symptoms. However, some people may feel vague symptoms like headache, nausea, dizziness, blurred or double vision, nose bleeds, restlessness, poor sleep, amongst others. It is very important for adults to check their blood pressure regularly for early detection of any abnormality and prompt intervention. The extent of damage caused by hypertension depends on its severity and how long it continues without treatment. Most complications are seen in individuals who have not started medication or those with established disease but not compliant with medication and physician recommendation.
Hypertension, when established requires follow-up and prompt treatment and regular clinic visits as it is a long term (chronic). Self-medication is a common practice amongst many in Nigeria and hugely affects the management and outcome of the disease. The modality of treatment to be given will depend on the degree/severity of the disease on the individual upon presentation.
Lifestyle modification plays a huge role in both management and prevention of hypertension.
Some measures recommended include:
• Healthy weight: Maintaining a healthy weight is very essential. It is said that blood pressure rises as one’s body weight increases. Obesity can predispose to or worsen hypertension. The target/healthy body mass index (a measure of weight relative to height) should be maintained. Remember to use healthy ways to lose weight if overweight or obese for sustained success.
• Be physically active: This helps to lower blood pressure and reduce the risk of heart disease. It also contributes to maintaining a healthy weight. It is recommended that adults should have 30minutes per day of moderate exercises five days a week. Examples of such exercises include brisk walking, bicycling, dancing and gardening. For individuals with hypertension, it is advised to check with your cardiologist for the suitable exercise allowed before starting.
• Healthy diet: Healthy eating can both prevent and better manage high blood pressure. Eating foods that are low in salt (sodium), saturated fat, total fat, sweets, sugared beverages, excess caffeine and cholesterol help prevent high blood pressure. Eating foods high in fruits, vegetables, whole grains, poultry, fish and nuts helps control blood pressure.
• Limited alcohol consumption: Excess alcohol may not only predispose to hypertension, it also worsens pre-existing disease. Moderate amounts are recommended, which is one drink a day for men and two drinks a day for women.
•Avoid cigarette smoking
•Take antihypertensive drugs as prescribed: For individuals that are on antihypertensive drugs, compliance to medication is advised. While on medication, individuals should still follow the lifestyle guidelines for effective control of hypertension.
• Effective stress management.
Hypertension can cause a lot of problems which do not only affect the individual involved but also affects the family, community and country at large. However, with lifestyle modification and medication, the burden may be lighter.
Health question of the week:
What is your blood pressure?