Hypertension is the presence of elevated blood pressure (BP). The latest statics from Centers for Disease Control (CDC) helps to drive home the need to take the measurement of your BP seriously. Of particular note is that CDC refers to Hypertension (HTN) as the silent killer, the same term we used on the subject in the article on the issue over three years ago. It is therefore necessary to echo the issue of HTN again. The graphic illustration from CDC helps to capture the issue

 \In essence about 36 million Americans have high BP that is not well managed. It is estimated that HTN causes about 1,000 deaths per day according to CDC.

Blood pressure is reported as two numbers, the upper number is the systolic pressure (measured when the heart contracts) and the lower number is the diastolic pressure (measured when the heart relaxes). The normal blood Normal BP is 120/80mmHg and less; pre HTN 120-139/80-89; HTN 140/90 and higher. However, it has been shown that the risk of death from heart disease and stroke begins to increase at levels as low as 115/75, and doubles for every increase of 20mmHg in systolic blood pressure or 10mmHg in diastolic blood pressure. If you are on medication for HTN, well controlled BP should be in the normal range.

Causes of Hypertension

Unknown: Most cases of HTN no definite cause is found (Essential HTN).

Secondary: HTN may be secondary to other diseases, such as: Kidney disease, some disorders related excess hormone secretion (cortisol, aldosterone), diabetes, sleep apnea and a host of other diseases.

Medications: some cold remedies, decongestants

What are the risk factors associated with high blood pressure?

Non modifiable risk

Age: The risk of high blood pressure increases with age. For people aged between 55-65 years the lifetime probability of developing essential hypertension is 90%.

Race: High blood pressure is more common in blacks. Complications are also common in blacks.

Family: Hypertension tends to run in families.

Modifiable risk (you can do something about it)

Obesity: Overweight and obese people are more likely to develop hypertension than people with normal weight.

Stress: Stress can cause temporary but significant increases in blood pressure.

Salt: High sodium intake causes your body to retain water and, thereby increasing blood pressure.

High cholesterol, high sugar (diabetes)

Smoking: Smoking has been associated with increase in blood pressure

Alcohol: Excessive alcohol intake damages the heart over time.

Lack of exercise: Living a sedentary life style.

What are the symptoms and signs? 

NONE: Most people with high blood pressure have no symptoms or signs they simply feel ok, even though they are at dangerously high BP level.

Sometimes: Headaches, dizzy spells, and others just feel funny

Symptoms related to complications: Stroke, chest pain (which may imply heart attack), swelling of the body from kidney failure, sudden death.

Complications of High Blood Pressure

• Stroke: Since the blood vessels are working under increased pressure, they are like pipes that all have a sudden change in pressure, which can burst. When vessels burst in the brain it results in stroke (hemorrhagic stroke)
• Damage to Arteries: Excessive pressure makes the arteries thick (atherosclerosis).  Thickening of the arteries will reduce blood flow to whichever organ it supplies. If it is the heart it will cause a heart attack, brain stroke (ischemic stroke).
• Eyes: Can cause loss of vision.
• Kidney: Kidney damage that decreases its ability to get waste product out of the body. With eventual failure of the kidney dialysis will be required.
• Thinking Ability: Dementia is more common in people who have high blood pressure.
• Premature death

What can you do?

• Have your BP checked, know the exact numbers 
• Take less salt – you do not need more than 1500mg of salt per day.  
• Maintain a healthy weight for your height- Your blood pressure is reduced by 5/20mmhg for every 22lbs of weight loss. 
• Eat healthy food- Plenty of fruits and vegetables, and nuts as well. Eat very little saturated fat 
• Exercise Regularly- At least 30 minutes of moderate/vigorous activity (that makes you sweat) at least 4-5 days a week. 
• Avoid Smoking 
• Reduces stress 

Take home message

• Measure blood pressure regularly at least twice a year, more frequently if you are told it is high, or you are under stress. 
• Do not depend on feelings as a good indicator of your BP level. By the time you feel your BP, it may be too late. 
• Seek medical care, irrespective of your immigration status 
• If the doctor gives you medications please take it. 

Dr. Oluwatoyosi Dairo can be contacted at Amazing Medical Services at 110-16 Sutphin Blvd, Jamaica NY, 11435 or phone (718) 526 7600.

References

Mayoclinic.com- tools for a healthier life

Centers for Disease Control

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