Hypertension – the ‘silent killer’ that afflicts millions of people globally as well as locally
To educate South Africans about the potential deadly outcome of a lack of, or poor management of hypertension (HTN), also known as high blood pressure (BP), pharmaceutical manufacturer and supplier Novartis is running the Beat2Beat Pressure Pledge campaign, issuing a call to action to all South Africans to take advantage of the opportunity to have their blood pressure tested.
Dis-Chem Pharmacies nationwide and select corporate companies have elected to be a part of the Beat2Beat Pressure Pledge campaign, offering this service to their respective consumers and employees from 24 June – 7 July 2013.
The Beat2Beat Pressure Pledge campaign, puts the spotlight on the importance of prevention, early detection and treatment of high blood pressure to ensure a healthy heart beat, therefore a healthy life.
According to Prof B L Rayner of the Department of Medicine, University of Cape Town, and President of the Southern African Hypertension Society, hypertension is a global health burden affecting developed and developing countries, including South Africa. The high prevalence of hypertension worldwide contributes to the present and anticipated pandemic of cardio-vascular disease (CVD), which is of particular concern in developing countries.
Prof Rayner says statistics show that hypertension is a major and costly contributor to CVD: it accounted for R4-R5 billion in direct and indirect expenditure in 1991, and was previously shown to constitute 7.5% of the direct total healthcare spend in South Africa.
Indeed, the statistics are stark: with some 6.3 million people living with high blood pressure, South Africa has one of the highest rates of hypertension worldwide. About 130 heart attacks and 240 strokes occur daily in South Africa. This means that 10 people will suffer a stroke and five people will have a heart attack every hour.
Likewise, the African continent has a high incidence of BP, with the prevalence in sub- Saharan Africa varying between 10%-29%, depending on the country. Even in developed countries like the United States, high blood pressure continues to take its toll. One in three (68 million) US adults have high blood pressure and less than half of patients have it adequately controlled. With no serious action on this issue, it’s predicted that by 2030 more than 100 million adults will have high blood pressure, resulting in staggering increases in healthcare costs, disability and lost productivity for the US.
“These statistics show that people don’t realise how important it is to know your blood pressure. If you don’t know if you are hypertensive, you could be living with a ticking time bomb,” says Dr Vash Mungal-Singh, CEO of the Heart and Stroke Foundation South Africa, who calls on South Africans to find out their blood pressure level as soon as possible.
High Blood Pressure
Similar to the concept of air pressure in a car tyre, blood pressure is simply the physical pressure of blood in the blood vessels. Blood pressure differs between individuals. Some people have low, some average and some high blood pressure levels. While normal blood pressure would be 120 mm Hg systolic and 80 mm Hg diastolic (120/80), most doctors consider blood pressures of 140/90 and greater to be high. The precise values that doctors might interpret as high blood pressure depend to an extent on individual circumstances. For example, in patients with diabetes, the definition of hypertension is considered by some to be pressures greater than 130/80.
High blood pressure is more common in older age groups and in people with a family history of hypertension. It is also more frequent in those who are overweight. However, high blood pressure can affect young, slim people with no family history, so no one should consider himself or herself immune from high blood pressure.
Uncontrolled hypertension
Untreated hypertension shortens life expectancy by approximately five years. If left uncontrolled, high blood pressure can cause blindness, kidney disease, stroke and heart failure, and the risk increases in the presence of other risk factors such as diabetes.
It can also lead to the enlargement of the heart, while blood vessels may develop bulges (aneurysms) and weak spots that make them more likely to clog and burst.
Moreover, uncontrolled high blood pressure damages the brain’s structure and function as early as young middle-age, and even the brains of middle-aged people who clinically would not be considered to have hypertension have evidence of silent structural brain damage, a study has found.
Causes, symptoms
In more than 90% of patients the causes of high blood pressure are unknown, although many hereditary and lifestyle factors play a role in its development. The latter include smoking, excessive alcohol consumption, obesity, high saturated fat intake, high salt intake and physical inactivity. It is also the most prevalent cardiovascular disease (affecting the heart and blood vessels) and is a major risk factor for both illness and death.
Widely known as the ‘silent killer’, high blood pressure often has no warning signs or obvious symptoms. Many people do not know that they have high blood pressure, so knowing your blood pressure level is therefore the first step to preventing and controlling hypertension.
Treatment
The good news is that high blood pressure doesn’t have to be a death sentence; in fact, hypertension is relatively easy to prevent, diagnose and treat, thus lowering your blood pressure to normal levels.
According to Prof Rayner, a healthy lifestyle remains the cornerstone of managing hypertension regardless of BP level: in addition to decreasing BP, it enhances antihypertensive drug efficiency and decreases total cardio vascular risk. However most patients will still require additional antihypertensive medications. Treatment is for life and medication should not be stopped when the blood pressure is normalised.
Even a modest reduction in blood pressure results in a 30-45% reduction in stroke, a 20-25% reduction in heart attack and a more than 50% reduction in heart failure. However the best results are achieved if blood pressure is controlled below 140/90.
If a person’s blood pressure is 140/90 or higher, the doctor will likely prescribe medication in addition to lifestyle modifications. It’s imperative that BP sufferers follow their healthcare professional’s recommendations carefully, even if it means taking medication every day for the rest of their life. High blood pressure is a lifelong disease, and by partnering with their healthcare team, they can successfully reach their treatment goals and enjoy the benefits of better health.
Once a treatment program becomes routine, maintaining a lower blood pressure is easier. Remind yourself that by managing your blood pressure, you are lowering your risk of heart attack, heart failure, stroke, peripheral artery disease and kidney disease. Death rates from these diseases have decreased significantly, thanks in part to earlier and better treatment of BP.
Even if your blood pressure is normal (less than 120 mm Hg systolic AND less than 80 mm Hg diastolic) and your goal is prevention only, lifestyle modifications provide a sound prescription for healthy living.
QUICK TIPS – Eating and drinking tips for a healthy diet
· Decrease total salt (sodium) intake and do this in consultation with your doctor or dietician. Besides table salt, high sodium levels are found in: packet soups, stock cubes, gravies, processed cheese, many breakfast cereals, bread, salty snacks, tinned food, ham, bacon, tongue, corned beef, and salami. Reduce your high salt intake slowly, one’s taste buds adapts to lower levels of salt within 6 weeks. To improve the taste of your food use lemon juice, herbs and spices as alternative seasoning.
· If you drink alcohol, drink sensibly. Limit alcohol intake to a maximum of: 2 standard drinks per day for men, 1 standard drink per day for women and small men.
· Eat plenty of fruits and vegetables for their fibre, micronutrients and antioxidants.
· Try and eat a diet which includes less total fat and which is low in saturated fat.
· Regularly use low-fat dairy products.
· Have a higher intake of high-fibre wholegrain foods.
· Use sugar and sugar-containing foods and drinks sparingly.
· Avoid intake of beverages with high caffeine levels, – 1 – 2 cups of coffee per day will not increase your BP.
· Stop the use of all tobacco products. Nicotine replacement therapy should be used for patients with hypertension while under medical supervision.
Hypertension is relatively easy to prevent, diagnose and treat. So act now and get your BP tested. If you’ve been diagnosed with high blood pressure, start by making a few small changes as often as you can. Over time, you will be able to live a healthier and longer life.
Source: Southern African Hypertension Society – http://hypertension.org.za
