WOW | Heart Health

What Do You Need To Know About HIGH BLOOD PRESSURE

High Blood Pressure or hypertension is a condition in which blood pressure stays high for a long period of time. Persistent high blood pressure is undesirable because it puts undue stress on the heart, blood vessels and other organs.

Today in urban Nepal, almost one third of the adult population already has high blood pressure. According to WHO data, millions of people die each year because of high blood pressure worldwide with the risk of stroke, heart attack as well as damage to kidney and eyes.

What Causes High Blood Pressure?
Learning what causes hypertension can help realise whether you’re at high risk. Even if you currently have normal blood pressure, knowing what contributes to hypertension will allow you to lower the risk in future with changes in your lifestyle.

About 5-10 percent of patients have High blood Pressure (HBP) because of an underlying disease such as kidney or thyroid. Treatment of the disease may normalise BP. For the remaining 90 percent of patients, the exact cause of HBP remains unknown.

Though age, sex, family history and genetic factors cannot be modified, there are many life style related factors which are important and can be suitable altered. Some of the more common contributors to HBP are:

  • Sedentary lifestyle: Regular physical exercise helps maintain normal blood pressure, but only a handful do the needed amount of exercise. At least 40 mins of aerobic exercise should be done 5-6 days a week.
  • Smoking: Cigarettes contain nicotine and several toxic chemicals. These raise blood pressure making the heart labour to maintain blood flow. Moreover the drugs for decreasing blood pressure may not work well if smoking is not discontinued.
  • Weight gain: Extra weight increases blood pressure. Losing a few pounds is often the patient’s first goal after being diagnosed with HBP.
  • Diet: Fats, cholesterol rich foods and salt can all raise blood pressure. Salt intake should be not more than half tea spoon a day (about 3 gm).
  • Birth Control pills: Few women may develop increase in blood pressure while on birth control pills.
  • Alcohol: Excessive alcohol consumption has been linked to hypertension.
  • Stress: Stress is clearly related to HBP specially if it is chronic. Excessive thinking and not able to relax can accelerate the aging process.
  • Heredity: Family history does play a role in hypertension and cardiovascular diseases. Genetics seem to be one of the important causes of high blood pressure; that’s just something we have to live with. While you can’t change your genes, you can change your lifestyle.

Self Monitoring of Blood Pressure
You can check your own blood pressure at home by purchasing a monitoring device from a drug or department store. Many of the newer electronic instruments do not require use of stethoscopes. Periodically check your instrument with your doctor to make sure that it is working properly. Prefer a device that measures your arm BP and not one that is tied on the wrist.

What are the Symptoms of High Blood Pressure?
Unfortunately a person with HBP may not have any clearly identifiable  symptoms. That’s why high blood pressure is such a dangerous condition. There may be a mild uneasiness or headache. Many patients may not perceive anything until HBP does its damage and they’re suddenly confronted with heart problems, or even a stroke. Often patients discover HBP when their blood pressure is routinely checked. By nature, HBP is often a silent menace.

How to measure Blood Pressure? 
The blood pressure reading should be taken three times and the first reading should be discarded. A mean of the second and third reading should be accepted as the actual reading. The person should be fully relaxed and should not have consumed a cigarette, tea or coffee in the previous hour. The person should be sitting on a chair with a back rest.

Treatment Options
In general, the closer your blood pressure is to 120/80 the better it is for your health. Your doctor should decide whether or not you need a pill. You should start with the above-mentioned lifestyle changes and avoid salt rich foods (like papad, chutneys, pickles, potato chips, salted popcorn and cheese. Try to stay relaxed. Pick up pranayam/ meditation classes. Relaxing breathing exercises surely help.

If your blood pressure doesn’t fall below 140/90, drug therapy is warranted. Many patients may need more than one pill. It is important to quit smoking for these pills to act effectively.

What Is The Best Time To Take The Pills?
BP medications should be taken early in the morning. Contrary to popular belief, our blood pressure is at its maximum during the early hours. Most heart attacks and strokes also occur during the early hours. If you are taking more than one pill, it may be a good idea to take another pill at bed time.

Side Effects of Drugs
Patients are often concerned about the side effects of drugs. Fortunately most BP pills are very safe. However, a drug may occasionally cause swollen feet, dry cough or an asthmatic attack. If you do have any of these problems, report to your doctor and he may change the drug.

Is Low Blood Pressure A Problem?
If you have mild dizziness or weakness and have blood pressure of 90/ 60 mm Hg, you may think it is because of low blood pressure. This may be a temporary feeling of weakness, and can be solved by just lying down or taking some extra fluids. However, there is really no disease like chronic low blood pressure. This does not need any treatment. There are actually no drugs to increase your blood pressure.  Most people with low blood pressure are at a lower risk of developing any heart disease and hence, you need not feel anxious about it!

Finally, high BP is not a big deal, as long as one keeps a watch on it and controls it well. It’s a good idea to have a BP instrument in every house. Try to stay relaxed and laugh many times a day! Be conscious of what and how much you eat and drink. Simple measures and regular medications may be of use to combat with this easily manageable yet a dangerous disease.

Dr Bharat Rawat (MD DM FAPSIC FACC FSCAI – USA) is the Associate Director Cardiology at Medanta Super Specialty Hospital in Indore, India. He may be contacted on 00919717783168.