by Dr. Izuagba Kelechi. U.
- Hypertension also known as high blood pressure is a medical condition in which there’s persistently elevated systolic and diastolic blood pressure of > or = 140/90 mmHg in adults (WHO)
- It is a non-communicable disease, very common and can be “Asymptomatic” and if it is not detected and controlled, it can often lead to lethal complications.
- The prevalence of hypertension increases with advancing age and it is a major risk factor for coronary artery diseases, heart failure, stroke and renal insufficiency.
- Because hypertension is almost without symptoms except for headaches in some people, it hides without knowing it and is therefore referred to as a “SILENT KILLER”.
- Higher in both extremes of socio-economic groups.
- Commoner in blacks/black population
- Prevalence in Nigeria is 11.2% in adults
- Increasing awareness and early diagnosis will improve the control of high blood pressure. This will help to reduce cardiovascular complications which can lead to morbidity and mortality
- Effective BP control is possible and can be achieved
CLASSIFICATION OF HYPERTENSION
Based on JNC-7 classification, it can be
- Normal BP = <120/<80 mmHg
- Optimum BP = 120/80 mmHg
- Pre-hypertension = 120-139/80-89 mmHg
- Stage 1 hypertension = 140-159/90-99 mmHg
- Stage 2 hypertension = >or=160/>or =100 mmHg
Based on the cause / aetiology:
- Primary hypertension / essential / idiopathic(unknown)
- Secondary hypertension
The primary/essential hypertension is the “commonest” accounting for 95% of cases
Because the cause is unknown, it is non-curable; and treatment is for life
The primary hypertension is likely due to interplay between factors (risk factors) which maybe different among individuals
The secondary hypertension accounts for the remaining 5% of cases.
RISK FACTORS OF HYPERTENSION (PRIMARY TYPE)
- Hereditary/generic factors i.e. family history
- Advancing age (45years and above)
- Dietary factors e.g. excessive salt intake, low k+ , low vegetables/fresh fruits, saturated fats (hyperlipidemia)
- Excessive alcohol consumption
- Physical inactivity
- Socio-economic status (both high and low)
- Gender factor – less in pre-menopausal women, more in men (oestrogen is protective)
- Geographical factors e.g. in KOMA people of Nigeria, high blood pressure is virtually non-existent and there’s no rise with age than in western organized societies.
FACTORS THAT TRANSIENTLY INCREASE BP
- Sexual orgasm
- Exercise (brisk rise in systolic BP)
N/B: The secondary types are usually due to underlying systematic diseases e.g. renal, endocrine, neurological and exogenous factors and are not the focus of discussion.
COMMON PRESENTATIONS OF HYPERTENSION
- Asymptomatic (i.e. no symptoms hence called a “silent killer”)
- Occasional symptoms e.g.
- Palpitations (awareness of one’s heart beat)
- Non-medical treatment: lifestyle modification e.g.
- Weight reduction
- Reduced salt and alcohol intake
- Stop smoking
- Dietary approach e.g. take more fruits and vegetables
- Reduce intake of refined sugar
- Medical treatment: The use of drugs (anti-hypertensives) e.g. Thiazides (hydrochlorothiazide), calcium channel blockers (Amlodipine), etc.
N/B: Always adhere to your medications with lifestyle modifications. This will help reduce the blood pressure and will prevent fatal complications of the disease.
- Hypertension is a very common disorder in aged people and it is associated with higher risk of cardiovascular morbidity and mortality
- Effective blood pressure control can be achieved with strict adherence to medications and life style changes
- Every adult must “routinely” check his/her blood pressure at least 2 times weekly if “undiagnosed” as this disease does not show or give clues hence referred to a silent killer
- For the “diagnosed” patients, they must have a personal BP apparatus with the assistance of a medical personnel (nurses) to always check their blood pressure daily to control the BP in addition to strictly adhering to their daily medications and lifestyle modifications
- Visit your doctor if there are complaints
- Early diagnosis and prompt intervention are key to management of hypertension
GO CHECK YOUR BLOOD PRESSURE TODAY!