HEALTH: Hypertension: When blood pressure goes up

“Noncommunicable diseases will be the predominant global public health challenge of the 21st century.” – The New England Journal of Medicine

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“Once considered diseases of industrialized countries or of the affluent in developing countries, noncommunicable diseases are now recognized as global problems,” says Priorities in Health, the companion volume of Disease Control Priorities in Developing Countries.

That is what the Geneva-based World Health Organization (WHO) is trumpeting, too. “Noncommunicable diseases are the leading killer today and are on the increase,” the United Nations health agency t said on its global status report on noncommunicable diseases.

“The rise of chronic noncommunicable diseases presents an enormous challenge,” says Dr. Margaret Chan, the WHO Director-General. “For some countries, it is no exaggeration to describe the situation as an impending disaster; a disaster for health, for society, and most of all for national economies.”

Noncommunicable diseases, also known as chronic diseases, are not passed from person to person. They are of long duration and generally slow progression. Random genetic abnormalities, heredity, lifestyle or environment can cause this kind of diseases.

Hypertension, or high blood pressure, is one of the noncommunicable diseases that affects around 14 million Filipinos, according to the Department of Health. On the other hand, the Food and Nutrition Research Institute (FNRI) shares this information: “Two in every 10 Filipino adults, 20 years and over, are hypertensive.”

The prevalence of hypertension in the country has considerably grown in recent years, and the need to address it should be more prioritized, the Philippine Heart Association – Council on Hypertension urges.

The number of adult Filipinos having hypertension “is still increasing despite treatment advances and that the majority of those being treated have poor blood pressure control,” the association said in a statement.

As lives become more sedentary and stressful, and diets loaded with saturated fats become the norm, hypertension is indeed becoming a serious problem in the country.
“A stubborn problem” is how health authorities consider hypertension because it involves so many of the body’s interlocking systems, and lying at the center of it all is the heart.

Medical science tells us that blood travels through our body by flowing through arteries, carrying oxygen-rich blood from our heart to other tissues and organs. Once oxygen is delivered to our tissues and organs, oxygen-poor blood travels back to our heart through our veins. Our heart then pumps this blood into our lungs, where it is replenished with oxygen. After returning to our heart, the blood is pumped out into our arteries again.

Blood pressure (BP) is the force exerted by blood against artery walls as it circulates through our body. Normally, people have certain standards of BP, with a reading of 140/90 considered the median or average. The upper number, called the systolic, refers to the pumping capability of the heart, while the lower number, termed the diastolic, refers to the pressure exerted by the blood vessels all over the body.

Dr. Willie T. Ong, chair of the Department of Medicine at Our Lady of Peace Hospital, defines high blood pressure as systolic pressure at rest that averages 140 mm Hg (millimeters mercury) or a diastolic blood pressure at rest that averages 90 mm Hg, or both.

An individual has a mild hypertension if the systolic BP is between 140 to 159 mm Hg or the diastolic BP is between 90 to 99 mm Hg. When the systolic BP is higher than 160 mm Hg or a diastolic BP is greater than 100 mm Hg, a person is said to have a moderate to severe hypertension.

Many things can cause blood pressure to rise. When we are asleep, our blood pressure is low because our body needs less oxygen-rich blood when it is at rest. On the other hand, when we are exercising, our body’s demands are greater, and so our blood pressure increases.

“It is perfectly normal for your blood pressure to rise and fall in response to your body’s needs throughout the day,” says Dr. Ong, an internist-cardiologist.

But when your blood pressure goes up and stays up, there’s cause for concern. “Although many people imagine high blood pressure to be a mild condition, left untreated it can lead to a number of serious medical problems,” warns Dr. Robert Buckman, author of What You Really Need to Know About High Blood Pressure.

Hypertension is known as a silent killer because of the lack of warning signs or symptoms so much so that many people do not realize they are already hypertensive.

“In most people, high blood pressure causes no symptoms, despite the coincidental occurrences of certain symptoms that are widely, but erroneously, associated with high blood pressure: headaches, nosebleeds, dizziness, a flushed face, and fatigue,” says The Merck Manual of Medical Information.

“People with high blood pressure may have these symptoms, but the symptoms occur just as frequently in people with normal blood pressure,” the Merck manual adds.

According to the manual, blood pressure is measured after a person sits or lies down for 5 minutes. It should be measured again after the person stands for a few minutes, especially if the person is older or has diabetes.

“Anyone with high blood pressure needs to be under a doctor’s care – not only for regular monitoring but often for medication as well,” recommends The Doctors Book of Home Remedies.

So, what do you do once hypertension sets in? Health experts recommend the following:

1. Know your blood pressure. You may feel no symptoms yet the body is slowly being destroyed by high blood pressure. Be proactive! Be aware of the risk! Have your blood pressure checked regularly – at least once a year. If your blood pressure level is borderline or elevated, see your doctor. So together, you can make a plan to bring your blood pressure under control.

2. Live a healthy lifestyle. A healthy lifestyle keeps you less likely to develop high blood pressure. You will also feel good knowing that you are protected from hypertension. Among those that you should consider are as follows: regular exercise, watching your weight, keeping stress under control, avoiding salty and fatty foods, avoiding too much caffeine, limiting alcohol intake, and quitting smoking.

“Through initially it may be hard to change your lifestyle and habits, a resolute determination, help from your friends and loved ones will make will make it easier to overcome the difficulties you may encounter along the way,” says Dr. Rafael Castillo, a cardiologist at the Manila Doctors’ Hospital.

3. Take your medication regularly. If you are consistently hypertensive despite undergoing a healthy lifestyle, your doctor will now prescribe a drug to combat your high blood pressure. Medications can safely and effectively lower high blood pressure. You’ll be most likely to remember your medication if you establish a routine, such as taking it immediately before breakfast or right after you take a bath.

Perhaps the best thing you can do for yourself once you’ve been diagnosed with hypertension is to invest in a home blood pressure monitor. A daily measurement of your blood pressure can indicate whether your medication and home remedies are actually working to lower your blood pressure.

However, doctors advise that even if you notice an improvement, you should not stop taking a doctor-prescribed medication unless you have your physician’s approval.

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