HEALTH – HYPERTENSION: What you need to know

By Gerry T. Estrera
Filipinos suffering from hypertension are increasing in number and most of them are walking time bombs which can explode anytime with serious complications.   “Two in every 10 Filipino adults, 20 years and over, are hypertensive,” reports the Food and Nutrition Research Institute.
About half of 12.6 million Filipinos with hypertension are not aware of their condition until they begin to suffer illnesses that have associated complication with hypertension.  “Hypertension per se does not kill, but the complications are the ones that disable and kill a hypertensive,” says Dr. Rafael Castillo, a cardiologist at the Manila Doctors’ Hospital.
“Hypertension is the leading risk factor for heart attack, or myocardial infarction,” informs Dr. Julian Whitaker, author of “Reversing Hypertension: A Vital New Program to Prevent, Treat, and Reduce High Blood Pressure.” “A heart attack occurs when part of the heart’s blood supply is suddenly reduced or cut off, usually do to a blockage in one of the coronary arteries supplying blood to the heart.  The portions of the heart muscle that cannot get adequate oxygen and nutrients die.  The more extensive the damage, the more serious the heart attack.”
In the Philippines, stroke affects about 500 out of 100,000 people, reports Dr. Jose Navarro, author of “Prevalence of Stroke: Community Survey,” which appeared in “The Philippine Journal of Neurology.”
“Don’t confuse a stroke with a heart attack,” reminds Dr. Isadore Rosenfeld, bestselling author of “The Best Treatment.”  “A stroke is what happens when the blood supply to a portion of the brain is interrupted; a heart attack is what you suffer when the blockage is in an artery within the heart.”
Hypertension is the primary factor underlying strokes and stroke-related deaths.  “Too much pressure can cause the bursting of a vessel – especially if that vessel has been weakened by age and the excess pressure of hypertension,” explains Dr. Whitaker. 
“Hypertension also contributes to atherosclerosis and arteriosclerosis, the narrowing and stiffening of the arteries that increases the likelihood of blood clots cutting off blood supply,” Dr. Whitaker continues.  “When either of these scenarios occurs in an artery in the brain, the result is a stroke.  There is a reduction in oxygen supply to that area of the brain, followed by cell degeneration and death.”
A lesser-known outcome of hypertension is memory loss and an increased risk of dementia and Alzheimer’s disease.  “It is believed that hypertension’s adverse effects on the brain are caused by the relentless pounding on the small vessels in the brain,” Dr. Whitaker writes.  The brains of patients with hypertension actually shrink – by as much as 20 percent, according to some studies.
Hypertension also accelerates the aging of the kidneys.  High blood pressure damages the arteries and arterioles that supply blood and nutrients to the kidneys.  As these arteries become stiff and less elastic, blood supply to the kidneys is reduced or, in some cases, cut off, causing damage to the kidneys themselves.
“Severe high blood pressure causes kidney malfunction over a relatively short period of time; however, even milder forms of uncontrolled hypertension can damage kidneys over several years, with no evident symptoms until severe damage has already occurred,” Dr. Whitaker claims. “Poorly controlled high blood pressure is responsible for approximately 25 percent of all cases of chronic kidney failure.”
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.
A person is said to be hypertensive if he or she has persistent elevations of BP: a systolic blood pressure greater than 140 mm Hg (millimeters mercury) or a diastolic blood pressure of more than 90 mm Hg.
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.
Majority of Filipinos with hypertension have no symptoms and many don’t even realize they have high blood pressure. “Practically nine out of 10 hypertensive patients have uncontrolled blood pressure which make them good candidates to develop heart attacks and strokes, or literally drop dead before they could realize what was wrong with them,” said Dr. Esperanza Cabral, who used to head the Philippine Society of Hypertension.
Studies have shown that only 14 percent of Filipinos with hypertension are aware of their condition.  Of those who know they’re hypertensive, only half are taking medications; and of those who are taking medications, less than half have their blood pressure controlled to optimal levels.
According to Dr. Castillo, detection comes late in many cases so that in 59 percent of patients detected by physicians for the first time.  “Which might be too late already,” he lamented, as the harm has already started even before these people get treatment.
What is alarming is that hypertension will soon become one of the country’s biggest health burdens.  Dr. Anthony Rodgers of the University of Auckland in New Zealand wrote in a report for the World Health Organization: “We are seeing that conditions like high blood pressure and high cholesterol are much more prominent in developing countries than previously thought and contribute significantly to their overall disease burden.”
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.  But even if you notice an improvement, don’t stop taking a doctor-prescribed medication unless you have your physician’s approval.
“Hypertension is truly a serious problem that requires more serious attention,” points out Dr. Cabral. “It’s no longer acceptable that just any doctor can treat any patient with hypertension. Many cases of hypertension are more complicated than they seem.”
Unknowingly, many Filipinos with high blood pressure can do something to lower their blood pressure.  If you’re among them, your doctor has probably mentioned the importance of regular exercise, avoiding smoking, managing stress and changing your diet, and to put limits on alcohol, salt, and fat.
But there are foods that can take your blood pressure down a notch or two. Frank Mangano, author of “Blood Pressure Miracle,” has identified at least five foods that can do the trick.  However, only three are common in the Philippines: banana, cocoa, and garlic.  (The other two are the artichokes and beets.)
In “The Healthy Food Directory,” author Michael Van Straten ranks banana near the top because the fruit helps alleviate 14 medical conditions.  “The banana is nature’s wonder fruit and the perfect fast food,” hailed Dr. Willie T. Ong in his book, “How to Live Longer.”
A 1997 study at Johns Hopkins University recommended eating at least five bananas daily to achieve the desired effect, and that is to lower elevated blood pressure levels. However, a study conducted by Indian researchers at the Kasturba medical college revealed that people who eat two bananas a day, for one whole week, can lower their blood pressure levels by 10 percent.
“Bananas are rich in potassium, which is responsible for the proper functioning of the heart. It works with sodium to maintain balance of the body’s fluids, which is an important factor in the regulation of blood pressure,” Mangano writes.
In the United States, the Food and Drug Administration has just allowed the banana industry to make official claims for the fruit’s ability to reduce the risk of blood pressure and stroke.
What about cacao?  A study conducted by researchers from Germany’s University Hospital of Cologne revealed that cocoa – which comes from cacao – can significantly lower high blood pressure levels. Study results were published in the Archives of Internal Medicine.  “The beneficial heart effects of cocoa are attributed to its flavonoid content, specifically procyanids,” Mangano informs.
Because cocoa is most commonly found in chocolate, people falsely assume that eating a lot of chocolate could be good for the health. “Keep in mind that cocoa in chocolates have undergone a lot of processing, and it has been mixed with loads of sugar, so this is not totally healthy,” Mangano writes.  “The best way to take advantage of the health benefits offered by cocoa is to choose raw cacao – it is good for the heart, the brain and the liver.”
From the earliest times, garlic has been used as a food. It formed part of the diet of the Israelites in Egypt (Numbers 11:5). It was consumed by the ancient Greek and Roman soldiers, sailors and rural classes.
Recently, researchers from South Australia’s University of Adelaide have conducted studies, which provide solid proof that the consumption of garlic can indeed help lower elevated blood pressure levels.
Garlic supplements in powder form were given and results revealed that it produced a reduction in systolic blood pressure. “Garlic has been known all over the world as a very important herb, especially with its heart-protecting capabilities,” Mangano writes.
The “Proceedings of the National Academy of Sciences” journal has published the results of a laboratory test showing how garlic juice can lead to a decrease in blood pressure levels.  “Although not as potent as prescription drugs, two or three cloves of garlic can help reduce cholesterol levels and can make the blood less sticky,” writes Dr. Ong. – ###