By Eduardo Gonzales, MD
I saw a Department of Health official on TV comparing high blood pressure to a time bomb. Why is this so? —firstname.lastname@example.org
Hypertension or high blood pressure, as a rule, is a symptomless condition. Thus, despite the fact that it is a major risk factor in the development of a number of highly fatal diseases, many people who have hypertension are either unaware they have it or choose to ignore the condition because they do not feel anything wrong with themselves. Yet, over time, hypertension invariably damages blood vessels and vital organs, which causes strokes, heart attacks and heart failures, aneurysm of arteries, peripheral arterial diseases and chronic kidney disease. Hence, untreated hypertension can be rightfully considered a “silent killer,” a time bomb that can explode anytime without warning and result in a fatal stroke or heart attack.
What is hypertension and what are its causes?
Hypertension occurs if a person’s blood pressure at rest is persistently high (i.e., systolic pressure that is equal or greater than 140 mmHg and/or diastolic pressure that is equal or greater than 90 mmHg).
Hypertension can be caused by an underlying disease such as of the kidneys, in which case it is called secondary hypertension. The treatment for this form of hypertension is directed at the underlying disease. In 90 to 95 percent of cases, however, the cause of a person’s hypertension remains unknown even after a thorough medical examination. In these instances, the condition is called primary or essential hypertension.
Practically everyone, i.e., more than 95 percent of all people, will develop essential hypertension at some point in their life, although some at a much later age than others. Essential hypertension results from the interplay of numerous genetic and environmental and lifestyle factors including excessive salt intake, insufficient potassium intake, obesity, excessive alcohol intake, sedentary lifestyle, and psychological stress. It cannot be cured but it can be controlled (i.e., the blood pressure can brought down to and kept at normal level) with treatment.
Hypertension in the Philippines
According to our Department of Health (DOH), about 12 million Filipinos are hypertensive and half of them are “walking time bombs” because they are unaware of or choose to ignore their condition. Hypertension accounts directly or indirectly for about 200,000 deaths every year in the Philippines. It is also the third leading cause of morbidity (2014 figures) in our country behind respiratory infections and pneumonia.
How to rein in hypertension
If you do not know your current blood pressure, have your blood pressure checked by a qualified health worker. If it is normal, well and good, but have it checked regularly, say every six months.
If you are hypertensive, you need to control your hypertension, i.e., you need to bring your blood pressure down to a normal level and keep it there. Hypertension cannot be cured but if you are able to control it, you will not damage your vital organs.
Hypertension can sometimes be controlled by simply acting on the the lifestyle factors that contribute to its development. Thus, if you are hypertensive, try:
- Shifting to a low-salt, high fiber diet that is rich in fish and vegetables.
- Moderating your alcohol consumption.
- Reducing to, and maintaining, a desirable body weight.
- Exercising regularly.
- Adopting stress management measures such as enough sleep, recreation, meditation, and relaxation techniques.
In a good number of people however, dietary and lifestyle changes alone will not rein in hypertension.If you are one of these people, you need to include antihypertensive drugs to you treatment regimen. There are several classes of antihypertensive drugs in the market. But, treatment with these drugs should be highly individualized and carried out under the supervision of a physician.
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