Dr Sushil Kumar Sharma
World Hypertension day is celebrated annually on the 17th May with the theme ‘Measure Your Blood Pressure Accurately, Control It, Live Longer’. The main aim of the day is to educate the public and increase awareness of hypertension, which is also commonly known as high blood pressure. The expanded theme for World Hypertension Day is Measure Your Blood Pressure, Control It, Live Longer, with a goal of increasing high blood pressure (BP) awareness in all populations around the world and focusing on combating low awareness rates worldwide, especially in low to middle income areas, and accurate blood pressure measurement methods.
Cardiovascular disease (CVD) is the leading cause of death worldwide, and high blood pressure (hypertension) is responsible for more than 33% of CVD deaths. Unfortunately more than a quarter of adult women and four in ten adult men have hypertension, and diagnosis, treatment, and control are suboptimal. Only a few countries show a population hypertension control rate of more than 50%.
Objectives:
Awareness of the symptoms of high blood pressure.
Motivation to know blood pressure measurements.
Knowledge of early prevention methods of high blood pressure.
Highlighting prevalence of high blood pressure in the community.
Facts:
High blood pressure occurs when systolic blood pressure is equal to or greater than 140 mm, and diastolic blood pressure is equal to or greater than 90 mm.
Two out of five adults have high blood pressure.
High blood pressure is a leading cause of premature death worldwide.
High blood pressure is called (the silent killer); as symptoms may not appear clearly.
Unhealthy lifestyle can increase the risk of high blood pressure, such as: eating too much salt, being overweight, lack of exercise, and smoking.
Prevalence: Hypertension is a major cause of a range of health problems such as strokes, heart attacks and kidney disease, and can also contribute to dementia. An estimated 1.28 billion adults aged 30-79 years worldwide have hypertension, most (two-thirds) living in low- and middle-income countries and the prevalence is expected to increase to 29% by 2025, driven largely by increases in economically developing nations. The high prevalence of hypertension exacts a tremendous public health burden. As a primary contributor to heart disease and stroke, the first and third leading causes of death worldwide, respectively, high blood pressure was the top modifiable risk factor for disability adjusted life-years lost worldwide. In some recent studies both covid-19 case fatality rates and hypertension prevalence increases with age, reaching 8.0% and over 50% respectively for the 70 to 79 year age group. One of the global targets for non communicable diseases is to reduce the prevalence of hypertension by 33% between 2010 and 2030.
Symptoms of Hypertension
Hypertension is generally a silent condition. Many people won’t experience any symptoms. It may take years or even decades for the condition to reach levels severe enough that symptoms become obvious. Even then, these symptoms may be attributed to other issues.
Symptoms of severe hypertension can include: Headaches, Shortness of breath, Epistaxis, Flushing, Dizziness, Chest pain. and Loss in Vision.
Basic and Optional Laboratory Tests for Primary Hypertension: Basic testing Fasting blood glucose, Complete blood count, Lipid profile, Serum creatinine with eGFR (Serum sodium, potassium, calcium), Thyroid-stimulating hormone, Urinalysis, Electrocardiogram, Optional testing Echocardiogram, Uric acid, and Urinary albumin to Creatinine ratio.
Categories of BP in Adults
Category SBP DBP
Normal <120 mm Hg <80 mm Hg Elevated Hypertension 120-129 mm Hg <80 mm Hg Stage1 Hypertension 130-139 mm Hg 80-89 mm Hg Stage 2 Hypertension >140 mm Hg 90 mm Hg
Complications of Uncontrolled Hypertension
The excessive pressure on your artery walls caused by high blood pressure can damage your blood vessels, as well as organs in your body. The higher your blood pressure and the longer it goes uncontrolled, the greater the damage.
Uncontrolled high blood pressure can lead to complications including:
Heart attack or stroke. High blood pressure can cause hardening and thickening of the arteries (atherosclerosis), which can lead to a heart attack, stroke or other complications.
Prevention of high blood pressure
Healthy lifestyle changes can help you control the factors that cause hypertension. Here are some of the most common home remedies.
Developing a healthy diet- A heart-healthy diet is vital for helping to reduce high blood pressure. It’s also important for managing hypertension that is under control and reducing the risk of complications. These complications include heart disease, stroke, and heart attack.
A heart-healthy diet emphasizes foods that include: fruits, vegetables, whole grains, lean proteins like fish.
Increasing physical activity – Reaching a healthy weight should include being more physically active. In addition to helping you shed pounds, exercise can help reduce stress, lower blood pressure naturally, and strengthen your cardiovascular system.
Aim to get 150 minutes of moderate physical activity each week. That’s about 30 minutes five times per week.
Maintaining healthy weight – If you are overweight or obese, losing weight through a heart-healthy diet and increased physical activity can help lower your blood pressure.
Managing stress – Exercise is a great way to manage stress. Other activities can also be helpful. These include: Meditation, Deep breathing, Massage, Muscle relaxation, and Yoga or tai chi.
These are all proven stress-reducing techniques. Getting adequate sleep can also help reduce stress levels.
Adopting a cleaner lifestyle – If you’re a smoker, try to quit. The chemicals in tobacco smoke damage the body’s tissues and harden blood vessel walls.
If you regularly consume too much alcohol or have an alcohol dependency, seek help to reduce the amount you drink or stop altogether. Alcohol can raise blood pressure.
As mentioned earlier, hypertension is one of the major causes of several cardiovascular diseases. It becomes important to raise awareness about this as it can also prove to be fatal in some cases.
Here is a look at the importance and significance of the day:
The World Hypertension League recognised that more than 50 per cent of the hypertensive population are ignorant about their condition.
Among the estimated billion-plus people affected by hypertension, less than 1 out of 5 has it under control.
The key factors contributing to a rise in hypertensive population are unhealthy diets, sedentary lifestyle, and alcohol and tobacco consumption.
To address this increasing prevalence of hypertension across the globe, World Hypertension Day encourages the citizens of all countries to spread awareness of this silent killer and put forth measures for its prevention and control.
Key Message
Proper management can control hypertension and prevent its complications.
Effective lifestyle and drug treatments are available that could control hypertension in most individuals. Newer drugs provide better control while avoiding the side effects that have limited therapy in the past.
A close collaboration between the physician and patient is needed to optimize better health outcome.
Preventive strategies in hypertension should follow the principle of continuum of care. While improving awareness is essential, it is paramount to couple these efforts with better quality of treatment, which eventually results in the desired effect of better BP control. Only 24.9 and 37.6 per cent of those diagnosed to have hypertension in rural and urban areas, respectively, were on treatment. It is also rather unfortunate that only one-tenth of the rural and one-fifth of the urban hypertensive population had their BP under control. Initiation of any screening programme should be coupled with strengthening of the existing infrastructure to cater the large number of newly diagnosed hypertensive added to the system as a consequence of improved screening. Trained workforce, provision of good quality drugs, built-in referral systems and availability of necessary investigations for confirmation and evaluation have to be put in place. Screening has to be accompanied with treatment that is available, affordable and accessible, and also of good quality. Efforts to improve quality of care should include capacity building of health professionals to reduce therapeutic inertia as well as better follow up to ensure improved adherence.
The importance and purpose of this day is to communicate to the public the importance of hypertension and its serious medical complications, and to provide information on its prevention, detection, and management. To do this requires cooperation of health care professionals, media, volunteer organizations and government in each country.
(The writer is M.D, D.M, FACC, M.I.A.A and Head Department of Cardiology SSH Jammu)