Hypertension: Killing you silently

By Henrylito D. Tacio

IF someone were to take your blood pressure immediately after jogging for four kilometers or being told that your loved one has figured in an accident, don’t be alarmed if the reading would seem high. “It’s natural for blood pressure to rise and fall with changes in activity or emotional state,” explains Dr. Willie Ong, medical consultant of the Makati Medical Center.

Under normal conditions, your heart beats about 60 to 80 times a minute. Your blood pressure rises with each heartbeat and falls when your heart relaxes between beats. Like the air pressure in your tires, your blood pressure can change from minute to minute. The pressure in your tires depends on the temperature and whether you’ve been driving. Your blood pressure changes with posture, exercise, sleeping, or even the level of your arm when the blood pressure is measured.

A blood pressure measurement has two numbers: the higher number (called systolic) represents the pressure when the heart contracts to start a heartbeat while the lower number (diastolic) corresponds to the pressure when the heart relaxes between beats. It’s also normal for blood pressure to vary from person to person, even from one area of your body to another. But when blood pressure remains consistently high, then that’s another story.

In the numbers game of hypertension, as medical science calls high blood pressure, 120 over 80 is the goal. Anything above those figures can be unhealthy. As the numbers climb, so do the risks. Of the two numbers, the first one is more likely to predict trouble. When it reaches 140, doctors start prescribing medication. In some diabetics or people with kidney disease, drug treatment can begin at 130/80.

In industrialized countries, hypertension is the most common of all cardiovascular diseases. But in recent years, developing countries like the Philippines are not spared. In fact, as many as 20 million Filipinos are likely to suffer from hypertension in the next 20 years, according to Dr. Anthony Michael Heagerty, president of the European Council of Hypertension. “Among the relatively young population of this country, 20 million would have unacceptable high blood pressure by 2025,” said the British doctor who recently came to the country.

Some experts maintained that in 90 to 95 percent of all cases of hypertension, the cause is unknown. “This is hogwash,” declares Dr. Julian Whitaker, author of ‘Reversing Hypertension.’ “In truth, hypertension is primarily a disease of lifestyle, caused by poor nutrition, obesity, inactivity, smoking, heavy drinking, and chronic stress. These lifestyle habits interfere with the self-regulating mechanisms that keep blood pressure under control.”

Hypertension also tends to run in the family. “Hypertension clusters in families,” explains Dr. Jayaram Lingamanaicker, acting head of the cardiology division at the Changi General Hospital in Singapore. “A sibling of hypertensive person has a 3.5 times risk of developing hypertension compared to his counterpart without a hypertensive parent.”

“Hypertension per se does not kill, but the complications are the ones that disable and kill a hypertensive,” points out Dr. Rafael Castillo, a cardiologist at Manila Doctors’ Hospital. Among the identified health hazards are the following: triples risk of drying from a heart attack, quadruples risk of heart failure, increases risk of dying from stroke sevenfold, increases risk of dementia and Alzheimer’s disease, intensifies aging process in kidneys (second leading cause of chronic kidney failure), and accelerates damage to arteries (leading to atherosclerosis and arteriosclerosis).

Hypertension is compared to a thief in the night. Hypertensives usually do not have any symptoms, which is why it is called a silent killer. In fact, studies have shown that only 14 percent of the 12.6 million Filipinos having the ailment 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 pressures controlled to optimal levels.

Hypertension is stealthy. “The majority of patients don’t usually see or feel any clearly identifiable symptoms,” says Dr Goh Ping Ping, a senior consultant cardiologist at the Changi General Hospital in Singapore. If symptoms do occur, they may include headaches, transient weakness of the body (especially one side), transient blindness, poor vision, chest pain or tightness, shortness of breath, numbness and tingling. In other people, the tell-tale signs include excessive perspiration, muscle cramps, palpitations and frequent urination. Oftentimes, hypertension is detected on routine screening or when a patient sees a doctor for some other illness.

There are two types of hypertension. The most common type is primary hypertension, sometimes referred to as essential hypertension. “Up to 95 percent of all patients with hypertension have this type, which is attributed to and many be modified by diet, exercise and other lifestyle habits,” writes Whitaker in his book. However, 5o to 10 percent of those with hypertension have secondary hypertension, in which high blood pressure stems from an underlying physical cause, such as kidney disease or adrenal disorders.

Until now, there is still no known cure for hypertension but it can be controlled with prescription medications available today. Should people with hypertension check their blood pressure regularly? “It depends,” says Dr. Philip Chua, chairman of Cardiovascular Surgery of the Cebu Cardiovascular Center at the Cebu Doctors’ Hospital and College of Medicine in central Philippines.

“If the blood pressure is erratic or hard to control, like when the patient is starting on a new medication for hypertension, the blood pressure should be checked once a day until the medication is adjusted and the blood pressure is basically controlled,” Dr. Chua explains. “If the blood pressure is within normal limits, as a response to treatment, the medications should be continued for life, and the blood pressure could be taken once a week. If it is really stable at the normal range, then it could be done once every two weeks or once a month.”

“Hypertension once diagnosed, the treatment is usually for life. As such, you should not discontinue your medications,” advises Dr. Lingamanaicker. “Even if you feel well, do not stop taking the prescribed medication.”

A healthy lifestyle keeps a hypertensive less likely to develop high blood pressure. “Though 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. Castillo.

Among the healthy lifestyle patients with hypertension should consider are as follows: watching his weight, avoiding too much caffeine, limiting alcohol intake, and avoiding salty and fatty foods. “Fatty food increases blood lipid levels and the body weight increases,” says Dr. Lingamanaicker. “Obesity worsens hypertension.” He advises hypertensives to eat fresh fruits and vegetables to increase intake of potassium, which lowers blood pressure.

Quitting smoking also helps. “Hypertensive should not smoke because this adds on tremendously to risk of heart attack and stroke,” Dr. Goh. Cigarette smoking causes the blood vessels to narrow which, then, tends to increase blood pressure.

If possible, lose weight. Carrying extra weight causes the heart to work more, forcing blood even harder through the vessels. A regular exercise may do the trick. “The benefits of exercise are enormous, and if you have hypertension, it just might save your life,” says Dr. Ong. “Regular exercise strengthens the heart and helps normalize blood pressure.” Among the recommended exercise activities are aerobics, bicycling, dancing, jogging, swimming, tennis and walking.

Another recommendation: avoid stress. You can’t always avoid stress, but you can learn better ways to cope with it. Researchers believe that stress does not come simply from having too much to do. Rather, it arises from situations that leave you feeling you have no control over matters. Next time you feel stressed, ask yourself why, then concentrate on solving the problem.

Do these recommended lifestyle changes, and you can expect to buy many more healthy years. “It’s that simple transaction – vigilance for life span – that makes blood pressure so worth controlling,” says an article which appeared in ‘Time’ magazine. “There are many diseases that resist everything science can throw at them. This is one you can beat.” — ###

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