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Hypertension - a silent killer

18 November, 2015 04:27
Hypertension - a silent killer

Ashraf Alam, 42, is a banker by profession. Last summer, when he collapsed on his office couch following debilitating chest pain, his co-workers rushed him to the nearest clinic. The attending doctor informed his family that he had suffered a massive stroke, a result of years of undiagnosed hypertension.

You probably know at least one person who suffers from hypertension, otherwise known as high blood pressure, a condition that millions of people around the world suffer from. According to the World Health Organisation, an estimated 7.5 million deaths occur annually worldwide because of hypertension. 

Unfortunately, like Alam, many patients of hypertension are not aware of the presence of this condition in their bodies, making it a silent killer.  

So, what exactly is it? Hypertension, or abnormally high blood pressure, is the most common cardiovascular disease. It is a condition in which the force of blood pushing against our artery walls is so high that it damages the healthy arteries and leads to life-threatening conditions like heart disease and stroke. Hypertension may go undetected for many years, which is why a routine health check-up is very important, because the earlier you catch it the sooner you can treat it. 

Rafi Sultan, 35, started smoking when he was only 17. Initially he smoked 2-3 cigarettes a day, however, the rate increased with time and in the following fifteen years he became a chain smoker, smoking up to 3 packs a day. Two years ago during a family get-together, when Sultan's cousin, then a final-year medical student, wanted to check her cousins' blood pressure levels with her new sphygmomanometer, he volunteered to be the first to have his pressure measured. That day his blood pressure reading was148/95 mmHG, a high blood pressure reading. At the request of his family, Sultan visited a general physician two days later. And just a week before his 33rd birthday, he was diagnosed with hypertension. 

It isn't just smoking that puts you at risk of developing hypertension. There are various other medications and conditions, such as obstructive sleep apnoea, kidney disease, adrenal gland tumours, certain congenital defects in blood vessels, certain medications such as birth control pills, thyroid problems, alcoholism, being overweight or obese, and using illegal drugs, such as cocaine and amphetamines, that may put you at greater risk for hypertension. 

There is another condition called prehypertension. A healthy person should have his or her blood pressure below 120/80 mmHG. However, people with prehypertension have their blood pressure between 120/80 mmHG and 139/89 mmHG. A prehypertension is a warning sign that you may get high blood pressure in the coming years.

Maliha Rahman, 55, thought she was a perfectly healthy woman until one day her blood pressure reached such high levels that she began to experience severe headache and vision problems. Her legs went numb and she fell on her bedroom floor – unconscious. Like Rahman, many people with hypertension may show no signs or symptoms for years even though their blood pressure readings are abnormally high. 

However, when a person's blood pressure reaches extremely high levels as it did in Rahman's case, the person may experience symptoms such as severe headaches, fatigue, vision problems, chest pain, blood in the urine, pounding in the chest, neck, or ears, and difficulty breathing. 

Risk factors
The risk of hypertension increases with age. People with a family history of hypertension tend to be at greater risk. Also, people who are overweight or obese, smoke tobacco, do not exercise, eat too much salt, and do not have enough potassium in their diet or drink too much alcohol are at risk. 




Diagnosis and tests
Doctors always stress the importance of routine health check-ups in detecting and managing hypertension. Because it's a silent killer, the only way to determine if you have hypertension is to have your blood pressure read at least once a year. "When a patient has a blood pressure of 140/90 or more, we say that he or she has hypertension," says Dr. Abdul Momen, Associate Professor of Cardiology, National Institute of Cardiovascular Diseases (NICVD).  You don't even always need to go to a doctor, just visit your local pharmacy to have your blood pressure measured. At a pharmacy, it usually costs between Tk 10-20 to have your blood pressure read. A lot of people also buy blood pressure monitors to measure their levels at home. 

People with a family history of hypertension need to be extra cautious. For instance, Maliha Rahman – who has a family history of hypertension – probably would not have collapsed on her bedroom floor that day if she had her blood pressure routinely checked.  



Hypertension in young people
Although we often associate hypertension with older people, it is important to remember that it can also affect children. Children who are overweight or obese may develop hypertension. Parents of children with a family history of hypertension need to be even more careful. That is why it is recommended that you have your child's blood pressure measured once a year starting at age 3. 

Dr. Momen observes that the case of young people suffering from hypertension is an increasing phenomenon these days. "With lack of physical activity and an overall unhealthy lifestyle, even young people these days are at risk of high blood pressure," he says. To protect your child from hypertension, keep an eye on the quantity and quality of food they eat. Limit your child's intake of sugary beverages and unhealthy snacks. Also, ensure that your child does enough physical activity every day. A sedentary lifestyle involving a lot of screen-time is responsible for rising childhood obesity in Bangladesh and also other parts of the world.  



What can you do?
Some healthy lifestyle changes can treat prehypertension and keep hypertension at bay. "Keep your BMI (Body Mass Index) within the ideal range. Eat plenty of fruits and vegetables. Cut down on salt consumption. Cut down on rice consumption. Instead of eating a plate full of rice with vegetables, eat a plate full of vegetables with rice. Quit smoking and do regular brisk walking," Dr. Momen suggests. 

If you are already diagnosed with hypertension, your doctor will probably prescribe you medicine along the lifestyle changes. "We find it hard to explain patients why they should take medication since they usually do not see any suffering or symptoms," Dr. Momen says. "Although you might not see any symptoms, hypertension may, in the long run, cause many different complications and diseases."  

Hypertension does not only cause heart disease and stroke. Untreated hypertension can cause kidney disease and failure, affect your eyesight, worsen many complications associated with diabetes, be a sign of preeclampsia in pregnant women, and so much more. Remember, hypertension can affect a person of any age! 

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