Hypertension, commonly known as High Blood Pressure, Blood Pressure or Pressure at its simplest, is a chronic, non – communicable illness very prevalent in our world today.

According to the World Health Organization (WHO) 1.13 billion people worldwide, accounting for a considerate 22% of the world’s population, are affected by Hypertension. Even more alarming is that a disease that was up to until recently considered to be one of our middle aged population, is now a disease manifesting as early as mid 20’s to early 30’s. Even further, Hypertension can be prevented and if not treated adequately can lead to life – threatening complications. In light of the above, coupled with the fact that having this condition puts one at risk of developing other diseases, not excluding the dreaded Corona virus, it is imperative that some amount of emphasis be placed on this disease.

The blood pressure is determined by the amount of blood that the heart pumps and the resistance to this blood flowing through the arteries. As a result, high blood pressure arises when the heart has to pump (more) blood through narrower arteries. This process may be unassociated with any causative factor leading to Primary Hypertension, the form that is very common in the middle aged and slow in its manifestation. The process may also be caused by an underlying condition and is then referred to as Secondary Hypertension. The World Health Organization (WHO) defines Hypertension as any blood pressure measured on two separate days giving values above or equal to 140/90mmHg.

There are several factors that put any one person at risk of developing Hypertension. These are grouped as Non modifiable and Modifiable risk factors. The Non modifiable risk factors are those events/situations of life that cannot be changed, such as:

• Age. One’s risk of Hypertension increases with age.
• Gender. Men tend to suffer from Hypertension earlier than women, however, after the age of menopause, the risk of developing Hypertension equalizes between men and women.
• Ethnicity. While found to be more prevalent and more life threatening among persons of African descent, Hypertension develops earlier in persons of other ethnic groups.
• Family History. Having a blood, first degree relative with Hypertension before the age of 60,puts one at risk of being hypertensive. The more family members affected with Hypertension, the more the risk increases.
• Presence of other Chronic Diseases. Having illnesses like Diabetes Mellitus or Hypercholesterolemia (High Cholesterol) increases the possibility of ending up with Hypertension.

The modifiable risk factors include:

• Obesity. The more weight a person has the more blood will be needed to supply the body with essential nutrients and oxygen. In order for this to happen there is an increased volume of blood to be circulated and likewise the pressure through the walls of the arteries.
• Physical Inactivity. In addition to its association with Obesity, sedentarism (limited physical activity) can lead to an increase in the heart rate, which in turn causes a stronger force on the arteries.
• Toxic Habits. Smoking tobacco and the consumption of alcohol can damage the arteries, making it harder for the heart to pump the blood around the body.
• Inappropriate diet. Too much salt in the diet may cause the body to retain fluid (water) and that can lead to increasing blood pressure.
• Use of certain medication for example Non – Steroidal Anti-inflammatory Drugs (Ibuprofen) and Oral Contraceptive Pills.

The presence of one or more risk factors does not necessarily mean an inevitable development of High Blood Pressure. Hypertension by itself, though, puts one at risk of developing Heart Attacks, Cerebrovascular Accidents (Stroke), Kidney Failure and Blindness among other diseases. Here again, the presence of Hypertension does not mean that these complications are a ‘must happen’ but firmly speaks to the need for adequate control of the blood pressure to prevent them.

It must be explained that a Hypertensive patient is at an increased risk of developing COVID – 19. Hypertension is very common among persons of the middle age which is one risk factor for COVID – 19. Additionally, having Hypertension weakens the immune system, another risk factor for contracting the Coronavirus. Even further, the Corona virus, like any other viral illness, can damage the respiratory system, making it harder for the heart to work, something that already happens in Hypertension. This, in turn, can lead to worsening symptoms of the High Blood Pressure.

Hypertension varies in its presentation. There may be the absence of symptoms, a reason for it being termed the ‘silent killer’. Another group of patients may display symptoms, yes, but those symptoms are not specific to Hypertension. At the other end of the spectrum, some patients will present symptoms highly suggestive of the complicated end (form) of the disease.

The non – specific symptoms of Hypertension that several patients present include, but are not limited to, moderate to severe headaches or head discomfort, vision changes, nose bleeds, neck pain or tension, weakness or any form of abnormal sensation in the extremities, drowsiness and or unexplained confusion.

In light of the fact that the disease in question can be prevented, the World Health Organization (WHO) has recommended the following to reduce the possibility of developing Hypertension:- reduce salt to less than 5g daily, eat fruits and vegetables regularly, avoid saturated and trans fats, avoid tobacco, reduce alcohol and be physically active every day.

Considering salt reduction, be observant for the presence of Sodium in foods, be wary of canned/preserved foods and do ensure to read the labels for the salt/sodium content. There leaves to be considered the use of the Dietary Approaches to Stop Hypertension diet, known as the DASH diet. This diet regimen combines a high intake of fiber, fruits and vegetables and low-fat dairy.

Physically active involves any cardiovascular exercise such as running, cycling or even swimming, done at least thirty minutes per day.

These same measures, among many others, can also be implemented and or enforced to control High Blood Pressure once diagnosed. The ‘others’ include taking your medications as prescribed by the doctor and self – monitoring of the blood pressure at home within the stipulated parameters, including resting from all forms of activity for at least fifteen minutes and correct positioning of the cuff.

Hypertension must be diagnosed and treated by qualified (medical) personnel. It is recommended that the doctor is consulted when self – monitoring done to aid in diagnosis provides consecutive high values; when there is the presence of symptoms highly suggestive of the disease; when medications given cause unbearable issues and or having continuously high blood pressure values in spite of following all that the doctor has recommended.

Hypertension is the ‘silent killer’; but also a disease that speaks loudly when present! Take care of your life, one – BP – check – at – a – time. Do visit your nearest health facility and have that much needed chat with your Primary Care Physician or Family Doctor. It may just save your life!

Submitted by

Aneisha Moore – Thorne

MD, MMed FamMed