Hypertension: Causes, Effects and Management

Michael Oketunmbi (real names withheld) is a man in his mid-40s and a director in a top notch insurance firm. He has always been a busy man who felt he was hale and hearty and has no need to go for regular medical checkup. Lately he has been having consistent headaches and dizzy spells that refused to go even after taking some analgesics. Unfortunately, he ignored those warning signals until it was almost too late. One day, climbing the staircase leading to his office, he suddenly felt a sharp pain in his heart region and almost collapsed if some security agents had not come to his rescue. He was rushed to a nearby hospital, where he was diagnosed with high blood pressure that almost caused him a heart attack.

Michael is just minuscule of adult Nigerians who go about their daily routine without a thought to the state of their health unless they have a visible symptom that will make them to visit the hospital for checkup. Unfortunately, more often than not, they arrive as corpses when they should have taken earlier precautions.

When someone suffers a heart attack, what does it really mean? Dr Obiroa Orji, a medical practitioner with the Military Hospital, Ikoyi and also a member of a Non Governmental Organisation (NGO) known as Doctors Reach out Initiative who spoke with Sunday Mirror on this issue described heart attack as “a disease condition of the heart. It is a life threatening condition in the sense that the blood vessel to the heart is compromised.  Between stroke and a heart attack, there is the underlying medical condition called hypertension or high blood pressure which can predispose a person to these problems. If there is high blood pressure as a lay man usually calls it, it can cause a narrowing of the vessels sup-plying blood either to the brain which can lead to stoke or to the heart on the other side causing a heart attack.”

Hypertension, commonly called high blood pressure (HBP) means high tension in the arteries. Arteries are vessels that carry blood from the pumping heart to all the tissues and organs of the body. With every heart beat, the heart pumps blood through the arteries to the rest of the body. Blood pressure is the force of blood that is pushing up against the walls of the blood vessels. If the pressure is too high, the heart has to work harder to pump, and this could lead to organ damage and several illnesses such as heart attack, stroke, heart failure, aneurysm, or renal failure.

Dr. Orji explained that his NGO bridges the gap between the people who are sick and in their homes and those who have sought medical help and are in between the next medical appointment.

The medical expert said high blood pres-sure occurs when a patient has an elevated blood pressure, where the systolic pres-sure is greater than 160 and the diastolic is greater than 90. Normal blood pressure is below 120/80 while blood pressure of 140/90 or above is considered high.

The top number, the systolic blood pres-sure, corresponds to the pressure in the arteries as the heart contracts and pumps blood forward into the arteries. The bottom number, the diastolic pressure, rep-resents the pressure in the arteries as the heart relaxes after the contraction. The diastolic pressure reflects the lowest pres-sure to which the arteries are exposed.

Medical research reveals that an elevation of the systolic and/or diastolic blood pressure increases the risk of developing heart (cardiac) disease, kidney (renal) disease, eye damage, and stroke (brain dam-age). These complications of hypertension are often referred to as end-organ damage because damage to these organs is the end result of chronic (long duration) high blood pressure. For that reason, the diagnosis of high blood pressure is important so efforts can be made to normalise blood pressure and prevent complications.

Hypertension has been dubbed the silent killer by many medical experts be-cause it comes with little or no symptoms to warn the victim.  Most of the time, it may seem as if a heart attack comes out of the blue, but there are numerous symptoms that can sound the alert, if you ob-serve the changes in your body.

  According to a recent Harvard study, only 25 per cent of heart attack victims had no prior symptoms. Some of those symptoms include:

• Fatigue or confusion

• Dizziness

• Nausea

• Problems with vision

• Chest pains

• Breathing problems

• Irregular heartbeat

• Blood in the urine

• Palpitation or increase in heartbeat

• Severe headaches

Dr Orji explained that although the exact causes of hypertension are usually unknown, there are several factors that have been highly associated with the condition. “Hypertension is the most popular black disease. There is what we call risk factors for hypertension if someone is said to be hypertensive.

These include:

• Smoking

• Obesity or being overweight

• Diabetes 

• Sedentary lifestyle 

• Lack of physical activity

• High levels of salt intake (sodium sensitivity)

• Vitamin D deficiency

• High levels of alcohol consumption

• Stress

• Aging

• Medicines such as birth control pills

• Genetics and a family history of hypertension

• Statistics in the USA indicate that African Americans have a higher incidence of hypertension than other ethnicities.

Dr Orji advises that people should be careful of their salt intake as it aggravates the blood pressure. “Salt has an osmotic pull that tend to retain water and when this occurs, there is rate pressure. It’s not that you shouldn’t take salt but excessive intake is what we have to guard against. The correct advice is that you should not eat salt in excess in addition to what has been added when the food was cooked,” he advised.

Following the silent nature of the symptoms associated with this disease, medical experts advocate prevention of this problem rather than treatment. This is because hypertension actually does not have a cure but it is a disease condition that is man-aged throughout the person’s lifetime.

According to the medical expert, “this is a disease condition you must have to manage for the rest of your life once it is diagnosed. It’s not like malaria you treat and then expect it to go. You must take your drugs, monitor your BP and in partnership with your doctor, who will know when to add some drugs or reduce the dosage if need be.

“Hypertension can best be prevented by adjusting your lifestyle so that proper diet and exercise are key components. It is important to maintain a healthy weight, reduce salt intake, reduce alcohol intake, and reduce stress.”

Dr Orji stressed, “It is really important that people appreciate that being diagnosed as hypertensive is not a death sentence, what it requires is your cooperation with your physician to make sure that you control this sickness. That your blood pressure is normal today does not mean it would not soar again tomorrow. Proper control and medication are essential. It is important that you keep taking your drugs and consulting your doctor to help put it under control.

“I think it would be wise for every adult to check their BP once in three months at worse once in six months. For people above 40 years, that’s where the risk of hypertension actually comes into play. Below 40 years, we have juvenile hypertension coming up once in a while. You can never tell. But if you are hypertensive, it is some-thing you should check every week or fort-nightly depending on the control. 

So in all, hypertension is the trigger for all these life threatening diseases or conditions. If you can control hypertension, then chances are that you can avoid having any of these conditions,” he said.

VANESSA OKWARA/NatMir.

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