Dr. Sushil Kumar Sharma
Every year 17th May is dedicated to World Hypertension Day (WHD). This is an initiative of the World Hypertension League (WHL), an umbrella organization of 85 national hypertension societies and leagues.
The world hypertension Day was 1st inaugurated in May 2005 and has become an annual event ever since. The purpose of the WHD is to promote Public awareness of hypertension and to encourage Citizens of all countries to prevent and control this silent killer, the modern epidemic. In other words, World Hypertension Day has been established to highlight the preventable stroke, heart and kidney disease caused by high blood pressure and to communicate to the public information on prevention, detection and treatment.
The Theme for 2016 is Know your Blood Pressure
Prevalence : Hypertension is one of the leading causes of the global burden of disease. One in Three adults worldwide has high blood pressure .The proportion increase with age from 1 in 10 people in their 20s and 30s to 5 in 10 people in their 50s. Approximately 7.6 million deaths (13 -15% of the Total) and 92 million disability – adjusted life worldwide were attributable to high blood pressure in 2001. Hypertension doubles the risk of cardiovascular diseases, including coronary heart disease (CHD), Congestive heart failure ( CHF), ischemic and hemorrhagic stroke, renal failure , and peripheral arterial disease. It often is associated with additional cardiovascular disease risk factors, and the risk of cardiovascular disease increases with the total burden of risk factors. Although antihypertensive therapy clearly reduces the risk of cardiovascular and renal disease, large segments of the hypertensive population are either untreated or in adequately treated.
Signs and Symptoms :-
High blood pressure is called the silent killer because it often does not produce any signs or symptoms to some patients. Few of the Patients may have headache, Dizziness or Epistaxis, palpitation, muscle cramps, giddiness, burning of eyes, distended neck veins, insomnia, neck pain & vertigo. But some patients have high blood pressure for years without knowing it and that is why called silent killer . Sign and symptoms typically don’t occur until high blood pressure has advanced to a higher possibility of life threatening-stage like cerebrovascular or renal disease.
Myth and signs
There’s a common misconception that people with high blood pressure also called HBP or hypertension, will experience symptoms such as nervousness, sweating, difficulty sleeping or facial flushing. The truth is that HBP is largely a symptomless condition. If you ignore your blood pressure because you think symptoms will alert you to the problem, you are taking a dangerous chance with your life. Everybody needs to know their blood pressure numbers, and everyone needs to prevent high blood pressure from developing.
In addition to extreme readings, a person in hypertensive crisis may experience:
* Severe headaches
* Severe anxiety
* Shortness of breath
* Epistaxis/Nose bleed.
HEALTHY BLOOD PRESSURE :-
Blood pressure Classification
SYSTOLIC, mmhg
DIASTOLIC, mmhg
Normal < 120 And < 80
Prehypertension 120 -139 Or 80 – 89
Stage 1 Hypertension 140 -159 Or 90 -99
Stage 2 hypertension > 160 Or > 100
Isolated Systolic Hypertension > 140 And < 90
Depending on methods of patient ascertainment, 80 – 95% of the hypertensives patients are diagnosed as having “essential ” hypertension. In the remaining 5 – 20 % of hypertensives patients, a specific underlying disorder causing the elevation of blood pressure. In individuals with ” secondary ” hypertension , a specific mechanism for the blood pressure elevation is often more apparent.
Secondary Causes of Systolic and Diastolic Hypertension are :- Renal, Renovascular , Adrenal, Aortic Coarctation, Obstructive Sleep Apnea, Preeclampsia/eclampsia, Neurogenic ,endocrine miscellaneous and Medications.
Risk factors for developing high blood pressure
Family history
Advanced age
Gender Related Risk Pattern
Lack of physical activity
Poor diet, especially one that includes too much salt
Overweight and Obesity
Alcohol Consumption
Stress and Ethnic Back ground
Possible contributing factors
There is some connection between blood pressure and these factors but science has not proven that they actually cause high blood pressure.
* Stress
* Smoking and second-hand smoke
* Sleep Apnea
Secondary hypertension
In 5-10 percent of high blood pressure cases, the HBP is caused by a pre-existing problem. This type of HBP is called secondary hypertension because another problem was present first.
Factors that may lead to secondary hypertension include:
* Kidney abnormality, including a tumor on the adrenal gland, which is located on top of the kidneys
* A structural abnormality of the aorta (the large blood vessel leaving the heart) that has existed since birth
* Narrowing of certain arteries
The good news is that these pre-existing problems can usually be fixed. For example, doctors can repair a narrowed artery that supplies blood to a kidney. Once the root cause of secondary hypertension is corrected, blood pressure typically returns to normal. For those with HBP, a physical exam and some tests can help your doctor determine whether your high blood pressure is primary or secondary hypertension
Prevention of High Blood Pressure
High blood pressure is preventable and treatable. The old adage, ‘Prevention is better than cure’ is especially true for high blood pressure.
LIFESTYLE MODIFICATION TO
MANAGE HYPERTENSION
Weight Reduction
Attain and maintain BMI < 25kg/m2
Dietary salt Reduction < 6g Nacl /d
Adapt DASH – type dietary plan Diet rich in fruits , vegetables, and low – fat diary products with reduced content of saturated and total fat.
Moderated of alcohol consumption for those who drink alcohol, consume < 2drinks/day in men and <1 drink/day in women
Physical activity
Regular aerobic activity, e.g., brisk walking for 30 min/day at least Five days a week .
The ultimate goal of World Hypertension Day observation is to give awareness of the consequences of Hypertension to the General Population, so that we can prevent, heart attack, heart failure, stroke, kidney failure, retinal hemorrhage and atherosclerosis. Hypertension though a huge burden could easily be tackled with conscious steps such as regular evaluation of Blood pressure ,follow the instructions given by doctor and do not stop the medicines without consulting the doctor.
(The author is HoD Cardiology)
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