Dr. Sushil Kumar Sharma
World Hypertension day is celebrated annually on the 17th May. The main aim of the day is to educate the public and increase awareness of hypertension, which is also commonly known as high blood pressure.Traditionally held on May 17th, due to covid-19 pandemic, The World Hypertension League (WHL) has announced that it will postpone the celebration of World Hypertension Day (WHD) 2020 until October 17, 2020. The expanded theme for World Hypertension Day is Measure Your Blood Pressure, Control It, Live Longer, with a goal of increasing high blood pressure (BP) awareness in all populations around the world
Prevalence:Hypertension is a major cause of a range of health problems such as strokes, heart attacks and kidney disease, and can also contribute to dementia. Globally, an estimated 26% of the world’s population (972 million people) has hypertension, and the prevalence is expected to increase to 29% by 2025, driven largely by increases in economically developing nations.The high prevalence of hypertension exacts a tremendous public health burden. As a primary contributor to heart disease and stroke, the first and third leading causes of death worldwide, respectively, high blood pressure was the top modifiable risk factor for disability adjusted life-years lost worldwide. In some recent studies both covid-19 case fatality rates and hypertension prevalence increases with age, reaching 8.0% and over 50% respectively for the 70 to 79 year age group.
Symptoms of hypertension
Hypertension is generally a silent condition. Many people won’t experience any symptoms. It may take years or even decades for the condition to reach levels severe enough that symptoms become obvious. Even then, these symptoms may be attributed to other issues.
Symptoms of severe hypertension can include:
* headaches
* shortness of breath
* Epistaxis
* flushing
* dizziness
* chest pain
* loss in Vision
These symptoms require immediate medical attention. They don’t occur in everyone with hypertension, but waiting for a symptom of this condition to appear could be fatal.The best way to know if you have hypertension is to get regular blood pressure readings.
Categories of BP in Adults
BP Category SBP DBP
Normal <120 mm Hg And <80 mm Hg
Elevated 120-129 mm Hg And <80 mm Hg
Hypertension
Stage 1 130-139 mm Hg Or 80-89 mm Hg
Stage 2 140 mm Hg Or 90 mm Hg
High blood pressure Emergencies
High blood pressure is usually a chronic condition that gradually causes damage over the years. But sometimes blood pressure rises so quickly and severely that it becomes a medical emergency requiring immediate treatment, often with hospitalization.
In these situations, high blood pressure can cause:
* Memory loss, personality changes, trouble concentrating, irritability or progressive loss of consciousness
* Stroke
* Severe damage to your body’s main artery (aortic dissection)
* Chest pain
* Heart attack
* Sudden impaired pumping of the heart, leading to fluid backup in the lungs resulting in shortness of breath (pulmonary edema)
* Sudden loss of kidney function
* Complications in pregnancy (preeclampsia or eclampsia)
* Blindness
Prevention of high blood pressure
Healthy lifestyle changes can help you control the factors that cause hypertension. Here are some of the most common home remedies.
Developing a healthy diet
A heart-healthy diet is vital for helping to reduce high blood pressure. It’s also important for managing hypertension that is under control and reducing the risk of complications. These complications include heart disease, stroke, and heart attack.
A heart-healthy diet emphasizes foods that include:
* fruits
* vegetables
* whole grains
* lean proteins like fish
* Increasing physical activity
Reaching a healthy weight should include being more physically active. In addition to helping you shed pounds, exercise can help reduce stress, lower blood pressure naturally, and strengthen your cardiovascular system.
Aim to get 150 minutes of moderate physical activity each week. That’s about 30 minutes five times per week.
Reaching a healthy weight
If you are overweight or obese, losing weight through a heart-healthy diet and increased physical activity can help lower your blood pressure.
Managing stress
Exercise is a great way to manage stress. Other activities can also be helpful. These include:
* meditation
* deep breathing
* massage
* muscle relaxation
* yoga or tai chi
These are all proven stress-reducing techniques. Getting adequate sleep can also help reduce stress levels.
Adopting a cleaner lifestyle
If you’re a smoker, try to quit. The chemicals in tobacco smoke damage the body’s tissues and harden blood vessel walls.
If you regularly consume too much alcohol or have an alcohol dependency, seek help to reduce the amount you drink or stop altogether. Alcohol can raise blood pressure.
Key Message
* Proper management can control hypertension and prevent its complications.
* Effective lifestyle and drug treatments are available that could control hypertension in most individuals. Newer drugs provide better control while avoiding the side effects that have limited therapy in the past.
* A close collaboration between the physician and patient is needed to optimize better health outcomes.
There is as yet no evidence that hypertension is related to outcomes of COVID-19, or that ACE inhibitor or ARB use is harmful, or for that matter beneficial, during the COVID-19 pandemic. Use of these agents should be maintained for the control of blood pressure, and they should not be discontinued, at least on the basis of current evidence at this time
The unintended consequences of discontinuing effective treatments for hypertension, without a suitable replacement titrated against blood pressure measurements under direct medical supervision, could put patients at needlessly increased cardiovascular and possibly coronavirus risk. In addition, managing such titration currently, when primary care is prioritizing acute illness over routine contacts (including blood pressure checks), makes the proposed strategy impractical and risks further diluting access to care.
(The author is Head Department of Cardiology)
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