World Hypertension Day: Don’t let the pressure get you

If unchecked, high blood pressure can be fatal. Some basic and useful information on detection, prevention and care

woman checking her BPHigh blood pressure or hypertension is a global epidemic. According to the World Health Organization [WHO] estimates, over 1.5 billion people worldwide, over the age of 18, suffer from high blood pressure. Hypertension does not discriminate between young and the old; rich and the poor; races and ethnicities. It has no symptoms and hence is called the ‘Silent Killer’. Hypertension is the most important risk factor for heart disease, stroke and kidney disease.

Each year, May 17 is designated World Hypertension Day [WHD], an initiative by the World Hypertension League [WHL], an umbrella organisation of 85 national hypertension societies and leagues. The aim is to highlight the serious medical complications of this condition and communicate to the public information on prevention, detection and treatment.

Blood pressure basics

Blood pressure is the force that blood exerts against the walls of arteries. Without pressure, blood would not circulate in the body.

A doctor/nurse/or healthcare professional diagnoses hypertension when blood pressure goes over ‘normal values’—when it is greater than or equal to 140mm Hg over 90mm Hg [140/90 mm Hg]—after taking your pressure a minimum of two times per visit during each of one to five visits over a six-month period. The first reading is called Systolic Blood Pressure and the second or lower reading is known as Diastolic Blood Pressure.

Possible causes

Numerous risk factors can influence your blood pressure. Although some of these factors cannot be modified, others can be improved through lifestyle changes. The most important ones are: non-modifiable factors that include age, gender and heredity; and modifiable factors that include sedentary lifestyle, obesity, diabetes, stress, smoking and high cholesterol.

Most serious consequences

Uncontrolled high blood pressure can damage your arteries and cause serious physical complications such as heart failure, angina [or chest pain], heart attack, stroke [cerebrovascular accident], kidney failure and other circulatory problems.

Are some people more at risk than others?

Hypertension is more frequently encountered among the middle-aged and the elderly; people with a family history of hypertension; the overweight; heavy drinkers; and diabetics.

Are you hypertensive?

The only way to determine this is to have your blood pressure checked. If you present any previous risk factors, you should have your pressure measured at least once every two years or as recommended by your doctor.

If you are hypertensive, it is recommended that you measure your blood pressure regularly at home. This helps you and your health care provider understand how your blood pressure is controlled on a day-to-day basis. It also shows how lifestyle changes and medications help control it. Your health care provider may ask you to measure and record your blood pressure twice a day for at least one week before each appointment. This record shows how well-controlled your blood pressure is during your daily routine.

Most modern machines are either fully or semi-automatic. Self-measurement of blood pressure is easy and safe. Some very anxious individuals or those with disabilities may have problems measuring their blood pressure. If this is the case, ask your health care provider to measure your blood pressure.

What is a normal home BP reading?

Daytime average blood pressure must be below 135/85 mm Hg. Treatment may be considered if the reading is consistently more than 135/85 mmHg at home. Consult your physician. Treatment for those with diabetes or kidney disease may be warranted when the reading is less than 135/85 mmHg.What if the blood pressure readings are abnormal?

Do not panic. Consult and follow the advice of your health care provider. Also, do not adjust medications yourself.

Managing the pressure

Modifying some living habits can help you keep it below the red line.

Change your diet: First of all, eat healthy. It’s essential to eat plenty of fruits and vegetables because they are rich in fibre and low in fat. You should also make it a point to eat foods containing ‘good’ fat [monounsaturated and polyunsaturated fats such as olive oil and canola oil] and reduce your intake of ‘bad’ fat [trans and saturated animal fat]. This will also help to keep your weight in check.

Drink less: Limit alcohol intake to one or two drinks a day, not exceeding 14 drinks per week for men and nine drinks per week for women [1 drink = 1 glass of wine, 148 ml; 1 glass of beer, 355ml; 1 glass of spirits, 44ml]. Avoid binge drinking.

Exercise every day: Regular exercise helps control blood pressure. If you are currently inactive and have decided to take up an exercise programme, consult your doctor first to make sure there are no contraindications.

Quit smoking: Smokers are at higher risk of hypertension. Controlling your blood pressure and preventing complications are good reasons to quit.

Cut down on salt: Limit the quantity of salt added to your diet, bringing it down to about one teaspoon of salt. You will also have to cut down foods having high salt content, such as sauces and dressings, seasonings, prepared foods, cheese, soups, and some breakfast cereals. Reduced salt intake [by half] can save approx 2.5 million people a year from dying of strokes and heart attacks worldwide.

Maintain a healthy body weight: Excess body weight can increase your blood pressure. Maintain a body weight corresponding to your height and healthy body mass index [BMI], in the range of 20-25 kg/m2. BMI is defined as body weight in kg/height in m2. Manage stress: Even if stress does not act directly on blood pressure, it can harm your ability to make changes in your living habits. Adopting healthy living habits is necessary even if you are not on medication for hypertension.

Treatment with medication – A lifelong contract

Hypertension is a chronic disease, meaning it cannot be cured. If changes in your living habits are not enough to improve your blood pressure, there are a variety of medications that will help you control it. These drugs bring blood pressure levels down to levels that will either prevent or reduce the risk of complications. However, your medication must be taken as prescribed even if you feel fine. For some people, this may mean taking two to three different medications to bring their blood pressure under control.

When in doubt, ask your doctor for advice.

Arun Chockalingam
Dr Arun Chockalingam is the Secretary General of the World Hypertension League. He holds MS, PhD, FACC, FAHA degrees and is the professor of Global Health at Simon Fraser University in Vancouver, Canada.


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