Hypertension also known as high blood pressure affects a significant number of residents of Anguilla. Almost everyone living here knows someone who has hypertension. Over time, uncontrolled high blood pressure increases the risk of heart disease, stroke, and kidney disease.
Why hypertension is called the silent killer?
High blood pressure is sometimes called a silent killer because it may have no outward symptoms for years. In fact, one in five people with the condition does not know he or she has it. Internally, it can quietly damage the heart, lungs, blood vessels, brain and kidneys if left untreated. Uncontrolled high blood pressure is a major risk factor for strokes and heart attacks.
What is hypertension?
Hypertension or high blood pressure is the force of blood pressing against the walls of your arteries. When it is too high, it raises the heart’s workload and can cause serious damage to the arteries. Over time, uncontrolled high blood pressure increases the risk of heart disease, stroke and kidney disease.
What Causes hypertension?
Normal blood pressure readings will fall below 120/80, while higher results over time can indicate hypertension. In most cases, the underlying cause of hypertension is unknown. The top number (systolic) shows the pressure when your heart beats. The lower number (diastolic) measures pressure at rest between heartbeats, when the heart refills with blood. Occasionally, kidney or adrenal gland disease can lead to hypertension.
Certain medications, such as birth control pills, cold remedies, decongestants, over-the-counter pain relievers and some prescription drugs can also cause hypertension.
Illegal drugs, such as cocaine and amphetamines can also cause hypertension.
Risk factors for hypertension
A risk factor for hypertension is something that increases your chances of developing this chronic condition. You can develop hypertension even if you do not have any risk factors. High blood pressure has many risk factors including the following:
• Age. The risk of high blood pressure increases as you age.
• Race. High blood pressure is particularly common among blacks, often developing at an earlier age than it does in whites. Serious complications, such as stroke and heart attack, also are more common in blacks.
• Family history. High blood pressure tends to run in families.
• Being overweight or obese. The more you weigh the more blood you need to supply oxygen and nutrients to your tissues. As the volume of blood circulated through your blood vessels increases, so does the pressure on your artery walls.
• Physically inactivity. People who are inactive tend to have higher heart rates. The higher your heart rate, the harder your heart must work with each contraction — and the stronger the force on your arteries. Lack of physical activity also increases the risk of being overweight.
• Using tobacco. Not only does smoking or chewing tobacco immediately raises your blood pressure temporarily, but the chemicals in tobacco can damage the lining of your artery walls. This can cause your arteries to narrow, increasing your blood pressure. Secondhand smoke also can increase your blood pressure.
• Too much salt (sodium) in your diet. Too much sodium in your diet can cause your body to retain fluid, which increases blood pressure.
• Too little potassium in your diet. Potassium helps balance the amount of sodium in your cells. If you do not get enough potassium in your diet, or retain enough potassium, you may accumulate too much sodium in your blood.
• Drinking too much alcohol. Over time, heavy drinking can damage your heart. Having more than two drinks a day can raise your blood pressure.
• Stress. High levels of stress can lead to a temporary, but dramatic, increase in blood pressure.
• Certain chronic conditions. Certain chronic conditions also may increase your risk of high blood pressure. These include high cholesterol, diabetes, kidney disease and sleep apnea.
Prehypertension
Some residents of Anguilla have prehypertension. These individuals have blood pressure thatis consistently just above the normal level — falling anywhere between 120 and 139 for systolic pressure or 80 to 89 for the diastolic pressure. People in this range have twice the risk of developing heart disease than those with a lower reading. Your doctor may recommend lifestyle changes to help lower your blood pressure.
The Hypertension Danger Zone
You have high blood pressure if readings average140/90 or higher — for either number — though you may still have no symptoms. At 180/110 and higher, you may be having a hypertensive crisis. A hypertensive crisis can lead to a stroke, heart attack, kidney damage, or loss of consciousness. Symptoms of a hypertensive crisis can include a severe headache, anxiety, nosebleeds, and feeling short of breath. You should seek urgent medical attention.
Who Gets High Blood Pressure?
Up to the age of 45, more men have high blood pressure than women. It becomes more common for both men and women as they age, and more women have hypertension by the time they reach 65. You have a greater risk if a close family member has high blood pressure or if you are diabetic. About 60% of people with diabetes have high blood pressure. Children can also get high blood pressure, especially if they are obese or overweight.
What are the symptoms of high blood pressure?
Most people with high blood pressure have no signs or symptoms, even if blood pressure readings reach dangerously high levels. Many individuals in Anguilla continue to deny that they have hypertension as they claim they are feeling well and have no symptoms.
Although a few people with early-stage high blood pressure may have dull headaches, dizzy spells or a few more nosebleeds than normal, these signs and symptoms typically do not occur until high blood pressure has reached a severe — even life-threatening — stage.
The only way you will know that you have high blood pressure is to have your pressure checked by a qualified and well trained health care professional.
Hypertension and pregnancy
Gestational hypertension is a kind of high blood pressure that occurs in the second half of pregnancy. Without treatment, it may lead to a serious condition called preeclampsia that endangers both the mother and baby. The condition can limit blood and oxygen flow to the baby and can affect the mother’s kidneys and brain. After the baby is born, the mother’s blood pressure usually settles.
Complications of uncontrolled high blood pressure?
Many Anguillians are not aware that they have hypertension and they, and some with known hypertension, do not seek care and often develop many complications associated with un-controlled high blood pressure. Some of these complications include the following:
• Heart attack or stroke.
• Aneurysm. Increased blood pressure can cause your blood vessels to weaken and bulge, forming an aneurysm. If an aneurysm ruptures, it can be life-threatening.
• Heart failure. To pump blood against the higher pressure in your vessels, your heart muscle thickens. Eventually, the thickened muscle may have a hard time pumping enough blood to meet your body’s needs, which can lead to heart failure.
• Weakened and narrowed blood vessels in your kidneys. This can prevent these organs from functioning normally. This can lead to kidney failure.
• Thickened, narrowed or torn blood vessels in the eyes. This can result in vision loss.
• Metabolic syndrome. This syndrome is a cluster of disorders of your body’s metabolism — including increased waist circumference, high triglycerides, low high-density lipoprotein (HDL), or “good,” cholesterol, high blood pressure, and high insulin levels. If you have high blood pressure, you’re more likely to have other components of metabolic syndrome. The more components you have, the greater your risk of developing diabetes, heart disease or stroke.
• Trouble with memory or understanding. Uncontrolled high blood pressure may also affect your ability to think, remember and learn. Trouble with memory or understanding concepts is more common in people who have high blood pressure.
Treatment
Treatment for hypertension will vary from one individual to another. Lifestyle changes such as diet modifications, and regular exercises, can go a long way toward controlling high blood pressure. Sometimes lifestyle changes are not enough. In addition to diet and exercise, your doctor may recommend medications to lower your blood pressure. Medications will vary depending on the stage of hypertension, and whether you also have other medical problems. Regular checking of your blood pressure is important in the control of high blood pressure.
Conclusion
Many residents of Anguilla are known to have hypertension and are under the care of health professions and have their blood pressure well controlled. Unfortunately, many other asymptomatic individuals have the disease and do not know they have it as hypertension often has few symptoms. Knowing your blood pressure is important in preventing or managing this disorder. Good control of high blood pressure goes a long way in preventing many of the complications associated with uncontrolled hypertension. Individuals are encouraged to have their blood pressure checked at regular intervals.
Ask Your Doctor is a health education column and is not a substitute for medical advice from your physician. Dr Brett Hodge is an Obstetrician/Gynaecologist and Family Doctor who has over thirty years in clinical practice. Dr Hodge has a medical practice in the Johnson Building in The Valley.
