Dr. Prabhakar Shetty, Chief of Cardiology, Columbia Asia Referral Hospital, Yeshwanthpur (A unit of Manipal Hospitals)
High blood pressure or hypertension causes multiple life-threatening problems and is described as the number one killer disease in the world. It is also called the silent killer as it creeps in slowly without the knowledge of a person and either kills or impairs the quality of life in later stages.
A blood pressure reading of 120/80 mmHg or below is considered normal and a reading of more than or equal to 130/80 mmHg is considered hypertension. This cut off reading is not absolute, and the risk of high blood pressure complications increase linearly from 115/70 and for every 20/10mmhg increase in blood pressure the risk doubles. Untreated blood pressure can increase the risk of stroke, heart failure, heart attack and kidney failure. Though the benefits of detecting high blood pressure early are immense, there is apprehension among the public at large for undergoing early testing and treatment as most see it as an unnecessary lifelong treatment. Little do they realize that high blood pressure can cut short the “long life”.
Hypertension during Covid times
Hypertension is becoming a much focused topic in the recent days with the increasing Covid cases. Growing data shows a higher risk of COVID-19 infections and complications in people with high blood pressure.
Fear of COVID may make people avoid getting their blood pressure checked and getting proper treatment. It is important to monitor and track your blood pressure, blood sugar levels as cardiovascular diseases are still the most important causes of death in the world.
Analysis of early data from different countries show that high blood pressure is the most common pre-existing condition among the hospitalized COVID patients to the tune of 30% to 50% .
Reasons why people develop high blood pressure
Genetic factors, diet and lifestyle all play a major role in development of high blood pressure.
- High sodium content in diet and low Potassium diet (vegetable, fruits and nuts)
- Excessive use of alcohol
- Obesity and associated sleep apnea
- Fast foods and the processed foods that are high in calories as well as sodium content
- Physical inactivity
Prevention and treatment of hypertension:
Prevention or treatment of high blood pressure is possible only if blood pressure is checked periodically starting at an early age. As the incidence of high BP increases with age, the preventive measures should be taken early in life and continued lifelong.
Some daily modifications that have shown to lower blood pressure are:
- A diet rich in fresh fruits, vegetables and low-fat dairy products
- Regular exercise such as brisk walking for about 30 to 45 minutes a day
- Modest weight loss
- Controlled intake of salt
Hypertension is a chronic disease and patient participation in the management is extremely important. Once a diagnosis of hypertension is made, a sincere effort should be made to modify the diet and lifestyle. If blood pressure readings are repeatedly high, there should be no hesitation in starting or adding antihypertensive medications at any time.
When diet and lifestyle changes fail to achieve the desired blood pressure readings, one should not be reluctant to take medications. Numerous clinical trials have shown reduction of heart attacks and strokes with blood pressure medications in patients with high blood pressure regardless of the type of medicine used. Fortunately, most of the blood pressure medicines have a good long-term safety record. They do need physician monitoring, especially those with diabetes or kidney disease.
Monitoring blood pressure at home may be reasonable if it is done appropriately with a well calibrated equipment. However, very frequent recording even when the BP is under reasonable control can make everyone’s life miserable and not recommended. It is, however, important to recognize that blood pressure readings often fluctuate, and an occasional reading in the higher range is not much of a concern. Home BP readings in general tend to be a bit lower than the ones taken at the hospital.
Drugs/ medications that may alter blood pressure:
People with high blood pressure should be alert to the possibility of their blood pressure increasing with other prescription or non-prescription medications. Some of them include:
- Steroids and oral contraceptives
- Some of the over-the-counter medications such as a cough syrup or a nasal decongestant.
- Most pain relief medicines may increase blood pressure. Hence long term use of these medications or related drugs increases the risk of developing high blood pressure.
If one is taking any medications or herbal preparations other than those prescribed by the doctors, it is highly recommended to discussed with the doctor to avoid any undesirable drug interactions.
Hypertension is thus one of the most important cardiovascular risk factors and is quite often unrecognized and untreated. It is time, people become proactive and monitor their BP regularly and take every step to avoid complications arising from this major condition. If recognized early and adequately treated, it is estimated that up to 80% of hypertension complications can be prevented. In particular, one can reduce their risk of stroke by 50%.
