Hypertension is a silent, invisible killer that rarely induces symptoms. In the United States, almost one in three individuals are affected by hypertension, of whom 80% are aware of the condition and only a half of those use medications to control it. What we see as hypertension in the clinics is just a tip of the iceberg, most cases remain largely undiagnosed. The fact that it is a forerunner to more sinister diseases like diabetes and stroke makes it all the more important to be aware of it.
Fortunately, it can be diagnosed using a simple test and there are things one can do to help keep blood pressure in a healthy range. Awareness about High Blood Pressure (BP) and its monitoring is the need of the hour. People who control their blood pressure are able to live healthy and fulfilling lives.
Hypertension is most often without any underlying cause (‘essential’ hypertension), rarely high pressure recordings are due to another underlying disorder involving the kidneys, arteries or the hormonal glands. In ancient times essential hypertension was considered primarily a disease of the aged, but off late it is being recognized more often in younger individuals and even at times in adolescence. This gradual shift in the epidemiological curve of the disease has been attributed to global change in lifestyle and obesity. There are higher chances of hypertension in people who have had a track record of higher blood pressure levels in their childhood.
Blood pressure is an objective measure of the pressure exerted on the walls of the vessels by blood travelling through it. Blood pressure is recorded as two numbers. The systolic blood pressure (the “upper” number) and the diastolic blood pressure (the “lower” number) which indicate the pressure during heart beat and in between the beats respectively. In a normal person blood pressure will be less than 120/80 mmHg. A person is labelled as hypertensive if the BP is more than 140/90 mmHg.
Pre-hypertension (BP between 120/80 to 140/90) is a phase when simple lifestyle changes can return the pressure back to normal. Hence it is recommended to get BP checked every 2 years following 20 years of age.
Diagnosis of high blood pressure is usually made after two or more successive readings that exceed healthy blood pressure ranges in a week. Some times anxiety in the clinic visit, leads on to fallacious high pressure recordings. Such ‘white coat hypertension’ can be obviated by encouraging home BP charting, which is convenient now with the easy availability of electronic BP apparatus.
Increasing public awareness is the key, as is access to early detection. Once the diagnosis has been done, it is important to know that once a hypertensive always a hypertensive; so efforts to lower it down should come in to effect immediately. Eating a balanced diet, reducing salt intake, avoiding harmful use of alcohol, getting regular exercise and shunning tobacco are a few to begin with.
First step in controlling BP is accurate home recording which can help in titrating the medications by the treating physician. Hence buying a good BP measuring instrument is utmost important. It is recommended to buy an automatic, cuff-style, bicep (upper-arm) monitor. Following the below instructions will help in getting the accurate reading.
1. Don’t smoke, exercise or drink caffeinated beverages or alcohol within 30 minutes of measurement.
2. Rest in a chair for at least 5 minutes with your left arm resting comfortably on a flat surface at heart level. Be calm and don’t talk.
3. Make sure you’re relaxed. Sit in a chair with your feet flat on the floor with your back straight and supported.
4. Every time you measure, take 3 readings, separated by at least 1 minute and record all the results.
5. It’s important to take the readings at the same time each day.
Regular use of blood pressure medicines go a long way in reducing day time excursions in pressure which are deleterious to the heart, brain and the kidneys. Control of BP can lower the risk of stroke and heart attack by more than 50 percent. Managing blood pressure is a lifelong commitment and can be achieved by employing a healthy life style.