Isn’t a person who shouts or shows anger labeled as someone suffering from high BP? Well, this is the biggest myth about the silent disease — hypertension or high blood pressure. You can be the calmest and most relaxed person but you still might be suffering from hypertension whereas an angry, ill-tempered person may not be having the disease.
On the occasion of World Hypertension Day (May 17), doctors detail about this quiet killer disease, including the risk factors, diagnosis, treatment, measures to keep it under control and ways to take correct BP readings at home.
Blood pressure is the lateral pressure exerted by the blood on the arterial walls. Usually men above 50 and menopausal women are more at risk though it is often found in the age bracket of 30s and 40s as well.
Hypertension: Major cause of morbidity and mortality
As per doctors, of the total number of brain strokes reported, 50-60 % can be attributed to hypertension. The strokes can be haemorrhagic or infarction. Hypertension also puts other organs at risk like the heart (heart attacks and heart failure), kidney (kidney failure and leakage of protein), liver (stressed liver metabolic disorder), eyes (loss of vision, retinopathy), diffused vascular diseases (aneurysms) and triggers bleeding from any weak points of organs such as the nose. It is one of the biggest causes of morbidity and mortality.
Dr Ravi Kanth Athuluri, senior cardiologist, Yashoda Hospital, says, “Severe, long standing untreated hypertension, can be risky and even fatal. It could cause changes in the arteries of the organs. For example, in brain, it would result in haemorrhage (intracranial bleeding) or occlusion of the artery (infarct). The pathophysiology of the disease is accumulation of unwanted substances (fats, collagen etc) in the arteries, which gets accelerated due to high BP.”
Keeping BP under control
Dr Ravi Kanth advises, “If there is a family history, get BP checked annually right from the age of 15. Limit the intake of salt, ensure to get 30 minutes-one hour of moderate intensity exercise (brisk walking) at least four days a week. One need not sweat a lot or do high intensity cardio but regular light weight exercise is sufficient. Prevent getting overweight or obese. Completely stop smoking and limit alcohol intake to maximum 60 ml that too occasionally in a tropical climate like India’s.”
Measures to check BP correctly
Medical experts also elaborate on the correct way to check the BP readings at home since many people do it the wrong way, which gives incorrect readings and causes panic. One should not come to a conclusion based on a single reading but rather take three to four readings. A normal BP should ideally be 140/90 and both the systolic, diastolic and mean readings are important.
Explaining the correct usage of BP apparatus at home, consultant senior cardiologist Dr Sunil Kapoor says, “Firstly, at least 30 minutes prior to the BP measurement, avoid eating food, bathing, exercising, smoking and drinking alcohol. As these will immediately enhance the blood pressure temporarily and show incorrect readings. Secondly, do not hold a conversation with anyone in person or over phone/video call. Talking or active listening will add to the BP readings. Instead sit quietly for 10 minutes before checking BP. Thirdly, put the cuff on the bare arm and not over clothing while taking measurement.”
“Since posture plays an important part in giving an accurate reading, the fourth point is taking the measurement seated in a correct posture. One should support the arm at heart level on which the apparatus will be attached. The person can rest the arm on a table or desk at heart level, keep the legs uncrossed and use a support for the back and feet while sitting on the chair. Failure to maintain the correct posture may show a higher BP reading,” adds the doctor.
Diagnosis and Treatment
The higher the BP is above the normal (140/90) and the longer in duration it stays high, the more risky it is. High BP is usually detected while checking the BP for some other disease like fever. “Hypertensive crisis can be 2 types — emergency & urgency. An emergency is where the BP is dreadfully high like 220/130, there is organ damage and bleeding and there is need to immediately bring it down. The crisis can also be urgency where the BP has to be brought down within a couple of days, there may be an infarct but no bleeding. If Hypertension is detected in stage 1 (mild) or stage 2 (moderate), we suggest lifestyle modification for three months and two months respectively before prescribing medicines. In stage 3 (severe), we suggest lifestyle modification for a month before prescribing medicines. However, a person’s age, genetics, overall health, co-morbidities are taken into consideration before prescribing medicines,” says Dr Ravi Kanth.
“Once hypertension is detected and if the patient has been prescribed medicines to keep BP in check, it has to be continued lifelong. Depending on his condition, the dosage can be increased or minimized by the doctor but it should not be stopped by the patient on his own,” avers the doctor.