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"Doctor, I think my blood is high!": hypertension or high blood pressure - a diagnosis for life.

Mrs K., a big Herero-speaking lady in her mid-fourties and mother of four children, comes into my consulting room and explains:

"Doctor, I think my blood is high. I become stressed so easily. I have terrible headaches at times. I get dizzy, when I walk too fast. A few years ago a doctor at the clinic told me that I have high blood pressure and prescribed me some medicine, but those tablets made me cough, so I stopped drinking them."

Mrs K. appears healthy at first glance, but she is quite obese (fat), weighing 97kg at 1,74m height. I first take her blood pressure. It is 190/120. I also examine her eyes, heart and lungs, but cannot find any obvious problems.

I explain to Mrs K. that she definitely has a very high blood pressure - and that her headaches and dizziness could result from this disease. But even more important is that her high blood pressure may have caused other harm to her body that does not show yet. So Mrs K. will need more examinations so that we can see if her heart, her kidneys or her blood vessels are damaged. On top of that she must start taking medicines as soon as possible to prevent further damage.

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The above is a very common scenario in a doctor's consulting room or clinic. High blood pressure, also named arterial hypertension, has been described as a "national disease" in Western countries for many years, but it has also become more and more common in Namibia as a result of certain lifestyle changes.

What does "high blood pressure" mean?

Blood pressure can be defined as the force with which the blood presses against our artery (blood vessel) walls, while travelling from our heart through the whole body. This force is determined by the amount of blood that the heart pumps through our blood vessels with every heart beat. It is also determined by the width and elasticity of our arteries. The higher the volume of blood, and the narrower the arteries, the higher the pressure will become inside the vessels.

Blood pressure is usually given as two numbers, such as 190/120 for Mrs K. This means that the pressure inside the blood vessels ranges between these two values: 190 is the highest pressure, when the heart is contracting, and 120 is the lowest pressure, when the heart is relaxed. A blood pressure of around 120/80 is normal, while values of 140/90 or above are considered as high.

What are the symptoms of high blood pressure?

Most people with high blood pressure have no signs or symptoms at all. This makes the disease so dangerous that it is sometimes called the "silent killer". Often high blood pressure is only detected when the high pressure within the arteries has already caused severe heart disease, kidney failure or strokes. Early symptoms that DO occur in some people include dull headaches, dizziness, fatigue, nosebleeds, vision changes or shortness of breath.

What causes high blood pressure?

Most of the time there is no clear cause. Some people have high, some people have low blood pressure.

However, there are some risk factors:

* It is more common in older and obese (fat) people.

* It is more common in black than in white people.

* It tends to run in families.

* Lack of physical activity, stress, smoking and alcohol abuse as well as a high salt intake can also promote high blood pressure.

What are the complications of high blood pressure?

The constant high pressure within our blood vessels is also called hypertension. It causes so-called artherosclerosis, a tightening and stiffening of the blood vessels, which in turn increases the blood pressure. A vicious cycle has started.

Artherosclerosis is especially significant in smaller blood vessels which we find in the brain, heart, kidneys and eyes. That is why we find most of the complications of high blood pressure in these organs, in the form of heart attacks, kidney failure, strokes or vision loss. On top of that the heart muscle will grow bigger over time, because it has to pump the blood with a lot of force through the thinning and tightening blood vessels, which can lead to heart failure.

What to do when diagnosed with high blood pressure?

When your blood pressure is detected as high for the first time at a clinic or during a doctor's visit, it does not mean immediately that you suffer from hypertension. Often, a single high blood pressure reading can be coincidental -maybe you have just had a strong cup of coffee, maybe you have run or walked fast just before the consultation, or maybe you are under emotional stress. Except when the blood pressure is severely high, you would usually be advised to come back another day to repeat the measurement. Only then can the doctor decide whether you really have constant high blood pressure.

With moderate hypertension it is advised to first try and lower the blood pressure by certain lifestyle changes. Measures to actively reduce your blood pressure yourself are:

* regular exercise - even just walking at a fast pace for 20 minutes every day

* a healthy diet - less salt, more fruit, vegetables and fibres, less fat

* maintaining a healthy weight

* reducing stress or practicing relaxation techniques

* no smoking and limiting your alcohol intake

If these lifestyle changes alone cannot bring your blood pressure down to normal values, taking so-called antihypertensives tablets in addition will become unavoidable. However, even when you already take high blood pressure medication the measures above can help you to limit the amount of tablets you need to take and make you feel better.

There is a huge range of anti-hypertensive tablets with many different methods of action, and of course different side-effects. So if one treatment does not work well for you (e.g. makes you very tired or gives you a cough, like with Mrs K.), tell your healthcare provider, and he or she will try to find a different kind of treatment that fits you better. Getting your blood pressure to acceptable values can be a long process, though, and needs patience as well as a good cooperation between sister or doctor and patient.

High blood pressure is not curable

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Hypertension is a chronic disease and is not curable. This means that once you have started antihypertensive treatment, you will probably have to continue with it for the rest of your life. You can, however, prevent the dramatic consequences it may cause by keeping the blood pressure low with the help of medication and a healthy lifestyle.

You should never stop taking blood pressure treatment - not even for a day- without consulting your doctor or sister first, because sudden termination of treatment may cause a dangerous rise in blood pressure or other side-effects.

By adapting to a healthy lifestyle and complying well with the intake of medication, you can live a completely normal life without any restrictions even though you have a chronic disease.

RELATED ARTICLE: Important Facts on Blood Pressure

* A blood pressure of 140/90 or above is considered as high.

* High blood pressure usually does not show any symptoms until it has caused serious damage to your organs.

* The most common long-term complications of high blood pressure are heart attack, stroke, kidney failure and vision loss.

* Numerous kinds of blood-pressure medications are available. Patient and doctor/sister need cooperation and patience to find the best treatment for each individual.

* Hypertension is not curable and requires lifelong treatment. Therefore never stop taking your medication without consulting your doctor first -it could be dangerous!

RELATED ARTICLE: Measures you can take to help reduce your blood pressure without medication:

Reduce your weight!

Exercise regularly!

Kepp a healthy diet!

Reduce stress!

No smoking and alcohol!

Limit your salt-intake!

RELATED ARTICLE: FOOD FACTS

A healthy diet to improve your blood pressure

Reduce salt intake!

Foods low in salt: milk, yoghurt, noodles, rice, potatoes, fresh vegetables, fruits, fresh meat and fish, water Not good - high in salt: Crackers, chips, cookies, cheese, sausage, tin pilchards, olives, ketchup, mustard, tin foods, any spices mixed with salt

Reduce fat intake!

Avoid saturated fatty acids such as butter,

fat and red meat.

Try to replace them with unsaturated fatty acids such as margarine, plant oils, fish.

Buy low-fat products (milk, yoghurt etc.)

Increase intake of fresh fruit and vegetables!

Try to maintain a high-fibre diet such as brown or whole wheat bread instead of white bread.
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Title Annotation:WOMEN'S HEALTH
Author:Wietersheim, Simone von
Publication:Sister Namibia
Geographic Code:6NAMI
Date:Apr 1, 2011
Words:1415
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