Hi folks! It’s Dr. Louella and we’ve reached the grand finale of our discussions on hypertension. Yeeaaah!!!!
This one you should definitely keep for your records because I’ll be reiterating and reminding you of all the important points, having already explained the mechanics of this disorder in detail.
Firstly blood pressure is derived from the pumping action of the heart as it forces blood into large blood vessels. This causes the blood to circulate around our bodies. The force with which the blood flows is called the blood pressure.
Just as we are unable to feel the blood circulating around our bodies, we are unable to feel our blood pressure. It is a common myth in Trinidad and Tobago that high blood pressure causes neck pain.
95% of high blood pressure cases are caused by the kidneys by an unknown mechanism. The other 5% have an identifiable cause, usually in younger individuals.
Certain emotional states, such as anger, pain and anxiety, as well as increased physical activity, can cause a temporary rise in blood pressure. This is not hypertension, which is a chronic condition. For this reason, not just one, but a few blood pressure readings need to be taken before a person is diagnosed as hypertensive.
Factors which predispose to the disease include a family history of hypertension, increasing age and certain ethnicities such as Afro-American or Afro-Caribbean.
Dietary associations of hypertension include a high sodium intake (salt, not fresh seasonings), low potassium intake, heavy consumption of alcohol and obesity. Increased oats and fruits in the diet help to reduce blood pressure. Physical inactivity is also associated with a higher blood pressure.
General guidelines for hypertension are that a reading of 120/80 or less is normal and ideal; a target of less than 140/90 is used for those on treatment; less than 150/90 is now used for those over 60 and 130/80 or less for those with certain diseases such as diabetes and heart disease.
Complications of hypertension are the dreaded stroke, heart failure, heart attack, kidney failure, aortic aneurysm and eye disease. Hypertension damages the inner lining of blood vessels allowing cholesterol to enter the wall and form a plaque that partially blocks blood flow.
If it a blood clot forms at the site it seals up the blockage long enough for no blood to flow and permanently damage brain or heart cells. The person then gets a stroke or heart attack.
The DASH diet has been shown to help lower blood pressure. It includes less salt, alcohol, red meat, fat and sweets including sweetened drinks.
But it also includes more fruits, vegetables and high fibre foods (whole grain products such as whole wheat/meal bread, bran, oats, as well as more peas, beans and nuts).
Weight loss for the overweight and obese is important in controlling hypertension. This can be achieved by a combination of dietary control and exercise. To lose weight you need to eat less and have a lower calorie intake but frequent little meals, and not starvation, is the key.
Exercise is beneficial in lowering blood pressure on its own, even in those of normal weight. Aerobic exercise can take many forms including running, skipping and dancing.
Some people can have their hypertension controlled through diet and exercise alone but most will still need the assistance of medication. Medication is varied but it must be stressed that it needs to be taken everyday, as prescribed by the doctor, unless the person is experiencing ill effects, which he must inform his doctor about.
So there! We’re done. That’s the end of hypertension. I’ve taught you almost everything I know. Feel free if you have questions or comments. See you next week. Dr. Louella is out!!!