‘Timely management of blood pressure crucial in preventing life-threatening conditions’

High blood pressure, medically known as hypertension, often lurks unnoticed, earning its reputation as the “silent killer.

A high blood pressure reading above 130/80 mm Hg can increase the risk of stroke, and elevated blood pressure can cause various physiological changes, such as damage to the blood vessels of the brain and bleeding in the brain.

These changes can cause ischemic or hemorrhagic strokes or strokes due to small vessel disease. A significant portion of hypertensive patients develop stroke. Studies indicate that the incidence of stroke in hypertensive patients can range from 18.18% to 78.9% depending on factors like age, duration of hypertension, and overall health.

These views were shared by renowned Prof. Rafiq Khanani, professor of pathology and president of Infection Control Society of Pakistan, at a public health awareness programme held yesterday at a prestigious community centre in Karachi, to commemorate World hypertension Day, which is observed globally on May 17.

This year’s theme is ‘Measure Your Blood Pressure Accurately, control it, Live Longer’, focusing on combating low awareness rates worldwide, especially in low to middle income countries.

Prof. Rafiq Khanani, who organizes this awareness programme, thanked the participants and promised that these public awareness activities would be continued in future.

“High blood pressure is a major risk factor for severe medical conditions such as coronary artery disease, stroke, heart failure, atrial fibrillation, vision loss, chronic kidney disease Sexual dysfunction in men or lower libido in women and even dementia,” said Prof. Faisal Ahmed, consultant interventional cardiologist and HoD, Liaquat National Hospital & OMI Group of Hospitals.

He said that hypertension is the fifth leading cause of death worldwide; around 7.6 million deaths per annum across the world are attributed to this silent killer, which is roughly 12.8% of all total deaths, while 22,917 deaths in Pakistan were attributed to hypertension.

Its prevalence is widespread with different studies concluding anywhere between one third and 50 per cent of the population suffering from hypertension. While 90 per cent of the cases of hypertension is idiopathic (unknown cause), in 5 per cent of the cases, it is caused by underlying conditions of heart, thyroid, kidney diseases or other illnesses, explained Prof. Faisal.

Prof. Faisal further recommended proper screening of hypertension for anyone over the age of 30 years. “Recent data indicates that more than half of the Pakistanis between 20 and 49 years of age with hypertension are not aware of their health condition and awareness is needed on the lifestyle changes they must make to avert the risk”.

Renowned cardiac surgeon Prof. Pervaiz Akhter Chaudhry, MD, (Sitara-i-Imtiaz), recorded a cardiac surgeon’s perspective to hypertension from Lahore.

Prof. Pervaiz Chaudhry (affiliated to Fresno Heart & Surgical Hospital, California) and at Omar Hospital, Lahore, was the first and so far the only Pakistani cardio-thoracic surgeon who initiated LVAD (Left Ventricular Assist Device) at NICVD, Karachi, and an expert of minimally invasive heart surgery. He said at the event that the damage inflicted by high blood pressure typically occurs gradually over time. However, if not promptly detected and managed, hypertension can wreak havoc on multiple organs, leading to dire outcomes.

He highlighted that the damage by uncontrolled hypertension leads to abnormal thickening and the formation of tiny tears in the vessel walls, creating a breeding ground for plaques composed of cholesterol and unhealthy fats.

These plaques obstruct blood flow, setting the stage for catastrophic events like heart attacks and strokes.

Hypertensive patients are more prone to develop both heart failure and myocardial infarction, but heart failure with preserved ejection fraction, also known as diastolic heart failure, is more commonly associated with hypertension.

Prof. Pervaiz advised that timely management of blood pressure is pivotal in preventing vascular damage and thwarting life-threatening conditions.

Chief guest Prof. Zaman Sheikh, who is consultant diabetologist and endocrinologist and former vice president of the Pakistan Endocrine Society, underscored that hypertension isn’t confined to the heart but affects arteries throughout the body, posing grave risks if left unchecked.

Prof. Zaman Sheikh elucidated hypertension’s staggering contribution to cardiovascular disease. “Hypertension surpasses other modifiable risk factors like smoking, dyslipidemia, and diabetes in its prevalence and impact on heart health. Hypertension, particularly when coupled with diabetes mellitus, significantly heightens the risk of these debilitating conditions.” He backs a comprehensive approach to blood pressure management, incorporating lifestyle modifications and medication, to mitigate the risk of complications and preserve overall health.

Prof. Zaman singles out the pivotal role of dietary choices in blood pressure management. Encouraging individuals to adopt a heart-healthy diet favours the inclusion of fruits, vegetables, whole grains, lean proteins, nuts, and legumes while limiting saturated fats, alcoholic beverages, and added sugars.

Reducing the intake of salt can help lower blood pressure. Most sodium in our diets comes from packaged and processed foods and eating these foods less often can help reduce your sodium intake and lower blood pressure.

Dr Zaman recommended adhering to the American Heart Association’s guidelines, urging individuals to monitor their sodium consumption diligently.

Foods high in potassium, such as bananas, potatoes, tomatoes, kidney beans, oranges, and spinach, are particularly important as potassium helps balance the sodium levels in your cells, which is essential for preventing and controlling high blood pressure, Prof. Zaman added.

Besides, Prof. Zaman recommended getting a regular healthcare checkup and taking up cardiovascular exercises, such as walking, running, cycling and swimming. He also advised people to strive to engage in a minimum of 150 minutes of aerobic activity with moderate intensity per week, or alternatively, 75 minutes of vigorous-intensity activity.

Prof. Zaman placed stress on early detection through vigilant blood pressure monitoring. Identifying high-risk individuals, including those with a family history of hypertension, smokers, chronic sleep deprivation, and previous elevated readings, is paramount. He also recommended the integration of home blood pressure monitoring into routine health practices, complemented by regular physician visits, to mitigate the risks associated with uncontrolled hypertension.