Health experts suggest ways to deal with high blood pressure

High blood pressure is one of the leading causes of premature deaths in the world. According to the World Health Organisation, it is estimated globally that about 1.28 billion adults aged between 30 and 79 have hypertension, and it is responsible for 7.6 million deaths per annum worldwide (13.5 per cent of the total), more than any other risk factors. Around 54 per cent of stroke and 47 per cent of coronary heart disease are attributable to high blood pressure.

These views were expressed by Prof Faisal Ahmed, consultant cardiologist and head of the cardiology department, Liaquat National Hospital, at a public health awareness seminar held at Neurospinal and Cancer Care Postgraduate Institute, Karachi, last week in connection with World Hypertension Day 2022. High blood pressure, which has no initial symptoms, can cause irregularities of the heartbeat while some patients also suffer from nosebleeds. In others, fatigue or confusion can be caused by pulmonary artery hypertension, in which the vessels responsible for carrying blood from the heart to the lungs undergo excessive pressure, causing fatigue. Such a condition also causes shortness of breath, chest pain, and light-headedness. Headaches of all kinds are often the only symptom of hypertension in a majority of patients and are often overlooked.

Disturbed vision is another sign of hypertension and is caused by damaged blood vessels. Pressure exerted on the optic nerve limits the functioning of the retina, causing vision problems, and then you have blood in the urine, which is common in high blood pressure.

Prof Faisal Ahmed advised that people aged 30-40 years should check their blood pressure at least once a year, and those above 40, every six months. For those who are diagnosed with hypertension, regular monitoring is the key, he added. “One should regularly monitor blood pressure at home as well as maintain a record of readings.”

“Every third Pakistani adult is suffering from hypertension, often touted as the silent killer. Its high prevalence makes all these people vulnerable to coronavirus (Covid-19 now again spreading in various parts of Pakistan), which may affect them more severely and as a result increases the death rate than those who are non-hypertensive,” said guest speaker Dr Namra Saifullah Khan, chief medical officer at the National Bank of Pakistan.

“It is becoming increasingly common among the younger population due to factors such as smoking, junk food intake, lack of physical activity, stress and resultant anxiety. Data indicates that more than half of the Pakistanis between 17 and 49 years of age with hypertension are not aware of their health condition while only 10 per cent have their hypertension under control in Pakistan. Therefore, awareness is needed on the healthy lifestyle changes. The risk of untreated hypertension also increases the risk of heart attack, stroke, kidney failure, and blindness significantly,” Dr Namra said.

“Summer heat is rising to its peak this year. Many parts of Pakistan experienced 49 degrees Celsius and a heat-wave warning has been issued. People need to take extra care to protect their hearts. Precautions are on high priority especially for older adults and individuals with high blood pressure, obesity or a history of heart disease and stroke. In the hot season, the body tries to cool itself by transferring blood from major organs to under the skin. This change makes the heart pump more blood, putting it under extreme stress,” explained Dr Namra.

“Pakistani food is heavily laden with salt and spices. Not only do they add flavour and taste to food, but they also contribute to maintaining balance in the human body. But we know that anything consumed in excess is almost always bad for the human body. Too much sodium in the diet not only leads to high blood pressure, heart disease, and strokes but also gives the feeling of being bloated. Consuming too much salt can also bring on swelling in different parts of the body caused by excessive fluids in the body’s tissues which are known as edema.

“Excess salt in the body also leaves one feeling thirsty most of the time. This happens because foods with high sodium content cause an imbalance in your body’s fluids, and only high-water consumption makes up for this. Excessive intake of salt results in sweating and further leads to dehydration. Hence to keep the body calm and control water loss, one should avoid excessive salt intake, especially during hot summers in Pakistan. It is for this reason that the US Food and Drug Administration (FDA) has stated that the average human adult should consume less than 2,300 milligrams of sodium per day, which is equal to about a teaspoon of salt,” Dr Namra said, highlighting the role of salt in hypertensive patients.

“Some heart medications like angiotensin receptor blockers, angiotensin-converting enzyme inhibitors, beta blockers, calcium channel blockers and diuretics, which disturb blood pressure responses or lower sodium in body, can exaggerate the body’s response to heat and causes you to feel ill,” she said. “Dehydration causes strain on your heart, putting it at risk. Hydration helps the heart more easily pump blood through the blood vessels to the muscles. And it helps the muscles work effectively.” She said that during normal weather drinking approximately 2-3 liters of fluid every day is suggested, whereas, in case of heat wave, fluid intake up to 3-5 liters is suggested.

Dr Namra advised exercising in an air-conditioned or well-ventilated facility or in a cooler; shaded area is best for hot days. It is imperative to get at least 30 minutes of physical activity every day. This helps in releasing feel good hormones or endorphins which can keep stress and anxiety at bay. Sit upright and work on your posture. She said wearing shorts and a t-shirt exposes the skin and encourages heat loss from sweat. She recommends wearing materials such as cotton that “wick” sweat to the surface to help with heat loss. Make sure to eat a healthy and balanced diet. When consumed in the right manner, food is like medicine for the body and the foundation of sound mental and physical health. Include lots of fresh fruits and vegetables, whole grains, legumes, seeds, and grains; because they carry antioxidants which can help prevent stress. Avoid processed and unhealthy food as much as possible. While a little stress is alright for the body, too much of it can create an imbalance and raise your blood pressure over the time. The body must then work twice as hard to restore this balance which can become another factor for stress. Thus, it is important to stay calm and bring balance by doing what makes you feel happy. Adeel Ahmed, manager, Marketing & Corporate Affairs at the NCCI & MHMT, thanked the audience and said that there is an urgent need for awareness of hypertension and the NCCI and M. Hashim Memorial Trust will initiate a campaign for early detection of hypertension in rural areas of Karachi.