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FAQs: Hypertension - a Preventable Silent Killer


Female Doctor assessing patient's blood pressure by Ivan-balvan _ iStock
Ivan-balvan _ iStock


What is Hypertension?


This condition is also called High blood pressure. It occurs when the pressure with which blood follows through the arteries increases beyond normal values. Arteries are blood vessels that transports oxygenated blood from the heart to other parts of the body.


Two numbers are used to record the pressure of blood as it flows through the arteries - the upper number is known as the systolic blood pressure while the lower number is known as the diastolic blood pressure. The systolic blood pressure measures the pressure within the arteries when the heart beats while the diastolic blood pressure measures the pressure of blood flow when the heart relaxes between each beat. A blood pressure of <120/80mmHg is considered normal.


Why is Hypertension called a Silent Killer?


This is because the condition is quite subtle and can be long-lasting without obvious symptoms until it is detected by blood pressure assessment. This implies that a person can be hypertensive over many years and still think s/he is healthy until when the resultant complications of high blood pressure such as stroke or heart attack occur suddenly and can lead to death if not managed promptly. This is also why it is one of the leading causes of preventable deaths in the world.


How are Blood Pressure Readings Categorized?


According to ACC/AHA (2017) Guideline, categories of blood pressure (BP) readings include:


- Normal BP: Systolic bp <120 mm Hg; Diastolic bp <80 mm Hg.

- Elevated BP: Systolic bp 120 - 129 mm Hg; Diastolic bp <80 mm Hg

- Hypertension Stage 1: Systolic bp 130 - 139 mm Hg; Diastolic bp 80 - 89 mm Hg.

- Hypertension Stage 2: Systolic bp >140 mm Hg; Diastolic bp >90 mm Hg.


Your blood pressure can be classified as high, if on 2 or more different visits to the hospital, the average measurement for 2 or more of your blood pressure assessment is > or equal to 130/90 mm Hg.


What are the Risk Factors of Hypertension?


The risk factors factors of hypertension can be classified into two: modifiable and non-modifiable risk factors.


- Modifiable Risk Factors: These factors are associated with lifestyle or behaviours that lead to hypertension such as cigarette smoking/tobacco use, excessive alcohol intake, consumption of high salt diet, obesity, sedentary lifestyle etc.


- Non-modifiable Risk Factors: These factors are associated structural makeups such as having a family history of hypertension, advanced age (>65 years), race and gender.


How do I Manage Hypertension?


High blood pressure can be effectively controlled and managed with lifestyle changes and drug therapy. Certain lifestyle changes such as: monitoring your blood pressure regularly, eating low salt foods, engaging in physical activities and exercises, losing excess weight, quitting smoking and excessive alcohol consumption can help in reducing your risk of having a high blood pressure.


Your healthcare provider may also prescribe you one or more antihypertensives to control your blood pressure when it is persistently high and when lifestyle changes alone aren't effective in regulating it. Examples include: Angiotensin Converting Enzyme (ACE) inhibitors e.g. Lisinopril, Angiotensin-2-Receptor Blockers e.g. Lorsatan, Calcium Channel Blockers e.g. Amlodipine, and Diuretics e.g. Hydrochlorothiazide.


How do I Prevent Hypertension?


Prevention of hypertension is centered on lifestyle changes. The following are lifestyle routines that can be adopted in preventing high blood pressure:

  • Monitor your blood pressure at least once every 5 years if at a lower risk of having hypertension, and once every year if at a higher risk of having the condition.

  • Eat food low in salt and saturated fat, but high in potassium, magnesium and calcium. Eat lots of vegetables and fruits.

  • Avoid sedentary lifestyle; sit less, exercise more.

  • Maintain a moderate weight; seek help losing weight if you are obese or overweight.

  • Seek help quitting tobacco use, cigarette smoking and use of illicit drugs such as methamphetamine, cocaine etc.


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