This is the second article on high blood pressure (BP) that we are discussing within a short span of three months. This is to emphasize the importance of this disease and also to raise awareness.
In my opinion, knowledge is our best weapon against high blood pressure. In countries such as the United States, the incidence of lifestyle diseases such as high blood pressure has risen while death from complications has decreased obviously due to improved medical care. What then happens to those of us who may find ourselves in areas with less sophisticated medical care? Prevention and optimizing management with life style modifications is key and the whole world will benefit immensely if we follow this path.
“ANATOMY” OF BLOOD PRESSURE
Blood pressure is the force that pushes blood through our arteries. This pressure swings up and down during the day so a single reading is only a snapshot of your usual pressure. One’s average blood pressure is critical in predicting complications and not the peaks and valleys.
Your healthcare professional will always measure two pressures. The higher one measures the force when the heart squeezes to pump blood and the lower one is the force in the arteries when the heart relaxes. When the higher one is 120 and the lower one 80 your doctor will tell you your blood pressure is 120 over 80 and will write it as 120/80.
To ensure that you do not get falsely elevated blood pressures avoid the following just before taking your blood pressure:
• Caffeine
• Nicotine
• Exercise- sit for at least 10 minutes before taking a reading
• Stress – do let me know when you find a way round this one
Sometimes your doctor will ask you to record your blood pressures at home over a period before he reviews them with you. This is often the case when he/she suspects there is an element of anxiety when you are in the hospital setting. You may give it a fanciful name such as “white coat hypertension” coined from the numerous professionals wearing white coats in the hospital that adds to our anxiety to further increase our blood pressure.
UNDERSTANDING BLOOD PRESSURE READINGS
Systolic BP Diastolic BP
Normal Below 120 Below 80
Prehypertension 120-139 80-89
Stage1 hypertension 140-159 90-99
Stage2 hypertension 160+ 100+
Isn’t it scary that high blood pressure shaves off five (5) years from an average person’s life? To make matters worse, it often does not cause any symptoms until it damages your circulation. That is a line of caution to those of us who think we will get a headache or feel unwell when our blood pressure rises above normal. Though you may feel perfectly well, high blood pressure silently makes your heart work too hard and it causes damage to your blood vessels, brain, eyes and kidneys. This is why it is referred to as the “silent killer” These days I am very wary of SILENCE. I definitely do not think all silence is golden since many conditions that make us see “red” are very silent – high blood pressure, high cholesterol, osteoporosis etc.
RED FLAGS
The ONLY way to know accurately if your blood pressure is elevated is to have your readings taken but we need to be extra careful when we fall into one of these ten (10) categories:
i. You have family members with Hypertension
ii. You lead an unhealthy life-style; alcohol, smoking
iii. You live a sedentary life – no exercises
iv. You have an extremely stressful life
v. You are overweight
vi. You are male
vii. You are over 40 years
viii. You have high Cholesterol
ix. You have Diabetes
x. You use steroids

How can one suspect he/she has hypertension
1. Most often NO WARNING
Others include:
2. Dizziness
3. Headaches
4. Chest pain
5. Palpitations
6. Nose bleeds
7. Weakness
8. Frequent Urination
9. Poor eyesight
Sometimes the first time you will know you have high blood pressure or are hypertensive is when you have a STROKE.
None of the symptoms above is diagnostic of High Blood pressure, some actually may be complications, so my dear reader do us all a favour and have your blood pressure checked today, we all have to stalk this silent killer and fight it lest it wins the battle against us.

DRAWING THE BATTLE LINES
Just a little lowering of our blood pressure translates into amplified protection. Lowering the upper reading by 10 points and the lower one by 5 points can lower our risk of stroke by up to 40% and the risk of heart attack by up to 25%. This definitely sounds exciting.
In general the closer your blood pressure is to 120/80 for someone diagnosed with hypertension the better. For the average patient the goal of management is to get our blood pressure below 140/90 but for those with diabetes, chronic kidney disease and heart disease our target should be lower than 130/80. You need not panic; we do not aim at this overnight. One step at a time and small healthy choices daily will get us there.
LIFE STYLE CHANGES THAT WILL BRING THE KILLER TO ITS KNEES
LIFESTYLE CHANGE LIKELY DROP IN UPPER READING PRACTICAL TIPS
Adopt the DASH Diet 8-14 points Eat plenty of fruits and vegetables, reduce total fat eaten
Reduce Sodium 2-11 points Do not add salt to cooked food and reduce salt used in cooking
Exercise 4-9 points At least 30minutes of aerobic exercise at least 5 days a week
Limit alcohol 2-4 points At most 2 drinks a day for males and 1 for females or avoid
Lose weight 5-20 points for every 10 kg lost Consistently exercise and modify your eating habits
Quit smoking 2-8 points If you smoke get help to quit

In addition to these lifestyle modifications please continue to take your medications as directed by your healthcare professional. The exercise bit remains a challenge since so many of us are extremely “busy”. Well if you are reading this piece before 9.30am this Saturday then you missed the walk I invited you to. That will have been a great beginning but put your act together and start gradually because “THE HEALTH AND WEALTH OF GHANA STARTS WITH YOU”

References:
• www.healthclubsgh.com
• Pri-med patient education centre