When to worry about your blood pressure

Normal blood pressure is vital to life. Without the pressure that forces the blood to flow around the circulatory system, no oxygen, hormones or nutrients will be delivered through the arteries to the tissues and organs.

However, blood pressure can become dangerously high, and it can also get too low.  Unfortunately, hypertension or high blood pressure affects millions of people globally. It affects the rich and the poor, the young and old, men and women, urban and rural populations, and the educated and illiterate alike.

World Health Organisation (WHO) estimates that one in six people worldwide or nearly one billion are affected by high blood pressure, and it is estimated that this number will increase to 1.5 billion by 2025.  Moreover, statistics from the Nigerian Hypertension Society show that one-third of Nigeria’s adult population is hypertensive.

When the heart beats, it squeezes and pushes blood through the arteries to the rest of the body. This force creates pressure on those blood vessels, and that’s the systolic blood pressure.

The diastolic reading, or the bottom number, is the pressure in the arteries when the heart rests between beats. This is the time when the heart fills with blood and gets oxygen.

According to Dr Abiodun Adeoye, a normal systolic pressure is below 120 and a normal diastolic blood pressure is lower than 80. But when it goes over 140/90, it is a clear indication that the force of the blood is pressing too aggressively against the artery walls.

High blood pressure can damage the body quietly for years even before any symptoms appear. High blood pressure causes the heart to work harder thus making an individual more prone to developing heart disease, stroke, vision issues and kidney failure.

“Some people will say when my blood pressure is high I know it. By the time you are having symptoms or you know when it is high, it is already damaging the body. So, symptoms should not even come; blood pressure must be kept under check,” Dr Adeoye reaffirmed.

He said that a persistent blood pressure that is over 140/90 mmHg should be a source of concern and investigated to know its cause or whatever treatment to go for.

Although the American Heart Association current guideline indicates over 130/80 mmHg as hypertension, Adeoye says “irrespective of the current blood pressure one is having, by the time there is an increment of 20 mmHG in systolic reading and 10 mmHg in diastolic reading, one should begin to ask what the problem really is.”

No doubt, with age, the blood pressure tends to go up and there is now the tendency for some individuals to believe that a high blood pressure reading is appropriate with ageing.

But according to him, “even with age, an individual’s blood pressure should be normal; the optimal should be below 120/80mmHg.”

People suffering from hypertension, if not treated right and on time, can experience organ damage, including death due to heart diseases caused by the poor blood flow.  Hypertension-related deaths constitute one third of global mortality cases.

Dr Okechukwu Ogah, a consultant cardiologist, University College Hospital (UCH), Ibadan, Oyo State who spoke on “Recent Advances in the Clinical Epidemiology of Heart Diseases in Sub Saharan Africa” at the Institute of Medical Research and Training (IMRAT), University of Ibadan lecture series in Ibadan, quoted the latest survey on heart failure in Nigeria as saying that hypertension was responsible for 45 per cent of all heart failure cases in Nigeria.

Uncontrolled high blood pressure can lead to a heart attack, dementia, cognitive impairment or stroke. It may also affect the kidneys and eye. High blood pressure can damage the eye blood vessels leading to the damage of optic nerve and retina.

The function of kidneys depends on healthy blood vessels. Kidney filters the waste and excess fluid from the blood, which cannot be done if the blood vessels are not in a good condition.

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Other problems caused by high blood pressure are sexual dysfunction, bone loss and trouble sleeping.

Nonetheless, he added that “if you get the blood pressure controlled, some of those damages may be reversed. So, the aim will be that those damages should not occur.”

High blood pressure can happen anytime. Studies show 80 per cent people over the age of 65 have high blood pressure. Systolic blood pressure rises as you age and the diastolic number reduces.

But the assumption that young people cannot have a raised blood pressure is dangerous. Currently, in Nigeria and other parts of the world, many experts are raising the alarm that younger Nigerians under the ages of 30 are being killed by hypertension while some come down with stroke.

According to Dr Adeoye, “An adult should have their blood pressure measured as often as possible, say weekly. In persons with hypertension, the guideline is measuring and recording its values morning and evening at least a week before the next hospital visit. This affords the doctor opportunity to know what the blood pressure behaviour is at home.”

Keeping a record of such blood pressure measurements, he added, will allow everyone who notices anomaly in its value to seek medical advice.

Although the disease could be hereditary, hypertension could be linked to unhealthy lifestyle, inactivity, stress, increased intake of salt and fatty foods, obesity, and inadequate intake of vegetables and fruits.

Professor Babatunde Salako, a nephrologist and Director General, Nigerian Institute of Medical Research (NIMR), stated that studies have proved that stress sometimes can contribute to a raised blood pressure.

However, he added that often times, even when stress as well as other factors that might raise blood pressure are gone, blood pressure could still remain high and persistent; thus indicating that cause of hypertension could be much more than stress.

“Work stress has been associated with raised blood pressure; marital stress has been associated with blood pressure and so on. But essentially, people should worry when their blood pressure is persistently high because it can cause damage to important organs of the body such as the heart, kidney, brain and eyes. So, they should not just overlook it.”

Many people also need medicine to control their high blood pressure. Blood pressure medicines don’t cure high blood pressure, but they help to control it.  The medicine might need to taken regularly, often for the rest of their life.

Tips for a healthy blood pressure:

* Keep a healthy body weight.

*Eat a diet rich in fruits, vegetables, and low-fat dairy products.

* Cut down on sodium salt in the diet.

*Take regular aerobic exercise, such as brisk walking, for at least 30 minutes a day, most days of the week.

*Moderate your alcohol intake.