Preventing High Blood Pressure

THE common saying and belief is that 'blood is life and life is blood'. Blood is pumped round the human body by the heart, normally located within the left side of the chest.

A network of blood vessels serves as pipes through which blood flows round the body. Blood pressure is a measure of that force that is required to pump blood round the body.

Elevated blood pressure (hypertension) is common worldwide. In Nigeria, going by 1999 survey (no new one since then), over 4.3 million people above the age of 15 years were considered as being hypertensive with about 33 per cent not aware that they had the problem!

The hypothetical case of today exemplifies the consequence of untreated hypertension in our society.

John is a business executive living in Abuja. He has a computer engineering firm that he has been managing for about 12 years. Typically, every day of the week is considered busy, thanks to his ever faithful employees and clients. He hardly has time for his family by virtue of his workload in the office.

He has promised Ronke, his wife, and Ronald and MacDonald, his two children, that the coming weekend will be a wonderful one, since he plans taking them out to an undisclosed weekend programme.

However, he has observed recently that he becomes stressed up easily. He gets tired a lot. He has been feeling 'somehow' before he left office, a vague discomfort over his forehead. He remembers that he has not taken his blood pressure drugs in recent time. He plans to take it after dinner.

Ronke returns from work late, as it occurs at times when there are new clients to attend to. After dinner, they both retire to bed early.

The following morning, Ronke wakes up early to prepare the children for school. She however observed that John is staying long in bed, over an hour since she has been busy with the children.

She goes straight into the bedroom to check on him. However, she is surprised to find him lying in a pool of urine on the floor, unable to move his right side. He has developed a stroke! What is blood pressure?
Blood pressure has two components: the systolic (SBP) and diastolic blood (DBP) pressures, usually written as 'SBP/DBP'.

Normal blood pressure oscillates between a minimum and a maximum. The unit of measurement is 'millimeter of mercury (mmHg)'. It depends on the following factors: amount of blood pumped during each heart beat, number of times the heart beats in a minute - otherwise referred to as the heart rate, and how stiff or pliant the blood vessels are. The stiffer or less pliant the blood vessels are, the higher the tendency for a high blood pressure.

The normal blood pressure ranges between 110/60mmHg to 140/90mmHg. The term 'hypertension' refers to an abnormally high blood pressure above 140/90mmHg.

What are the causes of high blood pressure?
In a great majority of people with high blood pressure (over 95%), an obvious cause may not be discovered. This is referred to medically as the 'Essential, Idiopathic or Benign Hypertension'.

In a few minority (less than 5%), it may be possible to identify a cause.

In Essential Hypertension, usually a member (or more) of the family of the individual with hypertension will also be seen to be having an elevated blood pressure.

High blood pressure may result from diseases of some organs in the body. Top on this list are diseases of the kidneys. Following kidney diseases is diabetes - the sugar disease.

Others include diseases of the thyroid gland (in the front of the neck), the pituitary gland (located in the brain), the pancreas, adrenals and the ovaries (all found in the tummy).

Other known causes of high blood pressure include some drugs, pregnancy, stress and some abnormalities of blood vessels in the body (atherosclerosis, coarctation of the aorta, abnormalities of the kidney vessels etc).

What are the consequences of an elevated blood pressure?
The consequence of a high blood pressure is damage to such organs as the heart, kidneys, eyes and brain. Such risks include development of stroke, heart diseases such as heart failure, heart attack, pain in the chest particularly during physical activity (angina); and kidney diseases/failure.

Others include pregnancy disorders e.g. abnormal babies, eclampsia (dangerous complication of pregnancy involving hypertension, excess protein in urine, abnormal swelling of the body, convulsions and unconsciousness), abortions, bleeding during pregnancy (ante partum haemorrhage) and during or after delivery - (postpartum hemorrhage). Eye disease and Peripheral Vascular Disease (diseases of the extremities e.g. hands and legs) may also result from prolonged elevated blood pressure.

(To be continued)