Hypertension  or “high blood pressure” is a serious medical condition that significantly increases the risks of heart, brain, kidney and other diseases.

An estimated 1.28 billion adults aged 30-79 years worldwide have hypertension.

An estimated 46% of adults with hypertension are unaware that they have the condition.

Hypertension often does not have any symptoms; hence its dubbed “The Silent Killer”. It is usually diagnosed incidentally when patients present with other medical conditions, on routine health screening or when patients present with complications related to it. Diagnosis of Hypertension is made when the blood pressure reading taken on two separate occasions is more than 140/90. Symptoms that may be related to Hypertension include early morning headaches, changes in vision, nosebleeds, fatigue, irregular heartbeats and chest pains.

Risk factors of Hypertension can be divided into non-modifiable and modifiable risks factors. Non-Modifiable risks factors include male gender, age more than 65 years, family history of hypertension and ethnicity, with black people being at higher risk.  Modifiable risk factors include being overweight, physical inactivity, smoking, poor diet which is high in salt, fats and with low fruit and vegetables intake.

Most people (90-95%) have Primary or Essential Hypertension, which means there is no identifiable cause of the high blood pressure. The remaining 5-10% have an identifiable cause of their Hypertension, hence we refer to them as having secondary hypertension. We suspect secondary hypertension in young patients or those with hypertension that is unusually difficult to control. The causes of Secondary hypertension include the following: endocrine disorders such as hyperthyroidism, diseases of the adrenal glands and kidneys. Other causes include drugs such as cocaine, anabolic steroids and combined oral contraceptives.

Uncontrolled hypertension leads to many complications in the body. These complications can eventually lead to death. These complications include stroke, heart disease and kidney disease. Other complications related to hypertension are deterioration in vision and peripheral arterial disease.

Effective management and treatment of hypertension requires clinicians and patients to work together to balance pharmacologic and nonpharmacologic interventions and prevent organ damage. The nonpharmacologic interventions include; eating a healthy diet with lots of fruits, vegetables and grains. One must also limit the amount of salt when cooking and for addition of salt to food at the table. Physical exercise is also an important aspect in the management of hypertension, and one requires at least 30 minutes of exercise  a day for 5 days a week. It is also important to stop smoking of all tobacco products and limit the amount of alcohol intake.

The patient also needs to be on the appropriate medication for adequate blood pressure control . It is vital to take the medication daily as prescribed by the doctor.

Hypertension does not need to continue being “ the silent killer’. We need to do regular screening so as to make an early diagnosis of Hypertension. Those that have already been diagnosed need to continue with pharmacological and nonpharmacologic interventions to achieve optimum blood pressure control.


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