Guarding against Hypertension

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While hypertension is one of the deadliest non-communicable diseases because it does not manifest physically, nonetheless, stakeholders advise that with lifestyle changes, the condition can be addressed, writes Martins Ifijeh

Have you ever had a phone conversation with someone so full of life, and in the next hour you hear he is gone? Ever been in a scenario where the person you shared happy moments with a night before did not see a new dawn because death came calling? How about someone you just played a football match with, who went into the game in good health, but as you bid yourselves farewell from the pitch, he goes home and blanks out on mother earth? One minute the person is strong enough for a football match and the next minute he is dead.

These are the traits synonymous with high blood pressure, otherwise known as hypertension. It is one silent killer that does not ring a bell to announce its arrival as it does not present signs and symptoms. All it does is stay in the body of its victim quietly until the day it strikes. And when it does, it leaves sorrows, tears and blood.

Fortunately for developed countries, the rate of prevalence of this silent killer has reduced drastically due to increased awareness on lifestyle modification and general well-being. But it has ironically doubled globally within the last 40 years, affecting over a billion people. This means it has a high prevalence rate in middle- and low-income countries like Nigeria, leaving people to dramatically die from the asymptomatic health condition.

Mr. Olawale Gbenga is one Nigerian whose family learnt the stings of hypertension the hard way. His mother, a 63-year-old retired teacher in Ibadan was full of life during the preparation for one of her daughter’s wedding, and had talked about how she will dress gorgeously and dance on that day. But she was wrong. Her blood pressure was not in sync with her decision.

“She had involved herself fully in the preparations for the traditional ceremony for Friday and the church wedding Saturday. By Wednesday of that week, mummy woke up full of life, but by afternoon, I was called that she had slumped and was gasping for breathe. That was how I left my place of work and rushed home, only to see her breathing was very faint.

“We immediately rushed her to the hospital where it was confirmed her blood pressure was far beyond normal. She had 182/125mmhg. While doctors were doing their best to stabilise her, and possibly bring the blood pressure to a reduced level, mummy was fast losing it, until she was eventually confirmed gone,” Olawale said.

Late Mrs. Gbenga had never had blood pressure check, because, according to the son, she never presented any situation that would warrant blood pressure check. “Mummy hardly fell sick, save for the usual headache when she is over stressed. For almost three to four years now, we did not have cause to take her to the hospital for any treatment, not even for typhoid”, he added.

But the doctor who attended to her says it is most likely Mrs. Gbenga has been living with hypertension for a long while, but because there was no culture of regular blood pressure checkup, she or her loved ones were ignorant that she had high blood pressure, which would have been managed through drugs and lifestyle medications before the unfortunate incident happened.
Olawale, who learnt the hard way says now he not only checks his aged father’s blood pressure regularly, but every member of their family are now aware of the need to check theirs on a regular basis.

Mrs. Gbenga is not the only one that has unfortunately lost her life to the silent killer, hundreds of thousands of Nigerians succumb yearly to the whip of the masked disease due to lack of awareness or underestimation of its effect.
A recent study has shown that over 100 million Nigerians are at risk of high blood pressure.

It is in addressing this concern and preventing millions of Nigerians like Mrs. Gbenga from dying that experts are raising alarm over the continuous high prevalence rate of the disease in the country. They are especially calling on Nigerians to be wary of lifestyle that predisposes one to hypertension, while also calling on them to cultivate the habit of continuously checking their blood pressure.

This perhaps explain why sudden deaths have been a common occurrence in the country since the last decade when non-communicable diseases like high blood pressure have been gaining grounds due to fast changing lifestyle of the citizens.
According to a public health physician and the Medical Director, Livingstone Medical Centre, Benin, Dr. Kenneth Efosa, the prevalence of hypertension in the country might be higher than the figures currently being used.

He said the current figure was unreliable because most Nigerians who were hypertensive do not bother to go for check up to know their blood pressure status, and hence there was no room for documenting a lot of people who may be suffering from it.
“Every Nigerian above 18 years old should be encouraged to check their blood pressure at least once every six months because the disease may not give any sign. So, if you know beforehand that your blood pressure is unstable, it would be easier to tackle it,” the MD stressed.

He however noted that high blood pressure was no longer a problem of adults alone, adding that, children have now been discovered to suffer from it. “So, my advice on routine check is that every family should own a sphygmomanometer or a computerised blood pressure machine. At their convenience they can check the blood pressure of every member of their family,” he added.

He explained that hypertension is the most powerful risk factor for cardiovascular disease, hence the need to tackle it head on.
“17 years ago, a quarter of the world adult had hypertension, but by year 2025, it would increase to 60 per cent. As we speak, one out of three adults may be hypertensive.”

According to him, lifestyle modification was key to tackling the disease, adding that what people eat and how they live their daily lives matter to the level of their blood pressure.

“We need to watch what we are eating. We should all make conscious efforts to reduce those risk factors like high intake of salts, can foods, among others. Our forefathers lived healthy because of the natural foods they were eating. Then, there was no high prevalence of hypertension, so I will say there is wisdom in being a bush man. We should patronise vegetables and fruits, as they are very helpful for the heart,” he added.

He said although high blood pressure has a genetic predisposition, it is principally a lifestyle disorder, adding that, with changes in lifestyle, the prevalence will reduce. He said the statistics are frightening and the incidence cuts across racial and socio-economic barriers, hence lifestyle modification is therefore key to both prevention and treatment.

“Sedentary lifestyle, mimicking eating lifestyle of westerners, and smoking are some of the major factors fueling hypertension prevalence in the country,” he added.

Efosa said while hypertension is a disease of choice, he was wondering why it is affecting one in three persons, adding that if Nigerians decide to improve their lifestyle health wise, there would be no need having high prevalence of the disease.

“In the past one month, I have lost three colleagues to complications of hypertension. It is not our custom to be taking drugs every day, so it is very important to have a healthy lifestyle, which has been proven to prevent the problem in the first case,” he added.

He said a disease that is both preventable and treatable should not be killing Nigerians, adding that, one of the problems was that many people living with hypertension do not know they have it. “Over 50 per cent of those with hypertension in this country do not know they have it,” he said.

According to him, habits to be stopped includes, lack of exercise, not getting enough sleep, reduction of caffeine intake, reduction in salt intake, reduction in alcohol consumption, among others.

“Exercise for 30 to 60 minutes five days a week will usually lower a person’s blood pressure by four to nine mmHg. It is important you check with your doctor before embarking on any physical activity. Exercise needs to be tailored to the needs and health of patients.”

He said reduction in alcohol intake was a double-edged sword against the disease.

“Alcohol in very small amounts may lower blood pressure, but if it is taken too much, or even in regular moderate amount, it may increase blood pressure.”

He believes if Nigerians cut short on fast foods, processed, as well as canned foods, and patronise vegetables and fruits, it would help a long way in reducing the prevalence rate of the scourge in the country. He also advocated for weight loss as a way out.

“If you are overweight, the nearer you get to your ideal weight, the more likely your blood pressure is going to fall,” adding, she said, “ even for those already on hypertension drugs, the treatment is more likely to be effective if the body weight is on a physiologic state,” he explained.