It is one of the commonest non infectious diseases affecting millions of people across the world. Many of them don’t even know they have this debilitating condition until it has reached an advanced stage afflicting most of their organs. When not controlled, it leads to heart attack, brain attack while long term hypertension may ultimately affect all organs including heart, brain, kidney, lungs, eyes and shut down our bodies.
Although hypertension is usually associated with aging , the risks being higher due to older people having less immunity and less exercise, as well as other pre-conditions like diabetes , cardiovascular diseases etc, medical doctors say they now see younger persons developing this condition.
They attribute this dangerous new trend to modern competitive living, resulting in undertaking heavy workloads to meet their goals, unhealthy food, such as, instant takeaways full of starch and fat, and living sedentary computer and T.V centered lives which limit their time of active exercise. Unhealthy lifestyles and habits such as, consumption of alcohol and tobacco smoking have further compounded their risks of early hypertension. Excessive salt consumption is another direct cause for hypertension. Most Lankans today consumer salt far in excess to the recommendations given by the World Health Organsation which the Health Ministry follows. According to the WHO only 2 grams of salt should be consumed per person per day. However, recent surveys have shown that the majority of Lankans consume much more – between 10-15 grams of salt per person on a daily basis.
This is why, the Non Communicable Diseases Unit has taken steps to instal Blood Pressure regulating units in main towns and cities on the instructions of the President and the Health Minister, to encourage all person over 35 years to have their blood pressure checked at least once a week, free of charge, with instant results.
To find out more about what hypertension is , how it is caused, how many Lankans are affected and why younger people are getting it, as well as preventive strategies by the Health Ministry, the Sunday Observer spoke to the Director, NCD Unit , Ministry of Health & Indigenous Medicine, Dr Thilak Siriwardane for his views .
Following are excerpts…
Q. Hypertension is one of the commonest non infectious diseases ( NCDs) afflicting millions of people across the world. Yet, many are also still confused by what exactly hypertension means. Is it the same thing as High Blood Pressure? ( HBP)
A. Hypertension is someone having persistent High Blood Pressure. The public know there is a condition called Hypertension but they don’t know that they have high blood pressure because it is commonly symptomless. It is accidentally found when checked by the doctor on a routine visit or visit due to another illness or in a screening program.
Q. How prevalent is it in Sri Lanka? In the UK a study published in the internet has revealed that HBP is by far the most common form of cardiovascular disease. Another study also from the internet conducted ends with the grim prediction that 90 % of Americans can expect to become victims of this life threatening silent killer during their life time. These are frightening warnings . Should we in Sri Lanka , a developing country, take them seriously? Are younger people getting it? Why? Is it work related since most people are now working overtime to meet family commitments and goals?
A. This is also a disease like diabetes. It is seen very rarely in childhood and associated with some other illness. In Sri Lanka, a fairly high percentage suffer from hypertension. There are youth suffering from hypertension but mostly, the middle aged and the elders contribute to the bulk of the patients. As Sri Lankans we should take it seriously.
Q. How does hypertension occur? What are the organs most likely to be affected ? Explain in detail .
A. Reason for hypertension is also multifactorial. Tobacco use, alcohol consumption, unhealthy diet and sedentary lifestyle and stress causes it. Almost all organs of the body are affected in hypertension, commonly heart, brain, lungs, kidney, etc.
Q. What happens when BP is not controlled? Why is it a problem?
A. When not controlled it will lead to cardiovascular diseases like heart attack and brain attack.
Long term Hypertension may have effects on all organs of the body including the heart, brain, kidney, lungs, eye, etc.
Q. Who are most at risk of getting it – age wise and gender wise?
A. When you become old your chance or risk of getting hypertension goes up. Also people with kidney diseases should check their blood pressure more often to detect hypertension early.
Your lifestyle may increase the risk of getting hypertension early if you smoke, consume tobacco and alcohol, eat unhealthy food, live a sedentary and stressful life.
Q. Is it hereditary? If a close relative has it, can you get it too?
A. If you have a family history of hypertension there is an increased risk of developing it. There is an increased risk of hypertension developing in you when become older too. But, family history and age alone does not make you a hypertensive. Other factors, tobacco, alcohol, diet, stress and lack of physical activity would decide when to get it.
Q. How early does hypertension develop in a person?
A. Usually, when they are in middle and older age, people think they would get hypertension. But with unhealthy lifestyles you are prone to get it even at an early young age.
Q. As symptoms are hard to detect, tell us how we can do so and what to look for?
A. You don’t have to wait for symptoms. Regular screening (probably yearly) or as advised by your family doctor or the Doctor in Healthy Lifestyle Center will help you to detect hypertension early and make your life healthier, controlling with drugs and lifestyle modifications.
Q. Many people have for years been told that BP is a natural result of ageing? Do you agree?
A. There are reports that anthropologists have found that in a variety of primitive people BP did not alter with age because they consumed diets with little or no salt .
This included Eskimos, the Masai in Africa, African Bushman, New Guinea Highlanders. Among them BP was virtually unknown. But scientists observed that the only time their BP rose was when they consumed modern diets dense in salt and calories. Therefore, we cannot say that hypertension is a result of natural aging.
Q. So, is salt the main culprit? Your comments?
A. No, as I explained earlier all main risk factors Tobacco, Alcohol , Unhealthy diet, Sedentary life and stressful life contribute to hypertension in addition to sex, ethnicity and heredity.
Q. Is BP avoidable? How effective are pills, diuretics?
A. There are no drugs to prevent hypertension. But there are drugs which act to reduce blood pressure in people.
They are not only diuretics. A new variety of drugs with less side effects and increased effectiveness and efficiency are available. Consultation of your doctor is the best time to ask about them.
Q. How do you measure BP? What is the optimal measurement that a diabetic and non diabetic should strive for?
A. Years back blood pressure was measured using mercury sphygmomanometers and aneroid machines.
But, technology has changed it. Electronic sphygmomanometers and advance machines are available like wrist watches.
Q. Is there a cure for BP?
A. Almost all NCDs are not curable up to the level of living without drugs. But you can control it with or without drugs by working with your physician closely.
Q. Apart from pills what are the options to prevent people’s BP rising and putting them at risk of dying from cardiovascular diseases like heart attacks and strokes? Is obesity also an issue causing hypertension?
A. Obesity and overweight are also an intermediate status like hypertension and high blood sugar caused by alcohol, diet, lack of exercises and tobacco. Controlling the above main four risk factors will help prevent or postpone you getting hypertension.
Q. Compared to other countries how much salt do average Lankans consume?
A. Around 10-15 grams per day which is very high when compared to developed countries.
Q. What is the recommended dosage according to the World Health Organisation?
A. Salt 2grams per day. Better if you can keep it below 5 grams per day.
Q. Statistics wise a survey in Sri Lanka in 2014 has revealed that BP and diabetes are the commonest NCDs in Sri Lanka. Your comments.
A. Sri Lanka’s commonest NCDs are Heart attack, Brain attack, Diabetes and Cancer.
Q. The Health Ministry is now encouraging all people over 35 years to check their BP at least once a week. The President has also instructed the NCD Unit to take necessary steps to instal Blood Pressure monitoring units in main cities and towns so that the public can check their BP free of charge. Tell us more about these units. Are they Life Style units? How many have been set up and what is their function?
A. There are more than 850 Healthy Lifestyle centres island wide. They have facilities to check blood pressure.
Q. Your advice to the public?
A. Eat less salt. Consume healthy food . Exercise more. Lead a stress free life and adopt relaxing techniques.