Hypertension

HYPERTENSION(Health Awareness Campaign for BAPCO employees)

Dr Syed RazaMD, MRCP(UK),FRCP(Edin.),Dip.Card.(UK)CCT (UK),FACC,FCCP

HYPERTENSIHYPERTENSION ON

IS IS

PREVENTABLPREVENTABLEE

Facts and Figures

• 30 per cent of women and men have high blood pressure

• 30 per cent of people with high blood pressure DO NOT KNOW that they have it.

• Less than 30 percent individuals reach target goals• Three times more likely to develop heart disease.• Five times more likely to develop stroke. • Twice as likely to die from these as people with a

normal blood pressure.

What is Normal Blood Pressure ?

Blood pressure of < 140 / 90 mmHg. Q: Which number is more important i.e. Upper (systolic) or Lower (Diastolic) A: Both

HYPERTENSION MYTHS

• Blood pressure causes Headache• ‘’I have no symptoms, why should I take

medication?• ‘’How soon can I stop medication once blood

pressure is controlled ?’’• ‘’My blood pressure is all due to stress’ ’• ‘’I do not want to take tablets as they have

side effects.’’

HYPERTENSION MYTHS: contd.

‘’ My blood pressure is high because I had a very salty meal last night.’’

‘’ I have been advised to take blood pressure pill at night’’

‘My blood pressure is higher in the left arm as I am left handed’

‘My blood pressure is always normal with my own BP machine at home’

Cause of Hypertension

There is no cause in 90% of patients. Precipitating factors causing a spike in blood

pressure - Stress poor sleep Excessive caffeine Smoking

Factors (Drugs and supplements) that may precipitate high blood pressure

• Pain Killers (Non steroidal anti-inflammatory).• Medications for flu and decongestants.• Some antidepressants.• Birth control pills• Herbal supplements : Arnica,

Ginkgo,Ginseng,Guarana, Licorice, Senna • Stimulants and illegal drugs: Amphetamine,

anabolic steroid, cocoine.

Looking for Cause for Hypertension

• Young patients < 35 years of age.• Usually problem in the arteries • kidney disease and • hormonal disturbances. Should be investigated extensively as

potentially treatable and hypertension is reversible.

High fat containing food

High sugar containing food.

Bad Companions !

Smoking and Alcohol

Control of Blood Pressure

Only about 30% of hypertensive population are controlled.

Blood Pressure Control (<140/90)56.4%

Probable Causes (patient factor)

• Patients’ knowledge and understanding• Poor compliance• Missed clinic appointments• Afraid of side effects• Cost issue• Misinformation and myths

Probable Causes (physician factor)

• Wrong choice of medication.• Inappropriate dosage or titration.• Afraid of complications.• Unaware of current guidelines and targets.• No or irregular follow ups.• No advice on life style changes.• Influenced by pharmaceutical companies.

Home Blood Pressure Monitoring

• Choose automatic blood pressure monitor.• Arm rather than wrist • Make sure your blood pressure monitor is

calibrated at least once every two years.• Make sure your blood pressure monitor is

accurate (clinically validated).• Choose the right size cuff

Home Blood Pressure Monitoring

• Quite environment• Seated• Measure morning and evening BP• Discard first day’s reading• At least two readings few minutes apart –

discard the first• DO NOT measure blood pressure too often.• Seek medical attention if you are worried.

What target organs are Involved?

• 1. Brain• 2. Heart• 3.Retina• 4. Kidneys

STROKE

Heart Attack & Heart Muscle Thickness

Kidney Failure

Eyes (Retinopathy)- may lead to blindness

Life Style Modification

How Low is ‘Low Salt’?

Recommendation for Salt Intake

2.3 gm per day 1.5 gm per day ifa. Hypertensionb.Diabetesc. > 50d.Blacke.Renal Disease

Antihypertensive Medication

Taking your blood pressure pills

• Different Medication suits different patients.• Take your medication first thing in the

morning unless told otherwise.• All your symptoms may not be side effects –

Discuss with your doctor• Do not stop your medication• Do not adjust your dosage yourself.

Take Home Message

• Blood Pressure is common• It is a silent killer• Blood pressure can be prevented• Life style changes is key to blood pressure

management.• Control other co-morbidities• Compliance with medication