A general practitioner, Dr. Olalekan Adelakun, discusses the risk factors and the management of hypertension in this interview with TOBI AWORINDE. What is hypertension? General hypertension we know is what is called systemic hypertension and that is an increase in the pressure with which the heart is working. The heart is a strong muscular pump and it pumps blood to every cell in our body.
We have trillions of cells and every cell in our body is kept alive by blood coming from the heart, carrying oxygen and energy. Any part of the body that is not supplied with blood after some time will die. What are the symptoms of hypertension?
We regard hypertension as a silent killer because, usually, it does not come with symptoms. It is one of those diseases that would creep into the body like a thief in the night and continue to do damage to various organs of the body and the person would not know that there is anything wrong. As the condition advances or worsens, the body tries to adjust to it and this is why, in most instances, people continue to feel that nothing is wrong with them.
Some people may have a slight headache, feel their heart beating and say, ‘I have not slept well.’ They pop some aspirin, paracetamol or Valium. But those painkillers don’t bring the blood pressure down. So, essentially, we should look at hypertension as a silent killer. The only way for you to know if you are hypertensive or not is to check your blood pressure.
What are the causes of hypertension?
That is the question everybody who is diagnosed with hypertension would ask themselves: ‘Why me? Why do I have it?’ And in 90 percent of the cases, you cannot find any cause in their body, and that is what is called primary or essential hypertension. That means it is not due to any disease.
For most of these people, family history is common. If your father, mother, or sibling is hypertensive, you should pay attention to your blood pressure. We are talking mostly about first-degree relationships, but it can even go to second-degree relationships, like your uncle or aunty, at times. That is where most of the people belong.
Of course, there are lifestyle issues too; for instance, when you take too much salt and fried foods. There is also a lack of exercise, common for people with a sedentary lifestyle. There is obesity, and there is also abuse of drugs, especially some over-the-counter drugs that people just like to buy and use, like the non-steroidal anti-inflammatory drugs (e.g. Ibuprofen, aspirin, diclofenac, etc) that could actually promote hypertension. Then some women, when pregnant, have what we call pregnancy-induced hypertension, which usually goes down after childbirth. But such women are good candidates for frank hypertension later in life.
What are some popular misconceptions about hypertension?
The most popular one is to relate every high blood pressure to stress. There is stress-induced hypertension, in other words, when you are stressed and your blood pressure goes up. And when you are really stressed, it could stay up there for a while. Stress can actually cause hypertension. But generally, in our environment, when someone says, ‘The doctor says I have hypertension,’ the response is, ‘What are you worrying about? I can’t have it; I don’t about anything.’ That actually presupposes that stress is a major cause of hypertension, but that is not right. Stress would increase hypertension; it would bring the blood pressure up, but it is not a major cause of hypertension. However, we usually describe a hypertensive person who is stressed as an accident waiting to happen; and this is because stress can cause complications easily. So, let’s get it right – Stress can cause hypertension, but stress is not a major cause of hypertension. But it can complicate hypertension easily.
Yes, our lifestyle contributes to hypertension a lot. We can look at risk factors for hypertension in terms of modifiable and non-modifiable reasons for hypertension. The non-modifiable ones are the ones you don’t have control over. Hypertension is regarded generally as a middle-aged condition. In other words, generally, we expect people from around the age of 40 going to 50 and upwards to have hypertension. But the fact of the matter is that a lot of people die from hypertension before the age of 40. However, generally, it is regarded as a middle-aged disease. Also, hypertension is more common in black men than in Caucasians. You cannot do anything about our color. If you are black, you are black.
Family history, as I mentioned, is a common risk factor for hypertension. You cannot do anything about what you have inherited from your forebears. And of course, hypertension generally starts earlier in men than in women because women have some protection against hypertension and some cardiac diseases because of their reproductive hormone – estrogen. The only thing is that, by the time they reach menopause, their own hypertension flares up. Those are non-modifiable conditions that nobody can do anything about.
But then we have the ones that are modifiable, which we have absolute control over. High cholesterol is a major cause of hypertension and it is based on what we put in our mouths – (being) overweight and (exhibiting) obesity. Some people would stand on a scale and the scale would scream because they would think there are two people standing on it, especially people who have truncal obesity. In other words, the abdomen is fat; that is where obesity locks a lot. We have so many men who are ‘pregnant’ going all over the place. That is a good source of hypertension.
Are there certain food types that hypertensive persons should avoid or consume more?
Basically, if you look at the things we consider as risk factors, like obesity, one would understand why consumption of too much carbohydrate is not advisable. In this part of the world, people eat out of greed, not for the needs of their bodies. That is why the average Nigerian man thinks it’s normal for them to have big tummies. But it is because people are eating too much carbohydrate.
Also, our people eat too much salt and too much oil – we fry this and fry that. We need very minimal oil and salt. We eat too much meat. There is goat meat all over the place. People are just eating and enjoying suya. I think we overindulge in food. Then we take a lot of drinks. Some people drink beer. A lot of those alcohols add to the calories in the body. All those things like alcohol that have high calories would add more to the body weight. Or if you sit down and take all these fizzy soft drinks, you will be piling a lot of calories in your body. All these things add substantially to the risk of having hypertension.
Is hypertension curable?
No, we don’t say we cure hypertension, but it is perfectly manageable: Tuck in your pocket and goes about your life. Just know what to do. If you have to use drugs, use your drugs, just know the rules and follow the rules. Once you have the discipline, you can live as long and as well as anybody else, despite having hypertension, if only you will manage it well.
Are there other ways hypertension can be treated?
From what I have said so far, it is not so much about medicine. It’s a management thing, not just about popping medicine. You need to know exactly what our risk factors are ab initio. Then change your lifestyle and your diet. You have to start doing exercise. You have to be able to manage your stress well. You have to be able to have adequate rest. You have to be positive about life. And then if you are placed on medications, you have to take your medication regularly and see your doctors regularly. The most important thing is to keep your blood pressure consistently and adequately normal. It must not be too high – that is hypertension. And it must not fall too low either – that is hypotension and that one can kill easily. Generally, all you have to do is know the rules and follow them.
source: Medicalworldnigeria
