What Is Hypertension (High Blood Pressure)?
Blood pressure is necessary to make our blood flow around the body to supply oxygen and nutrients to the muscles and vital organs. However, when the blood pressure gets too high, the heart has to pump harder and small blood vessels in the brain may burst to cause heart failure and strokes respectively.
That is why health practitioners keep advising patients to self-monitor their blood pressure regularly and eat well to maintain a healthy lifestyle.
How big is the problem?
The National Health Morbidity Survey 2015 found over 30% of Malaysians have hypertension but more than half do not even realise they are affected! The risk of hypertension increases as we get older especially after the age of 35 years.
How is blood pressure measured and what does it mean?
Your blood pressure is recorded as two numbers:
- Systolic blood pressure (the top number) is the pressure your blood is exerting against your artery walls when the heart beats
- Diastolic blood pressure (the bottom number) is the pressure your blood is exerting against your artery walls while the heart is resting between beats
Classification of Elevated Blood Pressure
Why do we need to treat high blood pressure?
What people do not realise is that high blood pressure is a ‘silent killer’ because in the beginning there is no symptoms until it is too late because it can cause the following:
- The smaller and more fragile blood vessels in the brain burst more easily due to the high pressure resulting in a stroke. Over 60% of patients with strokes have high blood pressure
- Heart failure. The heart has work harder to pump the blood causing it to enlarge and fail later in life
- Angina and heart attack. The high workload of heart makes it more likely to get a heart attack
- Kidney failure. The kidney filters blood at a rate of 125 ml/min which means it filters your entire blood volume 20-25 times a day. As such, the kidney filtration system is sensitive to any high-pressure damage. It is estimated that high blood pressure accounts for up to 30% of kidney failure cases requiring dialysis
- Vision loss. High pressure can cause a stroke in the eye when the fragile blood vessels burst
- Sexual dysfunction with loss of libido and erectile dysfunction in males
How often should I see my doctor when on treatment for hypertension?
You should visit your doctor for follow-up consultation between every 3-6 months and do some of the following tests to ensure you are not developing any of the blood pressure complications
- Measure your blood pressure
- Measure your weight and calculate your BMI
- Do blood tests to check for full blood count, glucose, cholesterol, electrolytes and kidney/liver function. Sometimes, a urine test is also useful to look for proteins in the urine.
- Do an ECG (heart tracing) or stress test every 1-2 years
Despite being on treatment, it is estimated that over 30% of patients do not achieve good blood pressure control despite being on medication. As such, healthcare practitioners recommend lifestyle modification which includes 30-60 minutes exercise daily (see the article “How much should we exercise daily”), dietary modification (see the article of the DASH diet for hypertension) and self-monitoring.
Do consult and connect with your healthcare practitioners such as your doctor, dietician or fitness trainers. While at home, check your blood pressure regularly and take charge of your health.
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