‘The Silent killer’ -- High blood pressure!

MANY people are unaware that they have high blood pressure, a condition that’s often referred to as the “silent killer”.

This killer, high blood pressure, is highly prevalent among adult populations of ages 45 or older. Recently, I was chatting with my brother in-law at the staff canteen of Muhimbili University of Health and Allied Sciences. He told me, last year one of his closest business partners fell at Mnazi Mmoja and collapsed instantly.

He was rushed to Muhimbili National Hospital (MNH) where he was admitted at intensive care unit where he remained unconscious for one week. His friend died after getting one of the complications of hypertension. Every person has blood pressure. If it is not readable you are dead.

If the reading is too low or too high it is bad news. Blood pressure is the force of your blood pushing against the walls of your arteries. Each time your heart beats, it pumps blood into the arteries.
Your blood pressure is highest when your heart beats, pumping the blood.

This is called systolic pressure. When your heart is at rest, between beats, your blood pressure falls. This is called diastolic pressure. Your blood pressure reading uses these two numbers. Usually the systolic number comes before or above the diastolic number.

A reading of 119/79 or lower is normal blood pressure 140/90 or higher is high blood pressure. Between 120 and 139 for the top number, or between 80 and 89 for the bottom number is called pre-hypertension. Prehypertension means you may end-up with high blood pressure, unless you take steps to prevent it. In adult populations, BP may vary with age and sex.

The first figure is called systolic blood pressure while the lower figure is called the diastolic pressure. When your blood pressure rises doctors and nurses tell you have hypertension. The causes of hypertension are many but often it is because of mismanaged lifestyle.

Some people tend to eat more food than what their body needs and as a result they get “vitambi” obese thinking it is a status symbol! Some people also drink a lot of alcohol and eat bulky “kiti moto” (pork) and “nyama choma” roasted meat.

After eating heavy meals they do not do any exercise because they are tired and heavily drunk. The serious risks posed by untreated high blood pressure are often misunderstood. When your blood pressure increases it puts an extra strain on the heart and blood vessels.

However, you can control high blood pressure through healthy lifestyle habits such as doing exercises, dieting, and taking medicines, if needed. Talking on ITV at the 45-minute session on Monday 10th January, the Chief Executive Officer of the Jakaya Cardiac Institute reported that their medical staff observed 63 percent out of 1,813 people who volunteered to get their blood tested at the Leaders club in Dar es Salaam were found to have raised blood pressure.

Unfortunately, the majority were unaware of the problem and had not noticed any symptoms. They were comfortably walking around with that silent killer. Whenever your blood pressure puts strain on the heart you increase the risk for getting a heart attack and stroke. If you get either heart attack or stroke you become incapacitated.

Without treatment the risk of dying from any of the above conditions is high. The public needs to be much more aware about this condition. Once you have been diagnosed to have hypertension it is imperative you take charge.

You have to take your prescribed medicines regularly, also do exercises and monitor your blood pressure. You can buy your own BP machine from a local pharmacy and measure it weekly. Always take three readings and take the average.

Keeping a record will help you to monitor its trend over time so that whenever you visit the clinic you can discuss your progress with the physician. When your blood pressure is standardized or stable you should not abandon your medications and exercises.

Take charge of what you eat especially when you go to parties because often some people eat more food than what they need to eat, foods which have been prepared with lots of salt and hopeless oils. The best is for you to develop a habit of eating foods that are prepared at home and less so for the stuff that you have no control with.

Another thing to monitor is your waist line circumference and body mass index (BMI). If you see you have increased the size of your trousers or skirt this is a sign that you have gained more weight.

You can also monitor your body mass index (BMI) calculated by taking your weight in kilograms and dividing it with the square of your height in meters. The easiest way is to buy a bathroom scale and keep it at home so that you can measure your weight at home.

The scales on the street are unreliable because they are not calibrated to make sure they provide you correct readings.

The medical profession is also hereby being challenged to establish and set up mobile clinics at shopping malls, workplaces, hospitals and community centers in large towns, municipalities and cities to take advantage of missed opportunity and identify those populations with high BP and refer them to hospitals for better care of the silent killer.

The long term effect is that we shall alleviate the burden of disease in our communities as we think of universal health coverage by 2030. If the medical personnel cannot measure your blood pressure reading it suggests that you are dead. No one wants to reach that stage.

The best goal is to embark on changing your lifestyle and behavior and refrain from walking around with the silent killer encroaching to take your life.

• Prepared by Gernard I Msamanga, MD, Dr Professor of Community Health, School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, P.O. Box 65015, Dar es Salaam, Tanzania. Email:gmsamanga748@gmail. com