Hypertension is also called “the silent killer” because high blood pressure often causes no symptoms for a long time. Even if the blood pressure is high, patient may feel fine. For this reason, many people who have high blood pressure don’t even know it. It is usually identified when somebody goes for a routine health check-up or during the check-up process of some other disease.
A patient suffering from hypertension may give symptoms of headache, giddiness, lack of sleep, lack of concentration, among others. Symptoms usually are not very specific and can be easily missed.
Some people may not know they have high blood pressure until they have a heart attack, a stroke, kidney damage, or other serious health problem. That’s why one should have blood pressure checked up regularly. If you have never been diagnosed with hypertension and you have no other serious medical problems, the American Heart Association recommends that you have your blood pressure checked at least once every 2 years. It is preferable to have a BP monitor at home, especially so if elderly people are at home. Home BP monitor usually comes in digital format. Many companies produce home BP monitors. They are fairly good, but they should be calibrated time to time to maintain accuracy.
Data shows the prevalence of hypertension in urban middle class is 32% in men and 30% in women. The life time risk of hypertension is 90% for men and women who were non-hypertensive at age 55 to 65 and survived to age of 80 to 85 years. These statistics show that high blood pressure is very common in the society and the incidence significantly increases with age.
One should try every possible means to prevent hypertension as there is no complete cure for it. Life style modification is very important for this.
Following are some useful recommendations to prevent and or treat hypertension
Diet: The diet should contain low fat, less salt, whole grain cereals, more of vegetables and fruits. Food item which contain high trans-fats such as bakery products, French fries, potato chips should be generally avoided. DASH ( Dietary approach to stop hypertension) eating pattern helps in preventing hypertension which consists of diet rich in fruits and vegetables, no fat or low fat milk and milk products, whole grain foods, fish, poultry, beans and seeds, and unsalted nuts.
Exercise: One should do aerobic exercise in regular basis for around 45 minutes to 1 hour daily for at least 5 days a week.
Weight: Obesity is a risk factor for high blood pressure, diabetes and heart disease. One should keep his/her weight in check. It is often possible to maintain a healthy weight by regular exercise and healthy diet. Weight is considered healthy when the body mass index is between age 20 and 25.
Alcohol consumption: Excess alcohol consumption can lead to hypertension. It is better to avoid alcohol. But if somebody takes it, it is advisable to limit to one or two drinks per day only.
Smoking: Smoking as a risk factor for many other diseases including hypertension. It should be stopped completely.
Patients already suffering from hypertension need to take the drugs regularly without fail and check with their physician in regular manner in addition to adhering to all the lifestyle measures as indicated above.
The joint national committee in USA revises hypertension guidelines every few years and it was revised last in 2014. According to the evidence based on medicine, it says elderly hypertensive patients with age 60 or more should have a goal to achieve BP of less than 150/ 90 mm Hg and younger patients to have a goal of less than 140/ 90 mm Hg.
The author is a Senior Cardiologist at Asian Heart Institute, Mumbai